Dataset Information

Depressive symptom severity as a predictor of attendance in the HOME behavioral weight loss trial.

ABSTRACT:

Objective

We examined whether total depressive symptoms and symptom clusters predicted behavioral weight loss attendance among economically disadvantaged adults in a randomized controlled trial.

Methods

150 adults with obesity were randomized to 12 months of in-person, video conference, or enhanced usual care weight loss groups. We categorized percent session attendance in the intervention arms into three levels: no attendance, poorer attendance, and better attendance.

Results

Higher baseline Patient Health Questionnaire-8 (PHQ-8) score was associated with a greater odds of being in the poorer versus better attendance group (OR = 1.94, 95% CI: 1.02-3.69, p = .04). A similar relationship between PHQ-8 score and odds of being in the no attendance versus better attendance group was observed but was not statistically significant (OR = 1.63, 95% CI: 0.94-2.81, p = .08). Both cognitive/affective and somatic clusters contributed to the depressive symptoms-attendance relationships.

Conclusion

Greater depressive symptoms at the start of a behavioral weight loss program may predict poorer subsequent session attendance. Screening for and addressing depression may improve intervention uptake. ClinicalTrials.gov Identifier: NCT02057952.

SUBMITTER: Shell AL

PROVIDER: S-EPMC7429242 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

Depressive symptom severity as a predictor of attendance in the HOME behavioral weight loss trial.

Shell Aubrey L AL Hsueh Loretta L Vrany Elizabeth A EA Clark Daniel O DO Keith NiCole R NR Xu Huiping H Stewart Jesse C JC

Journal of psychosomatic research 20200215

<h4>Objective</h4>We examined whether total depressive symptoms and symptom clusters predicted behavioral weight loss attendance among economically disadvantaged adults in a randomized controlled trial.<h4>Methods</h4>150 adults with obesity were randomized to 12 months of in-person, video conference, or enhanced usual care weight loss groups. We categorized percent session attendance in the intervention arms into three levels: no attendance, poorer attendance, and better attendance.<h4>Results< ...[more]

PMID: 32088427

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Project description:Depressive symptoms and binge eating are both prevalent in weight management populations and may be associated with reduced benefit from behavioral weight loss, including higher attrition, more perceived barriers, lower weight loss, and increased weight regain. These two potential risk factors for poor behavioral weight loss outcomes may also be associated with each other as depressive symptoms may trigger binge eating, and binge eating-related distress could increase depressive symptoms. The depressive symptom-binge eating link has not been well studied in weight management samples, and psychological processes involved in this relationship have not yet been elucidated. Psychological flexibility, an individual's ability to be connected with and conscious of the present moment and to engage in values-consistent behavior even in the presence of difficult internal experiences, may be one psychological process that changes the depressive symptom-binge eating relationship. High psychological flexibility may be a protective factor in the association of depressive symptoms with binge eating. This study examined the relationship between depressive symptom and binge eating and a potential interactive role of psychological flexibility. Participants (N = 468, 76% female) completed self-report questionnaires of binge eating, depressive symptoms, and psychological flexibility at baseline prior to initiating behavioral weight loss. Depressive symptoms were positively associated with binge eating (B = 1.00, p < 0.001). Psychological flexibility had an interactive role (B = -0.03, p = 0.005). Among participants with minimal to mild depressive symptoms, those with higher psychological flexibility had less severe binge eating. Findings suggest that psychological flexibility may be a protective factor in the association between depressive symptoms and binge eating in the majority of individuals initiating behavioral weight loss. Psychological flexibility is a psychological process to consider targeting for enhancing efficacy of weight loss treatment, especially among individuals with minimal to mild depressive symptoms and binge eating behavior.

Project description:IntroductionMany adults with overweight or obesity experience subclinical symptoms of depression, but little is known about how such symptoms are associated with physical activity (PA) or the experience of PA during behavioral weight loss (BWL) treatment.MethodsIn the current study, adults recruited from the community (N = 320) received 18 months of group-based BWL treatment and wore accelerometers at months 0, 6, and 18 to objectively measure PA. Participants with a mood disorder that was not well controlled were not eligible for the study and were referred for individual treatment. Depressive symptoms, PA barriers, discomfort avoidance, and self-control were self-reported with validated measures.ResultsAt baseline, the majority of participants indicated some depressive symptoms, mostly at subclinical levels. Results of multilevel models suggest that depressive symptoms were not significantly associated with concurrent measures of PA engagement (minutes/week) or sedentary behavior (minutes/week) at a given time point (i.e., baseline, 6 months, or 18 months). Results of cross-level interactions suggest that baseline depressive symptoms did not moderate the change in PA or sedentary behavior across time. Concurrent depressive symptoms and PA barriers were significantly and positively associated at a given time point (i.e., baseline, 6 months, or 18 months); however, baseline depressive symptoms did not moderate the improvement in perceived PA barriers across time. At baseline, higher discomfort avoidance and lower self-control each independently and partially mediated the relationship between depressive symptoms and PA barriers.ConclusionResults suggest that, among BWL samples in which most participants do not have clinically significant depressive symptoms, the likelihood of adopting and sustaining PA does not depend on the extent of depressive symptoms, but those with elevated symptoms may benefit from approaches that address their perception that engaging in PA is especially challenging.

Dataset Information

Depressive symptom severity as a predictor of attendance in the HOME behavioral weight loss trial.

Objective

Methods

Results

Conclusion

Publications

Depressive symptom severity as a predictor of attendance in the HOME behavioral weight loss trial.

Similar Datasets

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