Document Type
DNP Project
Publication Date
3-2025
Degree Name
Doctor of Nursing Practice
Faculty Advisor
Rosemary A. Johnson, DNP, APRN, ANP-BC
Practice Mentor
Kristen Campos, MSN, FNP
Abstract
Obesity is a growing, multifactorial epidemic. The CDC recommends a 5% weight reduction in order to prevent potential complications associated with overweight or obese status. Mental health, particularly depression, contributes to weight issues with obese individuals having an 18% greater risk of depression, and those with depression having a 37% greater risk of obesity. Both conditions may increase the risk of cardiovascular disease and mortality. Evidence suggests screening and managing depression in overweight/obese patient may lead weight loss and better health outcomes in this patient population.
Project Goals
- To improve weight loss outcomes in obese or overweight patients with a current target goal to obtain 1-2% monthly decrease in body weight for those who receive medical weight loss and mental health treatment over the course of 2 months.
- To implement a formal depression screening protocol at practice site and ensure adherence to protocol via weekly on-site chart audits.
- To establish the number of obese or overweight patients with depression (PHQ-9 Score >5) and compare weight loss of those who obtained referral and/or treatment for depression over 2 months.
Methods
BMI and PHQ-9 screening were collected at the initial visit. Participants who presented as overweight or obese received BMI screening at each monthly visit for 2 months thereafter to assess for change in BMI and analyze current treatments for weight loss and mental health.
Results
Thirty-three participants were included in this project. With implementation of PHQ-9 screening, 10 participants were found to have minimal depression, 8 with mild depression, and 1 with moderate-severe depression. Individuals with mild to moderate-severe depression scores (PHQ-9: 5-10+) had greater fluctuation in BMI than those with minimal depression (PHQ-9: 0-2). Men on average had a lower PHQ-9 score yet had greater weight loss percentages when compared to women. Results revealed an overall average of 1.39% (SD 3.29) BMI reduction at the second follow-up (week 4), and an overall 1.93% (SD 3.76) reduction at the final follow-up. Those who received mental health therapy referrals did not achieve weight loss goals (average of -0.79% [SD 3.48] reduction) as anticipated. However, the average PHQ-9 scores of those referred to therapy was 6.2 (SD 5.12) which was higher than the overall average of 3.67 (SD 3.92) which may have impeded weight loss progression. Lastly, this project accomplished the goal of implementing a formal depression screening protocol within this site though this was only noted after completion of the implementation phase.
Conclusion
The data suggests that mental health and weight loss treatment applied concurrently result in greater weight loss outcomes than alone. This supports the idea that weight loss is multifactorial as adherence, lifestyle or baseline characteristics play a significant role which may also be resulting in the variance in weight loss outcomes seen in those suffering from depression. Future studies may further analyze treatment type, physical activity, or dietary changes.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.
Recommended Citation
Ivos, A. (2025). Mental health screening and its effects on obese and overweight patients: Quality improvement project [Unpublish DNP project]. Sacred Heart University.
Comments
A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.