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Xu H, Zhang Z, Wang Y. Weight loss methods and risk of depression: Evidence from the NHANES 2005-2018 cohort. J Affect Disord 2025; 380:756-766. [PMID: 40185413 DOI: 10.1016/j.jad.2025.03.199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2024] [Revised: 03/12/2025] [Accepted: 03/31/2025] [Indexed: 04/07/2025]
Abstract
BACKGROUND Weight loss behaviors are increasingly common worldwide. While healthy weight loss methods, such as calorie control and exercise, can improve both physical and mental health, harmful practices-such as extreme dieting and the misuse of diet pills-may contribute to depressive symptoms. Understanding the psychological impact of different weight loss strategies is essential for promoting overall well-being. METHODOLOGY Data from 9334 non-pregnant participants aged 20-79 years from the 2005-2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. The sample consisted of 60.72 % women and 39.28 % men, with a median age of 47 years and a median BMI of 28.84. Depressive symptoms were assessed using the PHQ-9 scale. Weight loss methods were categorized into healthy practices (e.g., calorie control, exercise) and harmful practices (e.g., extreme dieting, diet pills). Logistic regression models were applied, adjusting for demographic and health factors. RESULTS Protective methods, including switching to lower-calorie foods (OR = 0.80, 95 % CI = 0.68-0.94), exercising (OR = 0.61, 95 % CI = 0.53-0.72), and eating more fruits and vegetables (OR = 0.78, 95 % CI = 0.66-0.92), were associated with a reduction in depressive symptoms. In contrast, harmful methods such as skipping meals (OR = 1.71, 95 % CI = 1.45-2.02), using diet pills (OR = 1.90, 95 % CI = 1.34-2.69), and vomiting (OR = 2.61, 95 % CI = 1.62-4.21) increased the risk of depressive symptoms. The number of harmful methods was positively correlated with increased depressive symptom risk (OR = 2.72, 95 % CI = 2.09-3.54), while a higher number of protective methods was linked to a decreased risk (OR = 0.50, 95 % CI = 0.37-0.68). CONCLUSION The emotional impact of weight loss practices is significant. Healthy weight loss strategies, such as exercise and calorie control, reduce the risk of depressive symptoms, whereas harmful methods increase the risk. These findings underscore the importance of promoting safe and sustainable weight loss methods to protect both physical and mental health.
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Affiliation(s)
- Huijie Xu
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China; School of Education, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Zheng Zhang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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Himmerich H. [Glucagon-like peptide-1 receptor agonists: a new pharmacological treatment option for psychiatric illnesses?]. DER NERVENARZT 2025; 96:247-254. [PMID: 40042613 PMCID: PMC12058874 DOI: 10.1007/s00115-025-01813-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/31/2025] [Indexed: 05/08/2025]
Abstract
Albiglutide, dulaglutide, exenatide, liraglutide, lixisenatide, orforglipron and semaglutide are glucagon-like peptide‑1 (GLP-1) receptor agonists. Tirzepatide targets not only GLP‑1 but also glucose-dependent insulinotropic peptide (GIP) receptors and retatrutide is a triple GLP‑1, GIP and glucagon receptor agonist. The GLP‑1 receptor agonists increase insulin release but suppress glucagon release. They slow down the emptying of the stomach and thus prevent blood sugar spikes. They reduce appetite and food intake. In the brain GLP‑1 receptor agonists lead to a better glycemic control and they appear to have anti-inflammatory and neuroprotective effects. It has been reported that GLP‑1 receptor agonists reduce oxidative stress and apoptosis, lower the risk of ischemia and promote neurogenesis. The GLP‑1 receptor agonists can also influence dopaminergic signal transduction in the nucleus accumbens. Therefore, they could modify the effect of cocaine, alcohol and nicotine. Preliminary investigations provide indications of the therapeutic benefits of GLP‑1 receptor agonists for people with dementia, eating disorders, psychopharmacologically induced weight gain, depression, anxiety and substance use disorders. Typical accompanying adverse reactions are gastrointestinal side effects, such as nausea, vomiting, diarrhea, eructation and gastroesophageal reflux. More severe side effects include pancreatitis, allergic reactions, renal function disorders and possibly an increased risk of thyroid cancer.
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Affiliation(s)
- Hubertus Himmerich
- Centre for Research in Eating and Weight Disorders (CREW), Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, SE5 8AB, London, Großbritannien.
- South London and Maudsley NHS Foundation Trust, London, Großbritannien.
