title: Lower depression scores associated with greater weight loss among rural black women in a behavioral weight loss program.
abstract: Depression and stress have been associated with less weight loss among some participants in behavioral weight loss (BWL) programs. The purpose of this study was to (1) measure the levels of depression and stress among a sample of black women living in rural Alabama and Mississippi who were participating in a BWL program and (2) examine the association between these psychosocial variables and weight loss outcomes of participants at 6 months. Overweight and obese black women in a BWL program (n = 409) completed validated surveys to measure depression and stress at baseline and 6 months. Weight and height were also measured at baseline and 6 months. Statistical tests were conducted to examine associations between depression, stress, and weight loss. Mean BMI at baseline was 38.68 kg/m2. Participants achieved a 1.17 kg/m2reduction in BMI at 6 months. When comparing by baseline depression or stress categories, no significant differences in weight loss outcomes were observed. Analysis of continuous data revealed a significant correlation between baseline depression score and change in BMI. In adjusted models, change in depression score over time was significantly associated with change in weight. No differences in weight loss outcomes at 6 months were observed when comparing participants with and without elevated depressive symptoms or elevated stress at baseline. This suggests that potential participants may not need to be excluded from BWL programs based on pre-specified cut points for these psychological conditions. Greater improvements in depression were associated with better weight loss outcomes suggesting that more emphasis on reducing depression may lead to greater weight losses for black women in BWL programs.
authors.affiliation: School of Medicine, Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South MT 639, Birmingham, AL, 35294-4410, USA. tiffanycarson@uabmc.edu.|Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA. tiffanycarson@uabmc.edu.|Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA. tiffanycarson@uabmc.edu.|Minority Health and Health Disparities Research Center, University of Alabama at Birmingham, Birmingham, AL, USA. tiffanycarson@uabmc.edu.
authors.forename: Tiffany L
authors.initials: TL
authors.lastname: Carson
authors.affiliation: School of Medicine, Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South MT 639, Birmingham, AL, 35294-4410, USA.|Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Bradford E
authors.initials: BE
authors.lastname: Jackson
authors.affiliation: School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Timiya S
authors.initials: TS
authors.lastname: Nolan
authors.affiliation: School of Medicine, Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South MT 639, Birmingham, AL, 35294-4410, USA.
authors.forename: Angela
authors.initials: A
authors.lastname: Williams
authors.affiliation: School of Medicine, Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South MT 639, Birmingham, AL, 35294-4410, USA.|Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.|Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, USA.|Minority Health and Health Disparities Research Center, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Monica L
authors.initials: ML
authors.lastname: Baskin
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D008875:Middle Aged; D050177:Overweight / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D011569:Psychiatric Status Rating Scales; D012424:Rural Population; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D016896:Treatment Outcome; D015431:Weight Loss; D061217:Weight Reduction Programs
keywords: Behavioral weight loss intervention; Black female; Deep South; Depression; Rural; Stress