CPCP: Depression and Obesity by Medical Student Amy Walz

Amy Walz M3

Amy Walz M3

So today we have a killer Clinical Problems in Consultation Psychiatry (CPCP) presentation by 3rd year medical student Amy Walz who is interested in eventually doing her residency in Pediatrics (which may explain some of the baby pictures in the slide set). Amy was curious about the literature about weight gain in patients with depression and any associations between antidepressant use and obesity. There’s a lot of statistics, hence the title “Depression and Obesity by the Numbers.”

I think the main idea we came away with was the importance of having thorough informed consent discussions with our patients about the adverse effects of antidepressants. Given the psychological (self esteem and so on) and physiological heartaches (because of the cardiovascular consequences of obesity) that weight gain has for most people, sitting down and explaining the risks, even if they may seem small to us as doctors, means a lot to patients.

In order to see the picture galleries of photos or powerpoint slides, click on one of the slides, which will open up the presentation to fill the screen. Use the arrow buttons to scroll left and right through the slides or up and down to view any annotations.

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Comments

  1. Excellent work is being done on this issue with Bipolar Disorder by Roger McIntyre, MD. At the UW Update this year he disclosed many research findings about bipolar disorder, obesity, migraine headaches, cognitive dysfunction and metabolic syndrome. His research was some of the most interesting I have seen in this area:

    http://real-psychiatry.blogspot.com/2014/10/university-of-wisconsin-2nd-annual.html

    Liked by 1 person

    • Thanks, George; I’ll pass this on to Amy, too!

      For readers, George is also referring to:

      Lin, C. H., et al. (2014). “Both body weight and BMI predicts improvement in symptom and functioning for patients with major depressive disorder.” J Affect Disord 161: 123-126.
      BACKGROUND: Obesity has shown a positive association with depression. We aimed to investigate the relationships among body weight, body mass index (BMI=kg/m(2)), change in a depression rating scale, and change in a functional scale with fluoxetine treatment for hospitalized patients with major depressive disorder (MDD). METHODS: A total of 131 acutely ill inpatients with MDD were enrolled to receive 20mg of fluoxetine daily for 6 weeks. The 17-item Hamilton Depression Rating Scale (HAMD-17) for symptom and the Work and Social Adjustment Scale (WSAS) for functioning were assessed at weeks 0, 1, 2, 3, 4, and 6. Remission was defined as a score of</=7 on the HAMD-17 at endpoint. Body weight, body length, and BMI were measured at baseline. Pearson correlation coefficients (r) were calculated among body weight, BMI, HAMD-17 score change, and WSAS score change. RESULTS: Of the 131 participants, 126 (96.2%) had at least one post-baseline assessment and were included in the analysis. Significant differences in body weight and BMI existed between remitters and nonremitters. There were statistically significant relationships among baseline body weight, baseline BMI, HAMD-17 score change, and WSAS score change at end point. LIMITATIONS: This is a short-term trial with relatively small sample size. CONCLUSIONS: Nonremitters had greater body weight and BMI before treatment. Increased body weight and BMI is correlated with the decreased improvement in symptom and functioning at end point. Depression and obesity should be treated concurrently to optimize clinical outcomes for the treatment of depression.

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