1. In this randomized controlled trial, integrated behavioral weight loss treatment, problem-solving therapy, and as needed antidepressant treatment led to a modest reduction in depression symptoms and weight loss at 12 months compared to care as usual.

2. The intervention was successful in non-Hispanic white patients, women, and those older than 45 years of age but relatively ineffective for men, those under 45 years of age, and Asian and Hispanic populations.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Depression and obesity are often co-morbid, and patients with obesity are more likely to present with depression than non-obese patients. Though some randomized trials of integrated interventions for obesity and depression have been tried, they have been small and have not included men. In this multicenter, randomized controlled trial, patients who received an integrated behavioral weight loss treatment, problem-solving therapy, and as needed antidepressant treatment had a modest reduction in depression symptoms and weight at 12 months compared to care as usual. The intervention was successful in non-Hispanic white patients, women, and those older than 45 years of age but relatively ineffective for men, those under 45 years of age, and Asian and Hispanic patients.

While there was a significant difference with the intervention, it was of modest benefit, and so it is unclear if the intervention would be clinically significant or cost-effective. Further, patients in the intervention group had a higher rate of antidepressant prescriptions which was a potential confounder. The generalizability of this study is reduced due to the homogenous population of patients with relatively high socioeconomic status in a single-payer system in Northern California.

Click to read the study in JAMA

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