Habitual Behavior as a Mediator Between Food-Related Behavioral Activation and Change in Symptoms of Depression in the MooDFOOD Trial

Abstract

In this study, we tested potential mediators that may explain change in depressive symptoms following exposure to a food-related behavioral activation intervention (F-BA). These included behavioral activation, avoidance and rumination, eating styles, body mass index, and dietary behavior at baseline and 3-month and 12-month follow-up. The trial used a community sample of 1,025 overweight adults with elevated depressive symptoms without current major depression. Participants were randomly assigned to one of four trial arms: either daily nutritional supplements (vs. placebo) alone or in combination with F-BA (vs. no F-BA) over 12 months. Although F-BA did not significantly reduce depressive symptoms (standardized regression coefficient [ b] = −0.223, SE = 0.129; p = .084), significant mediators included emotional eating ( b = −0.028, SE = 0.014; p = .042) and uncontrolled eating ( b = −0.039, SE = 0.016; p = .013), suggesting that learning adaptive responses to emotional and food cues may underlie effects of F-BA on depressive symptoms.