- Klinik für Psychiatrie, Psychotherapie und Psychotraumatologie, Bundeswehrkrankenhaus Berlin, Berlin, Deutschland.
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García-Gorrita C, Soriano JM, Merino-Torres JF, San Onofre N. Anthropometric Trajectories and Dietary Compliance During a Personalized Ketogenic Program. Nutrients 2025; 17:1475. [PMID: 40362784 PMCID: PMC12073587 DOI: 10.3390/nu17091475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2025] [Revised: 04/22/2025] [Accepted: 04/24/2025] [Indexed: 05/15/2025] Open
Abstract
BACKGROUND/OBJECTIVES Ketogenic diets (KDs) have gained attention for their potential to promote weight loss and metabolic improvements. However, data on long-term body composition changes and adherence rates in real-world settings remain limited. OBJECTIVE This study aimed to assess the effects of a personalized ketogenic dietary program on anthropometric parameters over a 9-month period and to evaluate adherence across time. METHODS A total of 491 adults participated in a longitudinal intervention involving a structured ketogenic nutrition plan with follow-up at 3, 6, and 9 months. Body weight, fat mass (FM), skeletal muscle mass (SMM), and other composition metrics were measured at each visit. RESULTS Significant reductions in body weight (-12.6 kg) and fat mass (-10.3 kg) were observed after 3 months (p < 0.001), with minimal changes at 6 months and partial regain by Month 9. SMM remained relatively stable throughout the study. Retention dropped substantially after 3 months, dropping from 487 to 115 participants at Month 6 and 41 at Month 9. Despite this, participants who completed the program maintained significant anthropometric improvements. CONCLUSIONS A well-formulated ketogenic diet may promote rapid fat loss while preserving lean mass in the short term. However, long-term adherence poses significant challenges. Strategies to enhance dietary sustainability and retention are essential for maximizing the benefits of KDs in clinical practice.
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Affiliation(s)
- Cayetano García-Gorrita
- Food & Health Lab, Institute of Materials Science, University of Valencia, 46980 Paterna, Spain;
| | - Jose M. Soriano
- Food & Health Lab, Institute of Materials Science, University of Valencia, 46980 Paterna, Spain;
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, 46026 Valencia, Spain;
| | - Juan F. Merino-Torres
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, 46026 Valencia, Spain;
- Department of Medicine, Faculty of Medicine, University of Valencia, 46010 Valencia, Spain
- Department of Endocrinology and Nutrition, University and Polytechnic Hospital La Fe, 46026 Valencia, Spain
| | - Nadia San Onofre
- NUTRALiSS Research Group, Faculty of Health Sciences, Universitat Oberta de Catalunya, Rambla del Poblenou 156, 08018 Barcelona, Spain;
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Sarmiento-Riveros A, Aguilar-Cordero MJ, Barahona-Barahona JA, Galindo GE, Carvallo C, Crespo FA, Burgos H. Child and Adolescent Health Programs in Obesity and Depression: A Systematic Review and Meta-Analysis. Nutrients 2025; 17:1088. [PMID: 40292529 PMCID: PMC11944606 DOI: 10.3390/nu17061088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2025] [Revised: 02/25/2025] [Accepted: 02/28/2025] [Indexed: 04/30/2025] Open
Abstract
Obesity and depression are public health issues of increasing concern worldwide. This study aims to evaluate programs that address obesity and their impact on depressive symptoms in children and adolescents. Obesity and depression share a bidirectional relationship, where each can serve as both a cause and a consequence of the other. METHODS A systematic review and meta-analysis were conducted following PRISMA criteria, with the registration recorded under PROSPERO code (CRD42024550644). The selected publications report on intervention programs for obesity and depression in children and adolescents aged 6 to 18 years. The selection was from databases including PUBMED, SCOPUS, LILACS, COCHRANE, WOS, SciELO, and ScienceDirect, using PICOS criteria to define inclusion. ROB-2 and ROBINS-1 were applied to assess bias. RESULTS Out of 3376 articles reviewed, eight met the inclusion criteria, some including several programs. These programs varied in duration and type, demonstrating changes in reducing Body Mass Index (BMI) and depressive symptoms. However, evidence supporting the effectiveness of programs that address both conditions is limited, particularly in developing countries. Additionally, the results exhibit high heterogeneity due to the diversity of evaluation criteria and methodological approaches, highlighting considerable risks of bias. CONCLUSIONS Intervention programs for obesity management show statistically significant effects on depressive symptoms, although there is heterogeneity in the designs for their standardization and long-term follow-up strategies; however, the evaluations consider DSM-5 and ICD-11 criteria, which contributes to homogeneity. It is vital to address these closely related issues from a multidimensional perspective, considering socio-emotional and psychological factors, and to promote early intervention to maximize effectiveness and enhance quality of life at various stages of development.
