ASPO Abstracts
Sex, Social Support, Depressive Symptoms, and Intervention Effect on Weight Loss among Overweight Appalachian Adults
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2020
Abstract Body:
Purpose: The primary outcome of a previous weight loss trial found that the intervention effect differed by sex. We
aimed to determine whether the difference in intervention effect on weight loss between males and females varied
by social support or depressive symptoms.
Methods: Secondary data analysis was conducted using a group-randomized trial that compared a 1-year faith-
based weight loss intervention (WbF) to an active control group (RoF) among overweight Appalachian adults. Self-
reported social support and depressive symptoms were classified as moderate vs. high and low vs. high,
respectively. At baseline and 12-months, weight was measured by research staff using a standard protocol; total
METs/hr/week of physical activity and total kcal/week were calculated from self-reported surveys. Mixed effect
models were used to account for the group-randomized design.
Results: Among the 472 participants who had complete data (WbF=287, RoF=185), 132 (28%) were males and
340 (72%) were females. High social support (91% vs. 89%) and high depressive symptoms (10.6% vs. 12.1%)
did not differ by sex, respectively. Difference in weight loss between males and females did not vary by social
support but varied by depressive symptoms without statistical significance. Among low depressive symptom
participants, the intervention effect on weight was -2.89 kg (95% CI: -4.86, -0.92) in males and -0.33 kg (95% CI:
-1.80, 1.14) in females; among high depressive symptom participants, the intervention effect on weight was +1.05
kg (95% CI: -4.10, 6.21) in males and -1.06 kg (95% CI: -4.26, 2.13) in females. When we further investigated the
difference between males and females by depressive symptoms, we found that among those with low depressive
symptoms, compared to females, males had similar total calorie reduction (diff=-1.98 kcal/week) but greater
increase in physical activity (diff=316.51 MET/hr/week). However, among those with high depressive symptoms,
compared to females, males had higher total calorie increase (diff=74.43 kcal/week) and greater physical activity
reduction (diff=1114.09 MET/hr/week).
Conclusions: Strategies to address depressive symptoms are needed to improve adherence and efficacy of weight
loss interventions among Appalachian adults, especially for males.
Keywords: lifestyle intervention;sex difference; depressive symptoms; weight loss