Abstract
The aim was to investigate the impact of a group-based weight management programme on symptoms of depression and anxiety compared with self-help in a randomised controlled trial (RCT). People with overweight (Body Mass Index [BMI]≥28kg/m2) were randomly allocated self-help (n = 211) or a group-based weight management programme for 12 weeks (n = 528) or 52 weeks (n = 528) between 18/10/2012 and 10/02/2014. Symptoms were assessed using the Hospital Anxiety and Depression Scale, at baseline, 3, 12 and 24 months. Linear regression modelling examined changes in Hospital Anxiety and Depression Scale between trial arms. At 3 months, there was a -0.6 point difference (95% confidence interval [CI], -1.1, -0.1) in depression score and -0.1 difference (95% CI, -0.7, 0.4) in anxiety score between group-based weight management programme and self-help. At subsequent time points there was no consistent evidence of a difference in depression or anxiety scores between trial arms. There was no evidence that depression or anxiety worsened at any time point. There was no evidence of harm to depression or anxiety symptoms as a result of attending a group-based weight loss programme. There was a transient reduction in symptoms of depression, but not anxiety, compared to self-help. This effect equates to less than 1 point out of 21 on the Hospital Anxiety and Depression Scale and is not clinically significant.
Highlights
The effect of obesity on physical health has been well documented [1,2,3,4,5]
The aim was to investigate the impact of a group-based weight management programme on symptoms of depression and anxiety compared with self-help in a randomised controlled trial (RCT)
There was no evidence of harm to depression or anxiety symptoms as a result of attending a group-based weight loss programme
Summary
The effect of obesity on physical health has been well documented [1,2,3,4,5]. People with obesity are at greater risk of poor mental health than those without, but the reasons for this are complicated [6]. Other studies show that intentional weight loss can reduce symptoms of depression, [9, 10] or improve quality of life scores, [11] this result is inconsistent, with some studies finding no evidence of a relationship between intentional weight loss and health related quality of life scores [12,13,14]. In the UK, the National Institute for Clinical Excellence recently consulted on the addition of two new Quality and Outcomes Framework indicators, to be applied from 2021 [18] These would financially incentivise referral from primary care of eligible adult patients to a weight management programme, resulting in a likely increase in number of patients accessing these services. Clarifying the effect that this may have on symptoms of depression and anxiety is of high importance if weight loss programmes are to be offered at scale
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