Plain language summary
Anxiety and depression are among the most common mental health problems and are associated with obesity and other chronic illnesses. The number of these disorders has not been reduced despite the increased use of cognitive behavioural therapy and pharmacotherapy. Current evidence suggests diet quality as a modifiable risk factor for mental illnesses. Additional studies are required to investigate the effect of dietary patterns as well as weight loss on improving symptoms. The first aim of this study was to investigate the effect of weight loss on overweight and obese patients, using two calorie-restricted diets, on anxiety and depression symptoms. The second aim was to analyse the role of the baseline psychological features in predicting future weight loss. The study was a randomized, longitudinal, and controlled intervention trial which lasted for 16 weeks. The study indicates that weight loss via calorie-controlled diets could improve depression symptoms in obese and overweight patients. Participants that lost more weight showed a larger amelioration in depression symptoms. The study also suggests that greater anxiety symptoms at the beginning of the intervention could predict a higher weight loss. These results, in addition to the positive effect on body composition, show that weight loss could become part of a health improvement plan.
Abstract
Current evidence proposes diet quality as a modifiable risk factor for mental or emotional impairments. However, additional studies are required to investigate the effect of dietary patterns and weight loss on improving psychological symptoms. The aim of this investigation was to evaluate the effect of energy-restriction, prescribed to overweight and obese participants, on anxiety and depression symptoms, as well as the potential predictive value of some baseline psychological features on weight loss. Overweight and obese participants (n = 305) were randomly assigned for 16 weeks to two hypocaloric diets with different macronutrient distribution: a moderately high-protein (MHP) diet and a low-fat (LF) diet. Anthropometrical, clinical, psychological, and lifestyle characteristics were assessed at baseline and at the end of the intervention. The nutritional intervention evidenced that weight loss has a beneficial effect on trait anxiety score in women (β = 0.24, p = 0.03), depression score in all population (β = 0.15, p = 0.02), particularly in women (β = 0.22, p = 0.03) and in subjects who followed the LF diet (β = 0.22, p = 0.04). Moreover, weight loss could be predicted by anxiety status at baseline, mainly in women and in those who were prescribed a LF diet. This trial suggests that weight loss triggers an improvement in psychological traits, and that anxiety symptoms could predict those volunteers that benefit most from a balanced calorie-restricted intervention, which will contribute to individualized precision nutrition.
Methodological quality
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