Carson Tiffany L, Jackson Bradford E, Nolan Timiya S, Williams Angela, Baskin Monica L
School of Medicine, Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South MT 639, Birmingham, AL, 35294-4410, USA.
Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
Transl Behav Med. 2017 Jun;7(2):320-329. doi: 10.1007/s13142-016-0452-2.
Depression and stress have been associated with less weight loss among some participants in behavioral weight loss (BWL) programs. The purpose of this study was to (1) measure the levels of depression and stress among a sample of black women living in rural Alabama and Mississippi who were participating in a BWL program and (2) examine the association between these psychosocial variables and weight loss outcomes of participants at 6 months. Overweight and obese black women in a BWL program (n = 409) completed validated surveys to measure depression and stress at baseline and 6 months. Weight and height were also measured at baseline and 6 months. Statistical tests were conducted to examine associations between depression, stress, and weight loss. Mean BMI at baseline was 38.68 kg/m. Participants achieved a 1.17 kg/m reduction in BMI at 6 months. When comparing by baseline depression or stress categories, no significant differences in weight loss outcomes were observed. Analysis of continuous data revealed a significant correlation between baseline depression score and change in BMI. In adjusted models, change in depression score over time was significantly associated with change in weight. No differences in weight loss outcomes at 6 months were observed when comparing participants with and without elevated depressive symptoms or elevated stress at baseline. This suggests that potential participants may not need to be excluded from BWL programs based on pre-specified cut points for these psychological conditions. Greater improvements in depression were associated with better weight loss outcomes suggesting that more emphasis on reducing depression may lead to greater weight losses for black women in BWL programs.
在一些行为减肥（BWL）项目的参与者中，抑郁和压力与体重减轻较少有关。本研究的目的是：（1）测量阿拉巴马州和密西西比州农村地区参与BWL项目的黑人女性样本中的抑郁和压力水平；（2）研究这些社会心理变量与参与者6个月时体重减轻结果之间的关联。参与BWL项目的超重和肥胖黑人女性（n = 409）在基线和6个月时完成了经过验证的调查，以测量抑郁和压力。在基线和6个月时还测量了体重和身高。进行了统计测试，以检验抑郁、压力与体重减轻之间的关联。基线时的平均BMI为38.68kg/m²。参与者在6个月时BMI降低了1.17kg/m²。按基线抑郁或压力类别进行比较时，未观察到体重减轻结果的显著差异。对连续数据的分析显示，基线抑郁评分与BMI变化之间存在显著相关性。在调整模型中，抑郁评分随时间的变化与体重变化显著相关。比较基线时有和没有抑郁症状升高或压力升高的参与者时，未观察到6个月时体重减轻结果的差异。这表明，潜在参与者可能无需根据这些心理状况的预先设定切点被排除在BWL项目之外。抑郁状况的更大改善与更好的体重减轻结果相关，这表明更多地强调减轻抑郁可能会使BWL项目中的黑人女性体重减轻更多。
