Collaborative Care Intervention Has Modest but Positive Results in Obesity and Depression

An integrated collaborative care intervention resulted in modest improvements in weight loss and depressive symptoms at 12 months in adults with obesity and depression, according to study results published in JAMA.

There are effective treatments that target obesity and depression individually, but there are few effective treatment regimens that address both conditions simultaneously. However, as there is a growing population of individuals who have both obesity and depression, there is a need for integrated strategies. Researchers conducted the RAINBOW (Research Aimed at Improving Both Mood and Weight) randomized clinical trial to compare an integrated collaborative care intervention with usual care for improving weight loss and depressive symptoms in adult patients with obesity and depression. The cohort included 409 individuals (mean age, 51 years; 70% women) who were randomly assigned to usual care or the intervention group, which included integrated behavioral weight loss treatment and problem-solving therapy, as needed antidepressants, and a diabetes prevention program. The 2 primary end points were changes in body mass index and in 20-item Depression Symptom Checklist scores (range, 0 [best] to 4 [worst]) at 12 months.

At follow-up, the mean body mass index dropped from 36.7 ± 6.9 kg/m2 to 35.9 ± 7.1 kg/m2 in the intervention arm vs a change from 36.6 ± 5.8 kg/m2 to 36.6 ± 6.0 kg/m2 in the usual care group (between-group mean difference, -0.7; 95% CI, -1.1 to -0.2; P =.01). The mean Depression Symptom Checklist score decreased in the intervention arm from 1.5 ± 0.5 to 1.1 ± 1.0 vs 1.5 ± 0.6 to 1.4 ± 1.3 in the usual care group (between-group mean difference, -0.2; 95% CI, -0.4 to 0; P =.01).

The researchers noted that the “effect sizes for both primary outcomes in this trial were modest and of uncertain clinical importance, and were limited to a duration of 12 months. Whether these outcomes will translate to important health outcomes or will be sustained over longer periods is unknown.”

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Ma J, Rosas LG, 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.

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