Obesity and Depression Can Be Treated With Collaborative Care

MedicalResearch.com Interview with:

Jun Ma, MD, PhD, FAHA, FABMRProfessor and Associate Head of Research, Department of MedicineDirector, Center for Health Behavior ResearchThe University of Illinois at Chicago

Dr. Jun Ma

Jun Ma, MD, PhD, FAHA, FABMR
Professor and Associate Head of Research
Department of Medicine
Director, Center for Health Behavior Research
The University of Illinois at Chicago

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Obesity and depression are major public health problems. Obesity affects 40% of United States (US) adults. About 20% in US women and 13% in men experience major depressive disorder at some point in their lifetime and, additionally, many adults have elevated depressive symptoms that do not meet clinical diagnostic criteria but can nevertheless negatively affect their health and quality of life. Obesity and depression share common risk factors, such as poor diet and lack of exercise, and cause other health problems, such as diabetes and cardiovascular disease. People with obesity are at increased risk of being depressed and, likewise, people with depression are at increased risk of being obese. Consequently, obesity and depression often co-occur. To date, there has been no integrated therapy to effectively treat patients affected by both conditions at the same time.

The RAINBOW randomized clinical trial addressed this gap.

The main finding from the trial is that, among adult patients with obesity and depression, a collaborative care intervention integrating behavioral weight loss treatment, problem-solving therapy, and as-needed antidepressant medications significantly improve weight loss and depressive symptoms over one year compared with usual care, which patients received through their primary care physicians. 

MedicalResearch.com: What should readers take away from your report?

Response: The RAINBOW trial provides first-ever evidence to show that obesity and depression can be effectively treated together through integrated behavior therapy with as-needed antidepressant medications and that the integrated intervention we studied is suited to being delivered as part of primary care, without requiring specialist referrals. This intervention fits the Psychiatric Collaborative Care Model that is reimbursable to integrate behavioral health care with primary care, which should facilitate adoption of the intervention.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future research is needed to study behavioral and biological mechanisms underlying the intervention effect and patient factors that may affect engagement with and response to the intervention as well as system and provider factors that may enable or hinder implementation of the intervention. More data in these regards are needed to make the intervention more effective, better tailored to diverse patient populations, and easier to adopt into routine clinical practice.

MedicalResearch.com: Is there anything else you would like to add?

Response: This research was supported by the National Heart, Lung, And Blood Institute of the National Institutes of Health under Award Number R01HL119453. The authors have no relevant conflicts of financial interest to disclose. 

Citation:

Ma J, Rosas LG, Lv N, et al. Effect of Integrated Behavioral Weight Loss Treatment and Problem-Solving Therapy on Body Mass Index and Depressive Symptoms Among Patients With Obesity and DepressionThe RAINBOW Randomized Clinical TrialJAMA. 2019;321(9):869–879. doi:10.1001/jama.2019.0557

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