Longitudinal associations of depressive and burnout symptoms with eating behavior and physical activity in occupational health clients with obesity.

INTRODUCTION: Depression and occupational burnout are prevalent mental health challenges in working-age populations and are linked to adverse health behaviors, with these concerns particularly relevant among individuals with obesity. Although prior research suggests associations with eating behaviors and physical activity, most studies rely on cross-sectional designs, leaving the temporal and potentially bidirectional relationships between mental health and health behaviors unclear. METHODS: This longitudinal study examined bidirectional associations between depressive and burnout symptoms, eating behavior, and physical activity among occupational health clients with obesity (N = 110; BMI 30-40 kg/m2) participating in a 12-month behavioral intervention. At baseline, the mean age was 50.8 years and mean BMI 34.2 kg/m2; 17% were male and most were white-collar workers. Assessments at baseline, 6, and 12 months included depression (BDI-21), burnout (BBI-15), eating competence (ecSI 2.0), dietary behaviors (TFEQ-R18), and physical activity (BHPAQ). A random-intercept cross-lagged panel model (RI-CLPM) was used to examine within-person longitudinal associations. RESULTS: Higher depressive symptoms predicted subsequent decreases in eating competence and increases in emotional eating, although the depression-emotional eating association was derived from a traditional CLPM rather than an RI-CLPM model due to convergence issues. Elevated burnout symptoms predicted subsequent increases in emotional eating and decreases in physical activity. In addition, emotional eating predicted later burnout symptoms. No longitudinal associations were observed between depression and physical activity, or between depression or burnout and uncontrolled eating. DISCUSSION: Elevated depressive and burnout symptoms may predispose individuals to less healthy behaviors, potentially limiting the effectiveness of health interventions. These findings highlight the interplay between mental health, eating, and physical activity, suggesting that addressing psychological distress in behavior change programs may improve outcomes for individuals with elevated depression and burnout. CLINICAL TRIALS: gov NCT04785586; RR2-10.1016/j.conctc.2020.100638.