1
|
Borgatti A, Morgan C, Stager L, Dutton GR. Associations between weight bias internalization, weight status, and health among a diverse cohort of freshman college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-10. [PMID: 38875131 DOI: 10.1080/07448481.2024.2346351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 04/09/2024] [Indexed: 06/16/2024]
Abstract
Mental health concerns are common among college students, especially students with higher body mass index (BMI). Weight bias internalization (WBI) is thought to contribute to these mental health disparities. However, little is known about how WBI differs among more diverse students, and to what extent WBI may explain associations between BMI and health in college populations. This study compared rates of WBI in Freshman college students (N = 1289) across gender, race/ethnicity, and sexual orientation, and assessed whether WBI mediated associations between BMI and mental health (depression, self-esteem, stress, loneliness) and behavioral health (disordered eating, physical activity, gym use). Black students and men demonstrated reduced WBI while bisexual women showed increased WBI. Further, WBI mediated the association of BMI with mental health and disordered eating, but not physical activity. These findings suggest that stigma may account for mental health disparities among higher-BMI students, and that minoritized groups are disproportionately impacted.
Collapse
Affiliation(s)
- Alena Borgatti
- Division of Preventive Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Casie Morgan
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lindsay Stager
- Department of Psychology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Psychiatry, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gareth R Dutton
- Division of Preventive Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA
| |
Collapse
|
2
|
Lam A, Piya MK, Foroughi N, Mohsin M, Chimoriya R, Kormas N, Conti J, Hay P. Predictors of Mental Health Outcomes in a Multidisciplinary Weight Management Program for Class 3 Obesity. Nutrients 2024; 16:1068. [PMID: 38613100 PMCID: PMC11013199 DOI: 10.3390/nu16071068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
This study aimed to examine the potential predictors of improvement in mental health outcomes following participation in an intensive non-surgical outpatient weight management program (WMP) in an Australian public hospital. This was a retrospective cohort study of all adults with Class 3 obesity (BMI ≥ 40 kg/m2) who enrolled in the WMP from March 2018 to June 2021. The participants completed the Eating Disorder Examination Questionnaire Short Version (EDE-QS), Kessler-10 Psychological Distress Scale, and 36-Item Short-Form Survey (SF-36) at baseline and 12-month follow-up. A total of 115 patients completed 12 months in the WMP and were included in the study, with 76.5% being female, a mean ± SD age at baseline of 51.3 ± 13.8 years, a weight of 146 ± 26 kg, and a BMI of 51.1 ± 8.6 kg/m2. The participants lost an average of 8.6 ± 0.2 kg over 12 months, and greater weight loss at follow-up was significantly associated with improved global EDE-QS scores, psychological distress, and improved mental health quality of life. However, improvements in most mental health outcomes were not predicted by weight loss alone. Notably, a lower eating disorder risk at baseline was associated with less psychological distress at follow-up and greater weight loss at follow-up. Our results also found an association between reduced psychological distress and reduced binge eating frequency. These findings support the inclusion components of obesity interventions that target the psychological correlates of obesity to support improved outcomes in people with Class 3 obesity. Future studies should aim to identify which aspects of the WMP helped improve people's psychological outcomes.
Collapse
Affiliation(s)
- Ashley Lam
- School of Psychology, Western Sydney University, Sydney, NSW 2560, Australia;
| | - Milan K. Piya
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (M.K.P.); (N.F.); (R.C.)
- Camden and Campbelltown Hospitals, Campbelltown, NSW 2560, Australia;
| | - Nasim Foroughi
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (M.K.P.); (N.F.); (R.C.)
| | - Mohammed Mohsin
- Mental Health Research and Teaching Unit, Liverpool Hospital, South Western Sydney Local Health District, NSW Health, Liverpool, NSW 1871, Australia;
- Faculty of Medicine & Health, School of Clinical Medicine, Discipline of Psychiatry, University of New South Wales, Kensington, NSW 2052, Australia
| | - Ritesh Chimoriya
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (M.K.P.); (N.F.); (R.C.)
| | - Nic Kormas
- Camden and Campbelltown Hospitals, Campbelltown, NSW 2560, Australia;
| | - Janet Conti
- School of Psychology, Western Sydney University, Sydney, NSW 2560, Australia;
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (M.K.P.); (N.F.); (R.C.)
