Treatment for Depressed, Obese Individuals at Risk for Cardiovascular Disease (CVD)

Inclusion Criteria * Female and male participants, with a BMI of 27 kg/m2 to 45 kg/m2 * Age 18 - 70 years old * Presence of current major depressive disorder or dysthymic disorder * At least 2 CVD risk factors, as characterized by the metabolic syndrome, including: * Elevated waist circumference (males 40 inches or 102 cm; females 35 inches of 88 cm) * Fasting blood glucose 100 mg/dL * Blood pressure 130/85 mm Hg * Triglycerides 150 mg/dL * Reduced HDL cholesterol (males 40 mg/dL; females 50 mg/dL) * OR medications for these conditions * Able to comply will all study procedures and schedule * Able to speak and read English Exclusion Criteria * Cardiovascular event (e.g., myocardial infarction, stroke) within the past 12 months * Use of tricyclic anti-depressants, monoamine oxidase inhibitors or paroxetine, mood stabilizers, or antipsychotic medications. (Note: participants who take SSRI/SNRI may be acceptable, provided they have been on a stable dose of these medications 3 months.) * Use of weight-loss medications or any medications known to significantly affect weight (e.g., oral steroids) in past 3 months * Weight loss of 5% or more in past 6 months * Enrollment in weight reduction program in prior 3 months * Treatment in individual psychotherapy for any psychiatric disorder in prior 3 months (Note: participants in couples or family counseling will be allowed.) * Severe depression or severe impairment of functioning as judged by the assessor or PI * Presence of active suicidal ideation * Diabetes * Alcohol/drug abuse/dependence * Renal/hepatic disease * Change in thyroid medications in last 3 months * Pregnant/lactating, within 6-months post-partum * Current diagnoses, or history within the last 5 years, of anorexia or bulimia * Psychotic symptoms or hospitalization for a psychiatric disorder in previous 12 months * Mood disorder NOS, substance-induced mood disorders, mood disorders due to a general medical condition * History of bipolar disorder * History of head trauma * Any changes in smoking behavior in prior 3 months (or plans to change in the next 3 months) * Plans for bariatric surgery * Any other uncontrolled major medical problems * Women who are pregnant