title: Randomized controlled trial of behavioral treatment for comorbid obesity and depression in women: the Be Active Trial.
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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors: Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
authors: S
authors: S
authors: Pagoto
authors: K L
authors: KL
authors: Schneider
authors: M C
authors: MC
authors: Whited
authors: J L
authors: JL
authors: Oleski
authors: P
authors: P
authors: Merriam
authors: B
authors: B
authors: Appelhans
authors: Y
authors: Y
authors: Ma
authors: B
authors: B
authors: Olendzki
authors: M E
authors: ME
authors: Waring
authors: A M
authors: AM
authors: Busch
authors: S
authors: S
authors: Lemon
authors: I
authors: I
authors: Ockene
authors: S
authors: S
authors: Crawford
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000534:rehabilitation / Q000628:therapy*; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D040242:Risk Reduction Behavior; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods