Initial investigation of behavioral activation therapy for co-morbid major depressive disorder and obesity

More than one-third of treatment-seeking obese patients are clinically depressed. No evidence-based treatments exist for individuals with comorbid depression and obesity. Behavioral activation (BA), an effective treatment for depression, might also facilitate weight loss. The objective of this study is to evaluate the feasibility and efficacy of BA plus nutrition counseling for weight loss among individuals with comorbid major depressive disorder (MDD) and obesity. The BA intervention targeted both weight reduction and depression in 14 obese patients (79% female; 86% Caucasian) who met criteria for MDD. At baseline, mean Beck Depression. Inventory (BDI-II) score was 26.71, and mean Hamilton Depression Rating Scale (HDRS) score was 16.00. Significant reductions at 12-weeks in both BDI-II and HDRS were observed with 10 participants reaching full remission at post treatment. Reductions in body weight, daily caloric intake, and physical activity were observed. BA with nutrition counseling appears to have potential as a weight loss treatment in the context of depression. Results support the need for a randomized controlled trial to evaluate the efficacy of BA for both weight loss and depression.