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« Thread started on: May 8th, 2007, 3:24pm »

Depressive Symptoms Not Linked With Self-Monitoring of Body Weight in Obese Women CME
News Author: Laurie Barclay, MD
CME Author: Charles Vega, MD

Release Date: May 1, 2007; Valid for credit through May 1, 2008 Credits Available

Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s) for physicians;
Family Physicians - up to 0.25 AAFP Prescribed credit(s) for physicians

May 1, 2007 Depressive symptoms are not associated with self-monitoring of body weight in obese women, according to the results of a study published in the April issue of Preventive Medicine.

"Research suggests that overweight and obesity are associated with depressive symptoms, particularly among women," write Jennifer A. Linde, PhD, from the University of Minnesota in Minneapolis, and colleagues. "Evidence from weight control trials suggests that higher weighing frequency is associated with greater weight loss or less weight gain. As limited data exist on the effects of self-weighing on body mass index (BMI) among overweight adults with or without depression, this study seeks to examine this issue using data from a population-based epidemiologic survey."

The authors used data from a large population-based cohort of 4655 women aged 40 to 65 years in the greater Seattle, Washington, area who were surveyed from November 2003 to February 2005. Sample-weighted regression models allowed evaluation of the associations of depression, self-weighing frequency, and BMI with demographic factors (race/ethnicity, employment status, smoking status, age, martial status, and educational attainment).

Higher self-weighing frequency and lack of depression status were independently associated with lower BMI, with no interaction observed between depression and self-weighing.

"Frequent self-weighing appears to be associated with lower BMI in both depressed and nondepressed overweight women," the authors write.

Study limitations include reliance on self-report for body weights and self-weighing frequencies and lack of generalizability to the broader US or global populations.

"Results from this study suggest that, after adjusting for BMI, there is no significant association between depressed mood and self-monitoring of body weight in a community-based sample of adult women," the authors conclude. "Given that obesity and depression are positively associated and that self-weighing protects against weight gain, the possibility that frequent weighing among those interested in weight control might improve mood as it improves weight should be explored. Future studies should examine the causal links between depression or related cognitive factors and the effectiveness of frequent self-weighing during weight control."

The National Institute of Mental Health supported this study.

Prev Med. 2007;00:000-000.

Clinical Context
It has been estimated that 32% of US adults are obese, and multiple factors can contribute to an individual's propensity toward obesity. Previous research has linked depression with a higher risk for obesity, particularly among women. At the same time, more frequent self-monitoring of weight is associated with a reduced trend toward obesity.

Despite the evidence that frequent self-monitoring of weight may reduce the risk for obesity, some healthcare professionals recommend against checking weight more often than once weekly among patients with depression. This is because of concern about possible psychological harm associated with a lack of progress in achieving weight goals. To explore this issue, the current study examines a cohort of women to determine the relationship between BMI, depression, and self-assessment of weight.

Study Highlights
Women between the ages of 40 and 65 years and who belonged to 1 large group-model health plan in Seattle, Washington, were eligible for study participation. 8000 women were invited to participate in a telephone interview to gather study data.
Participants were asked how frequently they weighed themselves, and the presence of depression was assessed by self-report of previous diagnosis as well as screening with the Patient Health Questionnaire. Data on BMI were available from self-assessment forms mailed to most health plan participants, and an independent review of these data suggested that it correlated well with clinical measurements.
4660 women completed the telephone survey. Women who refused to participate in the study were slightly younger and had a lower average BMI vs participants.
The mean age of subjects was 52.1 years, and the mean BMI was 28.3 kg/m2. 82.4% of the cohort were white.
Rates of subjects reporting never weighing themselves and weighing themselves monthly, weekly, and daily were 37%, 27%, 24%, and 12%, respectively. 5.1% of the cohort reported current major depression, and screening found another 7.8% of the group with moderate depression.
After regression analysis, depression was positively related to increasing BMI, while self-weighing frequency was negatively associated with BMI.
There was no significant relationship between depression and self-weighing behavior.
Pearls for Practice
Previous research has found that depression can increase the risk for obesity, but frequent self-monitoring of weight reduces this risk. There is some concern that frequent weighing among patients with depression may be associated with psychological damage if there is a lack of progress in achieving weight goals.
The current study suggests that frequent self-monitoring of weight may reduce BMI among depressed and nondepressed women.

1. Based on previous research, which of the following statements regarding trends in obesity in the United States is least accurate? (Required for credit)
The prevalence of obesity in the United States is 32%
Depression increases the risk for obesity
Frequent weight monitoring has no impact on the risk for obesity
There is concern that frequent weight monitoring may result in psychological damage among patients with depression

2. What is the main conclusion of the current study regarding the interactions between self-monitoring of weight, depression, and BMI among women? (Required for credit)
Self-weighing has no effect on BMI
Depression is more severe among women who weigh themselves frequently
Women who frequently weigh themselves have lower rates of depression
Frequent self-monitoring of weight may reduce BMI among depressed and nondepressed women

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