title: Depression as a predictor of weight regain among successful weight losers in the diabetes prevention program.
abstract: OBJECTIVE
  To determine whether depression symptoms or antidepressant medication use predicts weight regain in overweight individuals with impaired glucose tolerance (IGT) who are successful with initial weight loss.
  
  
  METHODS
  A total of 1,442 participants who successfully lost at least 3% of their baseline body weight after 12 months of participation in the randomized controlled Diabetes Prevention Program (DPP) continued in their assigned treatment group (metformin, intensive lifestyle, or placebo) and were followed into the Diabetes Prevention Program Outcome Study (DPPOS). Weight regain was defined as a return to baseline DPP body weight. Participant weight and antidepressant medication use were assessed every 6 months. Depression symptoms (Beck Depression Inventory [BDI] score ≥11) were assessed every 12 months.
  
  
  RESULTS
  Only 2.7% of the overall cohort had moderate to severe depression symptoms at baseline; most of the participants with BDI score ≥11 had only mild symptoms during the period of observation. In unadjusted analyses, both depression symptoms (hazard ratio 1.31 [95% CI 1.03-1.67], P = 0.03) and antidepressant medication use at either the previous visit (1.72 [1.37-2.15], P < 0.0001) or cumulatively as percent of visits (1.005 [1.002-1.008], P = 0.0003) were predictors of subsequent weight regain. After adjustment for multiple covariates, antidepressant use remained a significant predictor of weight regain (P < 0.0001 for the previous study visit; P = 0.0005 for the cumulative measure), while depression symptoms did not.
  
  
  CONCLUSIONS
  In individuals with IGT who do not have severe depression and who initially lose weight, antidepressant use may increase the risk of weight regain.
authors.affiliation: Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, USA. dppmail@biostat.bsc.gwu.edu
authors.forename: David W
authors.initials: DW
authors.lastname: Price
authors.forename: Yong
authors.initials: Y
authors.lastname: Ma
authors.forename: Richard R
authors.initials: RR
authors.lastname: Rubin
authors.forename: Leigh
authors.initials: L
authors.lastname: Perreault
authors.forename: George A
authors.initials: GA
authors.lastname: Bray
authors.forename: David
authors.initials: D
authors.lastname: Marrero
authors.forename: William C
authors.initials: WC
authors.lastname: Knowler
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.forename: D Yvette
authors.initials: DY
authors.lastname: Lacoursiere
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use; D001835:Body Weight / Q000187:drug effects / Q000502:physiology; D003863:Depression / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015431:Weight Loss / Q000187:drug effects / Q000502:physiology*
chemical_list: D000928:Antidepressive Agents