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, NSW 2560, Australia; (M.K.P.); (N.F.); (R.C.)
- Camden and Campbelltown Hospitals, Campbelltown, NSW 2560, Australia;
- Mental Health Research and Teaching Unit, Liverpool Hospital, South Western Sydney Local Health District, NSW Health, Liverpool, NSW 1871, Australia;
| |
Collapse
|
3
|
Cao B, Xu J, Li R, Teopiz KM, McIntyre RS, Chen H. Interventions targeting comorbid depression and overweight/obesity: A systematic review. J Affect Disord 2022; 314:222-232. [PMID: 35878825 DOI: 10.1016/j.jad.2022.07.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/18/2022] [Accepted: 07/17/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Overweight/obesity and depression are highly co-occurring conditions with shared pathophysiology as well as social and economic determinants. To our knowledge, this is the first systematic review aims to comprehensively synthesize extant literature with a focus on the effectiveness of interventions targeting obesity and depression comorbidity. METHODS We searched databases including MEDLINE, ProQuest Central, Web of Science, PsycINFO, Cochrane Library, from inception of the databases until Nov 12, 2021. Articles were included if they reported on the effects of pharmacological, psychological or dietary interventions on comorbid depression and overweight/obesity as their primary or secondary outcome. RESULTS Of the 5480 identified records, 19 eligible researches comprising 15 RCTs and 4 uncontrolled longitudinal studies for 3408 participants with comorbid depression and overweight/obesity. The available literature is not sufficient to inform evidence-based treatments targeting obesity and comorbid depression contemporaneously. Notwithstanding, the combination of CBT and lifestyle intervention show efficacy targeting obesity and comorbid depression as do some nutritional supplements, antidepressants and anti-diabetic agents. LIMITATIONS The high heterogeneity of various interventions in the included studies may cause a lack of comparability between different studies. CONCLUSIONS Concurrent management of depression and overweight/obesity is suggested by available data. There is a pressing need for studies that evaluate the effectiveness in real world samples of persons experiencing multiple co-occurring chronic diseases including but not limited to depression and overweight/obesity.
Collapse
Affiliation(s)
- Bing Cao
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China; National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing 400715, PR China.
| | - Jiatong Xu
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China
| | - Ruonan Li
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China
| | - Kayla M Teopiz
- Mood Disorders Psychopharmacology Unit, University of Toronto, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University of Toronto, Canada; Canadian Rapid Treatment Center of Excellence, Mississauga, Canada
| | - Hong Chen
- Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing 400715, PR China; National Demonstration Center for Experimental Psychology Education, Southwest University, Chongqing 400715, PR China.
| |
Collapse
|
4
|
Lin L, Bai S, Qin K, Wong CKH, Wu T, Chen D, Lu C, Chen W, Guo VY. Comorbid depression and obesity, and its transition on the risk of functional disability among middle-aged and older Chinese: a cohort study. BMC Geriatr 2022; 22:275. [PMID: 35366819 PMCID: PMC8976974 DOI: 10.1186/s12877-022-02972-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 03/24/2022] [Indexed: 12/27/2022] Open
Abstract
Background Evidence has indicated that depression and obesity were associated with functional disability, independently. However, little is known about the detrimental impact of comorbid depression and obesity, as well as its transition on functional disability. This study investigated the association of baseline depression-obesity status and its dynamic change with incident functional disability among middle-aged and older Chinese. Methods This cohort study included 5507 participants aged ≥45 years from the 2011 and 2015 waves of China Health and Retirement Longitudinal Study. Depression was defined with a score ≥ 10 using the 10-item Centre for Epidemiologic Studies Depression Scale. Obesity was defined as body mass index ≥28 kg/m2. Participants were cross-classified by depression and obesity status at baseline, and its change during follow-up. Logistic regression models were constructed to evaluate the association of baseline depression-obesity status and its transition with incident functional disability defined by the Katz index of activities of daily living scale. Results Over four-year follow-up, 510 (9.3%) participants developed functional disability. Individuals with baseline comorbid depression and obesity had the highest risk of functional disability (OR = 2.84, 95% CI: 1.95–4.15) than non-depressive participants without obesity, or those with depression or obesity alone. When investigating the dynamic changes of depression-obesity status on functional disability incidence, those with stable comorbidity throughout two surveys had the greatest risk of functional disability (OR = 4.06, 95% CI: 2.11–7.80). Progression of depression-obesity status was associated with increased risk of functional disability, while regression from baseline to follow-up was linked to attenuated risk estimates. Conclusions Among middle-aged and older Chinese adults, the risk of functional disability was exaggerated with comorbid depression and obesity. Our data further suggest that transitions of depression and obesity over time are associated with the risk of developing functional disability. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02972-1.
