Clinical Edge

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Collaborative Intervention for Obesity, Depression

JAMA; 2019 Mar 5; Ma, Goldman Rosas, Lv, et al

Among adults with obesity and depression, a collaborative care intervention integrating behavioral weight loss treatment, problem-solving therapy, and as-needed antidepressant medications significantly improved weight loss and depressive symptoms at 12 months, compared with usual care, according to a recent study. The Research Aimed at Improving Both Mood and Weight (RAINBOW) randomized clinical trial enrolled 409 adults with body mass indices (BMIs) of ≥30 (≥27 for Asian adults) and 9-item Patient Health Questionnaire (PHQ-9) scores of ≥10. Researchers found:

  • Among 409 participants randomized (70% were women; mean BMI of 36.7 [SD, 6.4]; mean PHQ-9 score of 13.8 [SD, 3.1]; and mean Symptom Checklist Depression Scale (SCL-20) score of 1.5 [SD, 0.5]), 344 (84.1%) completed 12-month follow-up.
  • At 12 months, mean BMI declined from 36.7 (SD, 6.9) to 35.9 (SD, 7.1) among intervention participants compared with a change in mean BMI from 36.6 (SD, 5.8) to 36.6 (SD, 6.0) among usual care participants.
  • Mean SCL-20 score declined from 1.5 (SD, 0.5) to 1.1 (SD, 1.0) at 12 months among intervention participants compared with a change in mean SCL-20 score from 1.5 (SD, 0.6) to 1.4 (SD, 1.3) among usual care participants.

Ma J, Goldman Rosas L, Lv N, et al. Effect of integrated behavioral weight loss treatment and problem-solving therapy on body mass index and depressive symptoms among patients with obesity and depression. The RAINBOW randomized clinical trial. JAMA. 2019;321(9):869-879. doi:10.1001/jama.2019.0557.