title: Reliable change in depression during behavioral weight loss treatment among women with major depression.
abstract: OBJECTIVE
  Although behavioral weight loss interventions generally have been shown to improve depressive symptoms, little is known as to whether some people with major depressive disorder experience worsening of depression during a weight loss intervention.
  
  
  METHODS
  Rates and predictors of change in depression symptoms among 148 obese women with major depressive disorder who participated in a trial comparing depression treatment plus behavioral weight loss treatment (Behavioral Activation; BA) to behavioral weight loss treatment alone (Lifestyle Intervention; LI) were examined. a statistically reliable change in depression was calculated as ≥9 points on the beck depression inventory in this sample.
  
  
  RESULTS
  At 6 months, 73% of participants in BA and 54% of participants in LI showed reliable improvement in depression symptoms and 1.5% of participants in BA and 1.3% of participants in LI showed reliable worsening in depression symptoms. Rates of reliable change were similar at 12 months. Participants who experienced reliable improvement in depression lost significantly more weight than those who did not in both conditions. In the LI condition, baseline psychiatric variables and change in physical activity during treatment were also related to reliable improvement in depression.
  
  
  CONCLUSIONS
  No evidence for an iatrogenic effect of behavioral weight loss treatment on depressive symptoms among obese women with major depressive disorder was detected; rather, behavioral weight loss treatment appears to be associated with significant concurrent improvement in depression. Even greater rates of reliable improvement were observed when depression treatment was added to weight loss treatment.
authors.affiliation: Alpert Medical School of Brown University, Department of Psychiatry and Human Behavior, Providence, Rhode Island, USA.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Busch
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Whited
authors.forename: Bradley M
authors.initials: BM
authors.lastname: Appelhans
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Schneider
authors.forename: Molly E
authors.initials: ME
authors.lastname: Waring
authors.forename: Michele A
authors.initials: MA
authors.lastname: DeBiasse
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Oleski
authors.forename: Sybil L
authors.initials: SL
authors.lastname: Crawford
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Pagoto
mesh_terms: D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D003863:Depression / Q000523:psychology*; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000178:diet therapy* / Q000523:psychology*; D010555:Personality Inventory; D016896:Treatment Outcome; D015431:Weight Loss; D061217:Weight Reduction Programs; D055815:Young Adult