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

Matthew Owens*, Ed Watkins, Mariska Bot, Ingeborg A. Brouwer, Miquel Roca, Elisabeth Kohls, Brenda W. J. H. Penninx, Gerard van Grootheest, Ulrich Hegerl, Margalida Gili, Marjolein Visser

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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.
Original languageEnglish
Pages (from-to)649-665
Number of pages17
JournalClinical Psychological Science
Issue number4
Early online date2021
Publication statusPublished - Jul 2021

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