title: Early-treatment weight loss predicts 6-month weight loss in women with obesity and depression: implications for stepped care.
abstract: OBJECTIVE
  Some adults with comorbid depression and obesity respond well to lifestyle interventions while others have poor outcomes. The objective of this study was to evaluate whether early-treatment weight loss progress predicts clinically significant 6-month weight loss among women with obesity and depression.
  
  
  METHODS
  We conducted a secondary analysis of data from 75 women with obesity and depression who received a standard lifestyle intervention. Relative risks (RRs) and 95% confidence intervals (CIs) for achieving ≥5% weight loss by 6 months were calculated based on whether they achieved ≥1 lb/week weight loss in weeks 2-8. Among those on target at week 3, we examined potential subsequent time points at which weight loss progress might identify additional individuals at risk for treatment failure.
  
  
  RESULTS
  At week 2, women who averaged ≥1 lb/week loss were twice as likely to achieve 5% weight loss by 6 months than those who did not (RR=2.40; 95% CI: 2.32-4.29); weight loss at weeks 3-8 was similarly predictive (RRs=2.02-3.20). Examining weight loss progress at week 3 and subsequently at a time point during weeks 4-8, 52-67% of participants were not on target with their weight loss, and those on target were 2-3 times as likely to achieve 5% weight loss by 6 months (RRs=1.82-2.92).
  
  
  CONCLUSIONS
  Weight loss progress as early as week 2 of treatment predicts weight loss outcomes for women with comorbid obesity and depression, which supports the feasibility of developing stepped care interventions that adjust treatment intensity based on early progress in this population.
authors.affiliation: Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States. Electronic address: molly.waring@umassmed.edu.
authors.forename: Molly E
authors.initials: ME
authors.lastname: Waring
authors.affiliation: Department of Psychology, Rosalind Franklin University, North Chicago, IL, United States. Electronic address: kristin.schneider@rosalindfranklin.edu.
authors.forename: Kristin L
authors.initials: KL
authors.lastname: Schneider
authors.affiliation: Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, United States. Electronic address: brad_appelhans@rush.edu.
authors.forename: Bradley M
authors.initials: BM
authors.lastname: Appelhans
authors.affiliation: Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, RI, United States; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States. Electronic address: andrew_busch@brown.edu.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Busch
authors.affiliation: Department of Psychology, East Carolina University, Greenville, NC, United States. Electronic address: whitedm@ecu.edu.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Whited
authors.affiliation: Division of Addiction, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, United States. Electronic address: stephanie.rodrigues@umassmed.edu.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Rodrigues
authors.affiliation: Division of Behavioral and Preventive Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States. Electronic address: stephenie.lemon@umassmed.edu.
authors.forename: Stephenie C
authors.initials: SC
authors.lastname: Lemon
authors.affiliation: Division of Behavioral and Preventive Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States. Electronic address: sherry.pagoto@umassmed.edu.
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Pagoto
mesh_terms: D000328:Adult; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Behavioral weight loss; Depression; Obesity; Stepped care
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