23 September 2019

Childhood weight loss can ease depression

Obesity Paediatrics

A study, recently published in JAMA Pediatrics, found when a children’s weight was managed in a structured fashion by a health professional, there was a low to moderate reduction in symptoms of depression and anxiety.

The findings counter concerns that weight loss programs for under 18-year-olds might increase the risk of affective disorders.
A meta-analysis included 44 studies which reported the treatment of children under the age of 18 for obesity, with a focus on dietary change. The treatment periods were between two weeks and 15 months in length.

Children who had received online weight loss intervention, pharmacotherapy or bariatric surgery were excluded from the study. All children also had their anxiety or depression clinically evaluated at the first treatment intervention and at follow-up appointments.

“The natural trajectory of depressive symptoms from childhood peaks at age 14 to 17 years, followed by a reduction into early adulthood,” the study authors said.

“Even a small reduction during obesity treatment may reduce the susceptibility of worsening symptoms at this vulnerable age, particularly as higher body weight is associated with an increased risk of developing depression.”

Dr Megan Gow, co-author and NMHRC early career research fellow at the University of Sydney Children’s Hospital Westmead clinical school, said improvements were more pronounced in children who continued to see a health professional.

“Interventions that went for a longer time and where the child had more frequent contact with their health professional had greater improvements for both the child’s weight loss and their mental health,” she said.

In addition, nutritional education had a more significant influence on symptoms of depression, when compared to children who were given prescriptive dietary advice.

“Children who were guided to eat more fruit, vegetables and to drink more water tended to have better outcomes than those who were provided with meal plans telling them exactly what they should eat,” Dr Gow said.

But the study authors said there could be a small proportion of young people who were at risk of worsening depression or anxiety with weight loss and may require additional support.

“Treatment of weight concerns should be considered within the treatment plan for young people with depression and obesity,” they concluded.

JAMA Pediatrics, 16 September