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Obesity and depression

Weight management reduces depression among black women

Interventions that focus on behavioural weight control may present a useful opportunity to address both obesity and depression

An intervention programme aimed at helping obese women maintain their weight without adding pounds also significantly reduced depression in nearly half the participants, according to a study by researchers from Duke University. The study, which appears online in the American Journal of Public Health, cites past research showing that women are twice as likely as men to suffer from depression, and more than one in seven black women will suffer major depression.

Various studies have shown that black women find it more difficult to lose weight compared to other groups; it's unclear why that disparity exists.

Lead author Dori Steinberg, a research scholar with the Duke Digital Health Science Center said the disparity might be partially influenced by differences in sociocultural norms related to weight, diet and physical activity or socioeconomic stressors and other barriers regarding access to treatment.

"Our goal was to prevent black women from getting into higher BMI ranges where the risk starts to increase dramatically," she added. "These higher occurrences may also have an impact on psychosocial outcomes such as depression. So interventions that focus on behavioural weight control may present a useful opportunity to address both obesity and depression."

As a result, the researchers instigated randomized trial to evaluate the effect of a weight gain prevention intervention (Shape Program) on depression among socioeconomically disadvantaged overweight and obese Black women.

The study was conducted with 185 low-income black women ages 25-44, each with a BMI 25-35, who were receiving primary care at five community health centres in central North Carolina.

The program used software built by Duke researchers that personalised a weight-gain prevention intervention for each of the 91 women in one of two groups. The intervention group tracked behavioural goals (i.e., no fast food) each week for 12 months via automated phone calls. Each participant also had monthly calls with a personal health coach and some took advantage of a YMCA membership.

The other 94 participants were randomly placed in a control group that received usual care from their physicians.

At the start of the 12-month study, 19 percent of intervention participants and 21 percent of usual-care women reported moderate to severe depression. But after 12 months, just 11 percent of intervention participants said they were still depressed, compared to 19 percent receiving usual care. At 18 months, 10 percent of the intervention group said they were depressed, while the usual-care group remained at 19 percent, according to the study.

"Interventions that focus on maintaining your weight, not just losing weight, may have more widespread effects," said Steinberg. "It is exciting that we improved depression among a population that is severely socioeconomically disadvantaged and has limited access to depression treatment. The reductions we saw in depression are comparable to what is seen with traditional approaches like counselling or medication treatment."

These findings were not related to how well the women did in the weight management programme nor whether they were taking depression medication.

"These results suggest that the 'maintain, don't gain' approach could be a first line of treatment for women who have barriers accessing traditional treatment approaches," said Steinberg. "A key challenge is getting health systems to use interventions like these, so we are evaluating the use of smartphone apps and text-messaging to make it easier for people to access them."

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