Collapse
|
5
|
Depression and obesity among females, are sex specificities considered? Arch Womens Ment Health 2021; 24:851-866. [PMID: 33880649 DOI: 10.1007/s00737-021-01123-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 03/21/2021] [Indexed: 12/13/2022]
Abstract
This study aimed to systematically review the relationship of obesity-depression in the female sex. We carried out a systematic search (PubMed, MEDLINE, Embase) to quantify the articles (controlled trials and randomized controlled trials) regarding obesity and depression on a female population or a mixed sample. Successively, we established whether the sex specificities were studied by the authors and if they reported on collecting data regarding factors that may contribute to the evolution of obesity and depression and that could be responsible for the greater susceptibility of females to those conditions. After applying the inclusion and exclusion criteria, we found a total of 20 articles with a female sample and 54 articles with a mixed sample. More than half of all articles (51.35%, n = 38) evaluated the relationship between depression and obesity, but only 20 (27.03%) evaluated this relationship among females; still, 80% of those (n = 16) presented supporting results. However, few articles considered confounding factors related to female hormones (12.16%, n = 9) and none of the articles focused on factors responsible for the binomial obesity-depression in the female sex. The resulting articles also supported that depression (and related impairments) influencing obesity (and related impairments) is a two-way road. This systematic review supports the concurrency of obesity-depression in females but also shows how sex specificities are ultimately under-investigated. Female sex specificity is not being actively considered when studying the binomial obesity-depression, even within a female sample. Future studies should focus on trying to understand how the female sex and normal hormonal variations influence these conditions.
Collapse
|
6
|
Venditti EM, Steinman LE, Lewis MA, Weiner BJ, Ma J. Seeking a pot of gold with integrated behavior therapy and research to improve health equity: insights from the RAINBOW trial for obesity and depression. Transl Behav Med 2021; 11:1691-1698. [PMID: 34244787 PMCID: PMC8344914 DOI: 10.1093/tbm/ibab069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
More than one third of adults in the United States (U.S.) live with multiple chronic conditions that affect their physical and mental health, functional outcomes, independence, and mortality. The COVID-19 pandemic has exposed not only an increased risk for infection, morbidity, and mortality among those with chronic conditions but long-standing health inequities by age, race, sex, and other social determinants. Obesity plus depression represent one such prevalent comorbidity for which few effective integrated interventions exist, prompting concern about the potential for secondary physical and mental health pandemics post COVID-19. Translational behavioral medicine research can play an important role in studying integrated collaborative healthcare approaches and advancing scientific understanding on how to engage and more effectively treat diverse populations with physical and mental health comorbidities. The RAINBOW (Research Aimed at Improving Both Mood and Weight) clinical trial experience offers a wealth of insights into the potential of collaborative care interventions to advance behavior therapy research and practice. Primary care patients with co-occurring obesity and depression were assigned to either Integrated Coaching for Mood and Weight (I-CARE), which blended Group Lifestyle Balance (GLB) for weight management and the Program to Encourage Active Rewarding Lives (PEARLS) for depression, or usual care, to examine clinical, cost-effectiveness, and implementation outcomes. This commentary highlights the empirical findings of eight RAINBOW research papers and discusses implications for future studies, including their relevance in the U.S. COVID-19 context. Organized by key principles of translational behavioral medicine research, the commentary aims to examine and embrace the heterogeneity of baseline and intervention response differences among those living with multiple chronic conditions. We conclude that to prevent health and healthcare disparities from widening further, tailored engagement, dissemination, and implementation strategies and flexible delivery formats are essential to improve treatment access and outcomes among underrepresented populations.
