--- title: "Intervention for obesity and depression-RCT | Sutter Health" description: "intervention for obesity and depression that improved weight and depressive symptoms may also confer benefits for quality of life and psychosocial functioning." url: "https://www.sutterhealth.org/research/publications/intervention-for-obesity-and-depression-rct-1055312710" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Intervention for obesity and depression-RCT # Effect of an intervention for obesity and depression on patient-centered outcomes: an RCT. Rosas LG, Azar KMJ, Lv N, Xiao L, Goldhaber-Fiebert JD, Snowden MB, Venditti EM, Lewis MM, Goldstein-Piekarski AN, & Ma J. _Am J Prev Med. pii: S0749-3797(19)30512-4. doi: 10.1016/j.amepre.2019.11.005. \[Epub ahead of print\]_ 2020-02-14 ## Abstract INTRODUCTION: An integrated collaborative care intervention was successful for treating comorbid obesity and depression. The effect of the integrated intervention on secondary outcomes of quality of life and psychosocial functioning were examined, as well as whether improvements in these secondary outcomes were correlated with improvements in the primary outcomes of weight and depressive symptoms. STUDY DESIGN: This RCT compared an integrated collaborative care intervention for obesity and depression to usual care. Data were analyzed in 2018. SETTING/PARTICIPANTS: Adult primary care patients (n=409) with a BMI ≥30 (≥27 if Asian) and 9-Item Patient Health Questionnaire score ≥10 were recruited from September 30, 2014 to January 12, 2017 from primary care clinics in Northern California. INTERVENTION: The 12-month intervention integrated a behavioral weight loss program and problem-solving therapy with as-needed antidepressant medications for depression. MAIN OUTCOME MEASURES: A priori secondary outcomes included health-related quality of life (Short Form-8 Health Survey), obesity-specific quality of life (Obesity-Related Problems Scale), sleep disturbance and sleep-related impairment (Patient-Reported Outcomes Measurement Information System), and functional disability (Sheehan Disability Scale) at baseline and 6 and 12 months. RESULTS: Participants randomized to the intervention experienced significantly greater improvements in obesity-specific problems, mental health-related quality of life, sleep disturbance, sleep-related impairment, and functional disability at 6 months but not 12 months. Improvements in obesity-related problems (β=0.01, 95% CI=0.01, 0.02) and sleep disturbance (β= -0.02, 95% CI= -0.04, 0) were associated with lower BMI. Improvements in the physical (β= -0.01, 95% CI= -0.01, 0) and mental health components (β= -0.02, 95% CI= -0.03, -0.02) of the Short Form-8 Health Survey as well as sleep disturbance (β=0.01, 95% CI=0.01, 0.02) and sleep-related impairment (β=0.01, 95% CI=0, 0.01) were associated with fewer depressive symptoms. CONCLUSIONS: An integrated collaborative care intervention for obesity and depression that was shown previously to improve weight and depressive symptoms may also confer benefits for quality of life and psychosocial functioning over 6 months. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/32067873) ![Kristen M J Azar, RN, MSN, MPH](https://dyn.mktgcdn.com/p/rFmyR1kiX8JzE5-XNwup0gVC1GRaVTlH7oSDlG0Tr5A/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) Kristen M J Azar, RN, MSN, MPH Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/kristen-m-j-azar-rn-msn-mph-1049680985) ## Research topics - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Mental Health](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Mental+Health%5C%22%22) - [Obesity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Obesity%5C%22%22) - [Sleep Disorders](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Sleep+Disorders%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Profiles of sociodemographic, behavioral, clinical and psychosocial characteristics among primary care patients with comorbid obesity and depression.](https://www.sutterhealth.org/research/publications/characteristics-primary-care-pts-with-obesity-depression-1055312347) Ma J, Xiao L, Lv N, Rosas LG, Lewis MA, Goldhaber-Fiebert JD, Venditti EM, Snowden MB, Lesser L, Ward E. Prev Med Rep. 8:42-50. doi: 10.1016/j.pmedr.2017.07.010. eCollection 2017 Dec. 2017 Aug 05 - Publication ### [Variability in engagement and progress in efficacious integrated collaborative care for primary care patients with obesity and depression: within-treatment analysis in the RAINBOW trial.](https://www.sutterhealth.org/research/publications/obesity-depression-rainbow-trial-within-treatment-analysis-1055312741) Lv N, Xiao L, Majd M, Lavori PW, Smyth JM, Rosas LG, Venditti EM, Snowden MB, Lewis MA, Ward E, Lesser L, Williams LM, Azar KMJ, Ma J. PLoS One. 15(4):e0231743. doi: 10.1371/journal.pone.0231743. eCollection 2020. 