Clinical management of major depressive disorder with comorbid obesity

Obesity is one of the most prevalent somatic comorbidities in individuals with major depressive disorder and greatly affects the course and prognosis of that disorder. The bidirectional relationship between major depressive disorder and obesity often creates a feedback cycle that challenges both patients and health-care providers. Gaps in interdisciplinary collaboration and limitations in knowledge transfer hinder the effective management of this patient population. This narrative Review synthesises current evidence from obesity and major depressive disorder research, offering a comprehensive risk stratification and monitoring framework that integrates psychological and metabolic parameters to enhance clinical decision making. We examine the latest evidence on pharmacological and psychotherapeutic interventions as well as lifestyle-based strategies-such as exercise, dietary modifications, and weight-loss medications-with the aim of alleviating depressive symptoms while supporting weight management and improving metabolic health. Bariatric surgery, which is a key component in obesity management, is not covered in this Review. Finally, we highlight the crucial need for an integrated, interdisciplinary treatment approach and provide practical guidance for optimising care to improve outcomes for individuals with major depressive disorder and comorbid obesity.