Depression and anxiety: their predictive function for weight loss in obese individuals

Abstract

Objective: To investigate the impact of current mental disorders on weight loss with special consideration of depressive and/or anxiety disorders as well as binge eating behavior in obese individuals undergoing different weight loss treatments.

Methods: Three different samples of obese individuals were investigated in a prospective, longitudinal study: participants in a conventional weight loss treatment program (CONV TREAT; n = 250), obesity surgery patients (OBES SURG; n = 153), and obese control individuals (OC; n = 128). Current mental disorders and BMI were assessed at baseline and at 4-year follow-up.

Results: OBES SURG patients with a depressive and/or anxiety disorder lost significantly less weight compared with those without a comorbid mental diagnosis. This result was not detected for CONV TREAT participants. A trend to gain weight was seen in OC participants with a depressive and/or anxiety disorder, whereas OC participants without current mental disorders at baseline lost some weight. Binge eating behavior at baseline did not predict weight loss at 4-year followup.

Conclusions: These results underline the importance of addressing current depressive and anxiety disorders in obese patients, especially when such patients are undergoing obesity surgery.

Fig. 1

Patient flow over 4-year follow-up period. Presentation of number of participants excluded from the analysis; number of individuals with any mental disorder, depressive disorder, and anxiety disorder; and composition of the subsample with comorbid anxiety and/or depressive disorders for both assessment time points (T1 and T2).

Fig. 2

Course of BMI over time. Mean scores for BMI at T1 and T2 separated according to intervention groups as well as present psychiatric diagnosis vs. no comorbid psychiatric diagnosis (OC NO = control probands with no comorbid psychiatric diagnosis; OC YES = control probands with a comorbid depressive/anxiety disorder at T1; CONV TREAT NO = participants of conventional treatment programs with no comorbid psychiatric diagnosis; CONV TREAT YES = participants of conventional treatment programs with a comorbid depressive/anxiety disorder at T1; OBES SURG NO = obese individuals undergoing obesity surgery (gastric banding) with no comorbid psychiatric diagnosis; OBES SURG YES = obese individuals undergoing obesity surgery (gastric banding) with comorbid depressive/anxiety disorder at T1).