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

Briana Applewhite, Brenda W.J.H. Penninx, Allan H. Young, Ulrike Schmidt, Hubertus Himmerich, Johanna L. Keeler*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background Individuals with overweight or obesity are at a high risk for so-called 'atypical' or immunometabolic depression, with associated neurovegetative symptoms including overeating, fatigue, weight gain, and a poor metabolic profile evidenced e.g. by dyslipidemia or hyperglycemia. Research has generated preliminary evidence for a low-calorie diet (LCD) in reducing depressive symptoms. The aim of the current systematic review and meta-analysis is to examine this evidence to determine whether a LCD reduces depressive symptoms in people with overweight or obesity. Methods Eligible studies were identified through PubMed, ISI Web of Science, and PsycINFO until August 2023. Standardized mean differences (SMDs) were derived using random-effects meta-analyses for (1) pre-post LCD comparisons of depression outcomes, and (2) LCD v. no-diet-control group comparisons of depression outcomes. Results A total of 25 studies were included in the pre-post meta-analysis, finding that depression scores were significantly lower following a LCD (SMD = -0.47), which was not significantly moderated by the addition of exercise or behavioral therapy as a non-diet adjunct. Meta-regressions indicated that a higher baseline BMI and greater weight reduction were associated with a greater reduction in depression scores. The intervention-control meta-analysis (n = 4) found that overweight or obese participants adhering to a LCD showed a nominally lower depression score compared with those given no intervention (SMD = -0.29). Conclusions There is evidence that LCDs may reduce depressive symptoms in people with overweight or obesity in the short term. Future well-controlled intervention studies, including a non-active control group, and longer-term follow-ups, are warranted in order to make more definitive conclusions.

Original languageEnglish
JournalPsychological Medicine
Early online date12 Dec 2023
DOIs
Publication statusE-pub ahead of print - 12 Dec 2023

Keywords

  • depression
  • diet
  • low-calorie diet
  • obesity
  • overweight

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