Longitudinal Effects of Supported Exercise on Elevated Anxiety and Depression Scores in Formerly Sedentary Adults With Severe Obesity

Abstract

Persistent anxiety and depression may be particularly high in individuals with obesity. Increasing exercise reliably improves mood in the general population; however, it has rarely been tested specifically in adults with severe obesity. Volunteer participants (60% women) of a theory-based cognitive-behavioral weight-management treatment with severe obesity and elevated (highest 10% based on normative values) depression (N = 89) or anxiety (N = 60) were assessed at baseline and Month 6 on measures of exercise output (overall, and whether the equivalent of three moderate sessions/week [i.e., ≥ 15 METs/week] were completed), corresponding mood, and exercise barriers self-efficacy. There were significant improvements (large effect sizes) in exercise outputs and mood. Increase in exercise outputs was significantly associated with reduced depression (β = −.52) and anxiety (β = −.67) scores. At least 15 METs/week of exercise was reached by 61% and 60% of participants, respectively. Participants demonstrated significantly greater reductions in depression and anxiety scores over 6 months than those completing lower amounts. Change in exercise barriers self-efficacy significantly mediated the following: (a) the prediction of depression change by change in exercise output and (b) the prediction of change in anxiety by completion/non-completion of ≥ 15 METs/week of exercise. Findings suggest substantial benefits for depression and anxiety in adults with severe obesity under conditions of moderate exercise supported by a community-based cognitive-behavioral treatment. Because of its identified mediation properties, future behavioral treatments should seek to increase barriers self-efficacy to maximize effects on elevated depression and anxiety and possibly weight.