Weight change and mental health status in a behavioral weight loss trial

Obesity, depression, and anxiety often co-occur, but research on weight change and mental health status is limited. This analysis examined how the mental component score (MCS-12) from the Short Form health survey changed over 24 months in weight loss trial participants with vs. without treatment see...

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Bibliographic Details
Published inJournal of affective disorders Vol. 334; pp. 302 - 306
Main Authors Goessl, Cody L., VanWormer, Jeffrey J., Pathak, Ram D., Ellerbeck, Edward F., Kurz, Daniel L., Befort, Christie A.
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier B.V 01.08.2023
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Summary:Obesity, depression, and anxiety often co-occur, but research on weight change and mental health status is limited. This analysis examined how the mental component score (MCS-12) from the Short Form health survey changed over 24 months in weight loss trial participants with vs. without treatment seeking for affective symptoms (TxASx) and by weight change quintiles. Participants with complete data (n = 1163) were analyzed from enrollees in a cluster-randomized, behavioral weight loss trial in rural U.S. Midwestern primary care practices. Participants received a lifestyle intervention with different delivery models, including in-clinic individual, in-clinic group, or telephone group counseling visits. Participants were stratified by baseline TxASx status and 24-month weight change quintiles. Mixed models were used to estimate MCS-12 scores. There was a significant group-by-time interaction at the 24-month follow-up. The largest 0–24 month increase in MCS-12 scores (+5.3 points [12 %]) was observed in participants with TxASx who lost the most weight during the trial, while the largest decrease in MCS-12 scores (−1.8 points [−3 %]) was observed in participants without TxASx who gained the most weight (p < 0.001). Notable limitations included self-reported mental health, the observational analytical design, and a largely homogenous source population, as well as the possibility of reverse causation biasing some findings. Mental health status generally improved, particularly among participants with TxASx who experienced significant weight loss. Those without TxASx who gained weight, however, had a decline in mental health status over 24 months. Replication of these findings is warranted. •Mental health of adults with obesity generally improved during a 24-month behavioral weight loss trial.•Mental health improved most in adults with affective disorder symptoms who lost significant weight over 24-months.•Mental health declined most in adults without affective disorder symptoms who gained weight over 24-months.
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ISSN:0165-0327
1573-2517
DOI:10.1016/j.jad.2023.04.113