title: Impact of intensive lifestyle intervention on depression and health-related quality of life in type 2 diabetes: the Look AHEAD Trial.
abstract: OBJECTIVE
  We examined the effects of an intensive lifestyle intervention (ILI), compared with a diabetes support and education (DSE) control intervention, on long-term changes in depression symptoms, antidepressant medication (ADM) use, and health-related quality of life (HRQoL) in overweight/obese individuals with type 2 diabetes.
  
  
  METHODS
  Look AHEAD was a multisite randomized controlled trial of 5,145 overweight/obese participants assigned to ILI (designed to produce weight loss) or DSE and followed for a median of 9.6 years. The Beck Depression Inventory (BDI) was administered at baseline, annually at years 1-4, and again at year 8. Mean BDI scores and incidence of BDI scores ≥10, indicative of likely mild or greater depression, were examined. Annually through year 10, participants reported their ADM use and completed the Medical Outcomes Study Short Form 36 (SF-36) questionnaire, which yields physical component summary (PCS) and mental component summary (MCS) scores.
  
  
  RESULTS
  ILI significantly reduced the incidence of mild or greater depression symptoms (BDI scores ≥10) compared with DSE (hazard ratio [HR] = 0.85; 95% CI 0.75-0.97; P = 0.0145). Although SF-36 PCS scores worsened over time in both groups, ILI participants reported better physical function than DSE throughout the first 8 years (all P values <0.01). There were no significant differences between treatment arms in the proportion of participants who used ADMs or in SF-36 MCS scores.
  
  
  CONCLUSIONS
  ILI for overweight/obese patients with type 2 diabetes may reduce the risk of developing clinically significant symptoms of depression and preserve physical HRQoL. These findings should be considered when evaluating the potential benefits of ILIs.
authors.forename: Richard R
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authors.lastname: Jakicic
authors.forename: Robert W
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authors.forename: Karen C
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authors.lastname: Johnson
authors.forename: Steven E
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authors.lastname: Kahn
authors.forename: William C
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authors.lastname: Knowler
authors.forename: Wei
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authors.lastname: Lang
authors.forename: Cora E
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authors.lastname: Lewis
authors.forename: Maria G
authors.initials: MG
authors.lastname: Montez
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authors.lastname: Murillo
authors.forename: David M
authors.initials: DM
authors.lastname: Nathan
authors.forename: Jennifer
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authors.lastname: Patricio
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authors.forename: Xavier
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authors.lastname: Pi-Sunyer
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authors.lastname: Pownall
authors.forename: W Jack
authors.initials: WJ
authors.lastname: Rejeski
authors.forename: Renate H
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authors.lastname: Rosenthal
authors.forename: Valerie
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authors.lastname: Ruelas
authors.forename: Katie
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authors.lastname: Van Dorsten
authors.forename: Mara
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authors.forename: Donald
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authors.lastname: Williamson
authors.forename: Rina R
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mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use; D003863:Depression / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D050177:Overweight / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
chemical_list: D000928:Antidepressive Agents