The effect of a "maintain, don't gain" approach to weight management on depression among black women: results from a randomized controlled trial

Am J Public Health. 2014 Sep;104(9):1766-73. doi: 10.2105/AJPH.2014.302004. Epub 2014 Jul 17.

Abstract

Objectives: We evaluated the effect of a weight gain prevention intervention (Shape Program) on depression among socioeconomically disadvantaged overweight and obese Black women.

Methods: Between 2009 and 2012, we conducted a randomized trial comparing a 12-month electronic health-based weight gain prevention intervention to usual primary care at 5 central North Carolina community health centers. We assessed depression with the Patient Health Questionnaire (PHQ-8). We analyzed change in depression score from baseline to 12- and 18-month follow-up across groups with mixed models. We used generalized estimating equation models to analyze group differences in the proportion above the clinical threshold for depression (PHQ-8 score ≥ 10).

Results: At baseline, 20% of participants reported depression. Twelve-month change in depression scores was larger for intervention participants (mean difference = -1.85; 95% confidence interval = -3.08, -0.61; P = .004). There was a significant reduction in the proportion of intervention participants with depression at 12 months with no change in the usual-care group (11% vs 19%; P = .035). All effects persisted after we controlled for weight change and medication use. We saw similar findings at 18 months.

Conclusions: The Shape Program, which includes no mention of mood, improved depression among socioeconomically disadvantaged Black women.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Black or African American*
  • Community Health Centers / organization & administration
  • Depression / ethnology
  • Depression / psychology*
  • Female
  • Goals
  • Health Behavior
  • Health Promotion / organization & administration*
  • Humans
  • North Carolina
  • Overweight / ethnology
  • Overweight / psychology*
  • Overweight / therapy*
  • Poverty
  • Socioeconomic Factors
  • Weight Gain*