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Clinical Studies and Practice

Randomized controlled trial of behavioral treatment for comorbid obesity and depression in women: the Be Active Trial

International Journal of Obesity volume 37, pages 1427–1434 (2013)Cite this article

Subjects

Abstract

Objective:

Depression is associated with increased risk for obesity and worse weight loss treatment outcomes. The purpose of the present study was to test the hypothesis that delivering evidence-based behavior therapy for depression before a lifestyle weight loss intervention improves both weight loss and depression.

Design:

In a randomized controlled trial, obese women with major depressive disorder (N=161, mean age=45.9 (s.d.: 10.8) years) were randomized to brief behavior therapy for depression treatment followed by a lifestyle intervention (BA) or a lifestyle intervention only (LI). Follow-up occurred at 6 and 12 months. Main outcome measures included weight loss and depression symptoms.

Results:

Intention-to-treat analyses revealed both conditions lost significant weight, but no differences between conditions in weight change at 6 months (BA=−3.0%, s.e.=−0.65%; LI=−3.7%, s.e.=0.63%; P=0.48) or 12 months (BA=−2.6%, s.e.=0.77%; LI=−3.1%, s.e.=0.74%; P=0.72). However, the BA condition evidenced significantly greater improvement in Beck Depression Inventory-II scores relative to the LI condition at both 6 months (BA mean change=−12.5, s.d.=0.85; LI mean change=−9.2, s.d.=0.80, P=0.005) and 12 months (BA mean change=−12.6, s.d.=0.97; LI mean change=−9.9, s.d.=0.93; P=0.045). Participants who experienced depression remission by 6 months (61.2%) lost greater weight (mean=−4.31%; s.e.=0.052) than those who did not (39.7%; mean=−2.47%, s.e.=0.53; P=.001).

Conclusion:

Adding behavior therapy to a lifestyle intervention results in greater depression remission but does not improve weight loss within 1 year. Improvement in depression is associated with greater weight loss.

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Acknowledgements

The project described was supported by grant 1R01MH078012 to Dr Pagoto from the National Institute of Mental Health. Partial salary support for Dr Waring is provided by National Heart Lung Blood Institute grant 1U01HL105268. All authors have full access to the data and take responsibility for the integrity of the data and the accuracy of the data analysis.

Author information

Authors and Affiliations

  1. Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA

    S Pagoto, J L Oleski, P Merriam, Y Ma, B Olendzki, S Lemon, I Ockene & S Crawford

  2. Department of Psychology, Rosalind Franklin University, Chicago, IL, USA

    K L Schneider

  3. Department of Psychology, East Carolina University, Greenville, NC, USA

    M C Whited

  4. Rush University, Chicago, IL, USA

    B Appelhans

  5. Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA

    M E Waring

  6. Alpert Medical School of Brown University and The Miriam Hospital, Providence, Rhode Island, USA

    A M Busch

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  1. S Pagoto
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Correspondence to S Pagoto.

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Additional information

This manuscript was presented as a paper at the 2012 Society of Behavioral Medicine Annual Conference in New Orleans, LA. It received a Paper Citation Award from SBM.

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Pagoto, S., Schneider, K., Whited, M. et al. Randomized controlled trial of behavioral treatment for comorbid obesity and depression in women: the Be Active Trial. Int J Obes 37, 1427–1434 (2013). https://doi.org/10.1038/ijo.2013.25

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