Integrated therapy treating obesity and depression is effective

An Integrated therapy directed towards curing obesity and depression together, has proven to be affective, a recent study suggests.

According to the study, an intervention combining behavioural weight loss treatment and problem-solving therapy with as-needed antidepressant medication for participants with co-occurring obesity and depression improved weight loss and depressive symptoms more effectively, when compared with routine physician care.

Obesity and depression commonly occur together. Approximately 43 per cent of adults with depression are obese, and adults with obesity are at increased risk of experiencing depression.

The study suggests that to treat both conditions, patients must visit multiple practitioners including dieticians, wellness coaches and mental health counsellors or psychiatrists.

The burden associated with visiting multiple health care providers consistently over the long periods of time required to treat obesity and depression can be significant and lead to dropping out of therapy altogether.

Additionally, these health services may not be available due to a lack of trained providers or reimbursement, and the cost of seeing numerous specialists can be prohibitive.

"We have shown that delivering obesity and depression therapy in one integrated program using dually trained health coaches who work within a care team that includes a primary care physician and a psychiatrist, is effective at reducing weight and improving depressive symptoms," said Dr Jun Ma, principal investigator on the study.

As part of the study, 204 participants were randomly assigned to receive the integrated collaborative care program and were seen by a health coach for one year.

In the first six months, they participated attended nine individual counselling sessions and watched 11 videos on healthy lifestyles.

In the following six months, participants had monthly telephone calls with their health coach. Two hundred and five participants randomly assigned to the usual care control group did not receive any additional intervention.

Participants in the integrated care program experienced more weight loss and decline in the severity of depressive symptoms over one year compared with control participants receiving usual care.

On average, patients in the integrated program experienced a decline in body mass index from 36.7 to 35.9 while participants in the usual care group had no change in BMI.

Participants receiving integrated therapy reported a decline in depression severity scores based on responses to a questionnaire from 1.5 to 1.1, compared with a change from 1.5 to 1.4 among those in the control group.

"While the demonstrated improvements in obesity and depression among participants receiving the integrated therapy were modest, the study represents a step forward because it points to an effective, practical way to integrate fragmented obesity and depression care into one combined therapy, with good potential for implementation in primary care settings, in part because the integrated mental health treatment in primary care settings is now also reimbursable by Medicare.

For patients, this approach is an attractive alternative to seeing multiple practitioners each charging for their services as is done traditionally," Ma said.