Collapse
Affiliation(s)
- Elizabeth M Venditti
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Lesley E Steinman
- Health Promotion Research Center, University of Washington, Seattle, WA, USA
| | | | - Bryan J Weiner
- Departments of Global Health and Health Services, University of Washington, Seattle, WA, USA
| | - Jun Ma
- Department of Medicine and Institute of Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|
7
|
Keller C, Ferrer RA, King RB, Collier E. Future directions of the National Institutes of Health Science of Behavior Change Program. Transl Behav Med 2021; 11:1795-1801. [PMID: 33837790 PMCID: PMC8083271 DOI: 10.1093/tbm/ibab029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background The National Institutes of Health Science of Behavior Change Common Fund Program has accelerated the investigation of mechanisms of behavior change applicable to multiple health behaviors and outcomes and facilitated the use of the experimental medicine approach to behavior change research. Purpose This commentary provides a brief background of the program, plans for its next phase, and thoughts about how the experimental medicine approach to behavior change research can inform future directions in two areas of science—reproductive health and COVID-19 vaccine uptake. Conclusions The incorporation of a mechanisms-based approach into behavior intervention research offers new opportunities for improving health.
Collapse
Affiliation(s)
| | | | - Rosalind B King
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Elaine Collier
- National Center for Advancing Translational Sciences, Bethesda, Maryland, USA
| |
Collapse
|
8
|
Effects of the Family Check-Up 4 Health on Parenting and Child Behavioral Health: A Randomized Clinical Trial in Primary Care. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 22:464-474. [PMID: 33715136 DOI: 10.1007/s11121-021-01213-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2021] [Indexed: 01/06/2023]
Abstract
The Family Check-Up 4 Health (FCU4Health) is an adaptation of the Family Check-Up (FCU) for delivery in primary care settings. While maintaining the original FCU's focus on parenting and child behavioral health, we added content targeting health behaviors. This study evaluated whether the adapted FCU maintained positive effects on parenting (positive behavior support, limit setting, parental warmth) and child behavioral health (self-regulation, conduct problems, emotional problems). Pediatric (6-12 years) primary care patients with a BMI ≥ 85th%ile (n = 240) were recruited from primary care clinics in Phoenix. Children were 75% Latino, 49% female, and 73% Medicaid recipients. This type 2 effectiveness-implementation hybrid trial compared families randomized to FCU4Health (n = 141) or usual care (n = 99). FCU4Health was delivered over a period of 6 months. This study focuses on a priori secondary outcomes included parenting and child behavioral health targets of the original FCU, assessed at baseline and 3, 6, and 12 months. Significant improvements were found for the FCU4Health condition, compared to usual care, in parenting from baseline to the 3-month assessment [β = .17 (.01; .32)]. Parenting predicted improvements in child self-regulation at 6-months [β = .17 (.03; .30)], which in turn predicted reductions in conduct problems [β = - .38 (- .51; - .23)] and emotional problems [β = - .24 (- .38; - .09)] at 12 months. Ethnicity and language of delivery (English or Spanish) did not moderate these effects. The FCU4Health can improve parenting and child behavioral health outcomes when delivered in primary care.Trial Registration Trial registration number: NCT03013309 ClinicalTrials.gov.
Collapse
|
9
|
Gao X, Yeung DCS, Bidulescu A. Effect of Integrated Intervention on Obesity and Depression. Am J Prev Med 2020; 59:458-459. [PMID: 32828323 DOI: 10.1016/j.amepre.2020.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 04/09/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Xiang Gao
- Department of Health and Exercise Science, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado
| | - Daniel Chi Shing Yeung
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, Indiana
| | - Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, Indiana
| |
Collapse
|