Tuesday, September 17, 2019

Meta-Analysis Highlights Potential Mental Health Benefits of Obesity Treatment for Youth

Despite the known benefits of weight loss for children and adolescents who are obese, some studies suggest that youth who diet may be at an increased risk of depression. A meta-analysis published Monday in JAMA Pediatrics suggests obesity treatment in youth is not associated with an increased risk of depression or anxiety; rather, the analysis points to the mental health benefits of such programs for this population.

“Structured and professionally run obesity treatment with a dietary component is associated with improvements in depression and anxiety for most participants,” wrote Hiba Jebeile, M.Nutr.Diet., of the University of Sydney and colleagues. “Treatment of weight concerns should be considered within the treatment plan for young people with depression and obesity.”

To examine the relationship between obesity treatment interventions and anxiety/depression symptoms in youth who were overweight, the authors searched through electronic databases for studies of interventions for youth who were overweight/obese published between 1987 and 2018. Only studies that evaluated outcomes in youth who participated in interventions with a dietary component (such as nutritional education) and assessed youth for anxiety/depression before and after participating in the intervention were included in the analysis. (Studies evaluating online interventions, pharmacotherapy, and bariatric surgery were not included in the analysis). A total of 44 studies, with a combined sample of 3,702 youth with a mean age range of 5.6 to 16.6 years (BMI range of 24.6 to 44.9), met these inclusion criteria. The duration of the interventions included in the analysis ranged from two weeks to 15 months.

The meta-analysis revealed a small reduction in depressive symptoms in the participants after the intervention, which the authors noted was maintained six months to 16 months from baseline. Similarly, anxiety symptoms were lower in study participants following the interventions and at follow-up.

“Interventions with weekly or fortnightly contact with the study team showed the greatest reduction in depressive symptoms, and longer intervention duration was associated with a larger reduction in anxiety. This may be due to the regular and extended support of a health care team,” Jebeile and colleagues wrote. Additionally, “interventions with a structured exercise program had a greater reduction in anxiety than physical activity education alone. A similar trend, although not statistically significant, was found for depressive symptoms.” They noted that the exercise programs, often delivered in a group format, were offered to participants several times per week, increasing their contact with study personnel and peers.

They concluded, “Overall, obesity treatment interventions are not associated with increased symptoms of depression and anxiety. However, clinicians should be aware that a small proportion of participants may be at risk of developing worsening pathology. Identification of these young people and provision of additional support may improve treatment outcomes.”

For related information, see the Psychiatric News article “Researchers Examine Link Between Mood, Food, and Obesity.”

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