2020 Apr 21 - Publication ### [A conceptual model of the role of complexity in the care of patients with multiple chronic conditions.](https://www.sutterhealth.org/research/publications/complexity-in-the-care-of-pts-with-chronic-conds-1055312633) Grembowski D, Schaefer J, Johnson KE, Fischer H, Moore SL, Tai-Seale M, Ricciardi R, Fraser JR, Miller D, LeRoy L; AHRQ MCC Research Network. Med Care. 52 Suppl 3:S7-S14. doi: 10.1097/MLR.0000000000000045. 2014 Mar 01 - Publication ### [Research Aimed at Improving Both Mood and Weight (RAINBOW) in Primary Care: A Type 1 hybrid design randomized controlled trial.](https://www.sutterhealth.org/research/publications/research-aimed-at-improving-both-mood-and-wt-1055312852) Ma J, Yank V, Lv N, Goldhaber-Fiebert JD, Lewis MA, Kaye Kramer M, Snowden MB, Rosas LG, Xiao L, Blonstein AC. Contemp Clin Trials. 43:260-78. doi: 10.1016/j.cct.2015.06.010. Epub 2015 June 19. 2015 Jul 01 - Publication ### [Adult obesity and office-based quality of care in the United States.](https://www.sutterhealth.org/research/publications/adult-obesity-and-office-care-quality-1055312917) Ma J, Xiao L, Stafford RS. Obesity. 17(5):1077–1085. 2009 May 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/intervention-for-obesity-and-depression-rct-1055312710#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Intervention for obesity and depression-RCT"}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/intervention-for-obesity-and-depression-rct-1055312710#medicalscholarlyarticle","name":"Effect of an intervention for obesity and depression on patient-centered outcomes: an RCT.","headline":"Intervention for obesity and depression-RCT","abstract":"INTRODUCTION: An integrated collaborative care intervention was successful for treating comorbid obesity and depression. The effect of the integrated intervention on secondary outcomes of quality of life and psychosocial functioning were examined, as well as whether improvements in these secondary outcomes were correlated with improvements in the primary outcomes of weight and depressive symptoms. STUDY DESIGN: This RCT compared an integrated collaborative care intervention for obesity and depression to usual care. Data were analyzed in 2018. SETTING/PARTICIPANTS: Adult primary care patients (n=409) with a BMI ≥30 (≥27 if Asian) and 9-Item Patient Health Questionnaire score ≥10 were recruited from September 30, 2014 to January 12, 2017 from primary care clinics in Northern California. INTERVENTION: The 12-month intervention integrated a behavioral weight loss program and problem-solving therapy with as-needed antidepressant medications for depression. MAIN OUTCOME MEASURES: A priori secondary outcomes included health-related quality of life (Short Form-8 Health Survey), obesity-specific quality of life (Obesity-Related Problems Scale), sleep disturbance and sleep-related impairment (Patient-Reported Outcomes Measurement Information System), and functional disability (Sheehan Disability Scale) at baseline and 6 and 12 months. RESULTS: Participants randomized to the intervention experienced significantly greater improvements in obesity-specific problems, mental health-related quality of life, sleep disturbance, sleep-related impairment, and functional disability at 6 months but not 12 months. Improvements in obesity-related problems (β=0.01, 95% CI=0.01, 0.02) and sleep disturbance (β= -0.02, 95% CI= -0.04, 0) were associated with lower BMI. Improvements in the physical (β= -0.01, 95% CI= -0.01, 0) and mental health components (β= -0.02, 95% CI= -0.03, -0.02) of the Short Form-8 Health Survey as well as sleep disturbance (β=0.01, 95% CI=0.01, 0.02) and sleep-related impairment (β=0.01, 95% CI=0, 0.01) were associated with fewer depressive symptoms. 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