Few Patients Are Treated for Both Obesity and Depression.

Abstract

Objectives: Understanding the epidemiology of treatment for patients with co-occurring depression and obesity can inform care quality. The objective of the study was to identify how patients with obesity and newly diagnosed depression are treated and whether treatment is associated with body mass index change.

Methods: This cohort study included adults with obesity and newly diagnosed depression who had ≥2 primary care visits between 2015 and 2020 at a large integrated health system. Treatment within 45 days of a depression diagnosis was identified, including antiobesity medication and group or individual weight management visits (eg, bariatric medicine); antidepressant prescriptions; or visits with a psychologist, social worker, or psychiatrist. Patients were grouped into treatment groups: none, depression only, weight management only, or both. Generalized structural equation models were used to identify the association between treatment group and body mass index change at 6 and 12 months, accounting for demographic and health characteristics as fixed variables and clinician identifier as a random variable.

Results: Of the 13,729 adults, 43% received depression treatment, 3% received weight management treatment, and 4% received both. Individuals who received weight management treatment only lost more weight at 6 months (β = -1.0 kg/m²) and 12 months (β = -1.07 kg/m²) than individuals with no treatment. Individuals who had both treatments lost more weight than individuals with depression treatment alone (6 months: β = -1.07 kg/m²; 12 months: β = -1.21 kg/m²) and underwent a similar average change than those who received weight management treatment alone (P > 0.05).

Conclusions: There is an opportunity to increase treatment for obesity among patients with newly diagnosed depression.