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Affiliation(s)
- Ana Sarmiento-Riveros
- Facultad de Salud, Escuela de Enfermería, Universidad Santo Tomás, Santiago 8370003, Chile; (A.S.-R.); (J.A.B.-B.)
| | - María José Aguilar-Cordero
- CTS-367, Andalusian Plan for Research, Development and Innovation, University of Granada, 18071 Granada, Spain;
| | - Juan A. Barahona-Barahona
- Facultad de Salud, Escuela de Enfermería, Universidad Santo Tomás, Santiago 8370003, Chile; (A.S.-R.); (J.A.B.-B.)
| | - Gabriel E. Galindo
- Centro de Investigación e Innovación en Gerontología Aplicada CIGAP, Facultad de Salud, Universidad Santo Tomás, Santiago 8370003, Chile (C.C.)
| | - Claudia Carvallo
- Centro de Investigación e Innovación en Gerontología Aplicada CIGAP, Facultad de Salud, Universidad Santo Tomás, Santiago 8370003, Chile (C.C.)
| | - Fernando A. Crespo
- Facultad de Economía y Negocios, Universidad Alberto Hurtado, Erasmo Escala 1835, Santiago 8340539, Chile;
| | - Héctor Burgos
- Facultad de Salud, Escuela de Enfermería, Universidad Santo Tomás, Santiago 8370003, Chile; (A.S.-R.); (J.A.B.-B.)
- Centro de Investigación e Innovación en Gerontología Aplicada CIGAP, Facultad de Salud, Universidad Santo Tomás, Santiago 8370003, Chile (C.C.)
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Applewhite B, Penninx BWJH, Young AH, Schmidt U, Himmerich H, Keeler JL. The effect of a low-calorie diet on depressive symptoms in individuals with overweight or obesity: a systematic review and meta-analysis of interventional studies - ADDENDUM. Psychol Med 2024; 54:1886. [PMID: 38248138 DOI: 10.1017/s0033291724000163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
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Jakubowska P, Balcerczyk-Lis M, Fortuna M, Janiak A, Kopaczyńska A, Skwira S, Młynarska E, Rysz J, Franczyk B. Influence of Metabolic Dysregulation in the Management of Depressive Disorder-Narrative Review. Nutrients 2024; 16:1665. [PMID: 38892598 PMCID: PMC11174513 DOI: 10.3390/nu16111665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/16/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
Depressive disorders are heterogeneous in nature, and their global reach makes them the cause of suffering for a million individuals worldwide. Standard treatment does not work for one in three people, and side effects can significantly reduce the quality of life. A multidisciplinary approach allows for a broader insight into the nature of the disease, given its complex etiology. One of its elements is the hypothesis of inflammation, which also accompanies obesity-related disease. Obesity and depression interact, causing many researchers to develop new non-pharmacological treatment methods for both diseases. One suggestion is physical exercises that have great potential to be used in clinical practice. They can exert changes on the central nervous system and thus modulate mood. Another is diet, which concentrates on active molecules that also affect the central nervous system (CNS). There is an urgent need to create appropriate criteria and recommendations that systematize existing knowledge and allow it to be used in practice. There is an urgent need to create appropriate criteria and recommendations that systematize existing knowledge and allow it to be used in practice.
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Affiliation(s)
- Paulina Jakubowska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Marta Balcerczyk-Lis
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Milena Fortuna
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Aleksandra Janiak
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Adrianna Kopaczyńska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Sylwia Skwira
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Ewelina Młynarska
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
| | - Beata Franczyk
- Department of Nephrocardiology, Medical University of Lodz, ul. Zeromskiego 113, 90-549 Lodz, Poland
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Himmerich H, McElroy SL. Glucagon-Like Peptide 1 Receptor Agonists in Psychiatry. J Clin Psychopharmacol 2024; 44:207-210. [PMID: 38635918 DOI: 10.1097/jcp.0000000000001869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
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McElroy SL. Question: What Is the Current State of Evidence Regarding Any Mood-Improving Properties of GLP-1 Receptor Agonists, and Are Psychiatrists Prescribing Them? J Clin Psychopharmacol 2024; 44:332-333. [PMID: 38639431 DOI: 10.1097/jcp.0000000000001867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
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