Impact of intensive lifestyle intervention on depression and health-related quality of life in type 2 diabetes: the Look AHEAD Trial

Richard R Rubin; Thomas A Wadden; Judy L Bahnson; George L Blackburn; Frederick L Brancati; George A Bray; Mace Coday; Scott J Crow; Jeffrey M Curtis; Gareth Dutton; Caitlin Egan; Mary Evans; Lin Ewing; Lucy Faulconbridge; John Foreyt; Sarah A Gaussoin; Edward W Gregg; Helen P Hazuda; James O Hill; Edward S Horton; Van S Hubbard; John M Jakicic; Robert W Jeffery; Karen C Johnson; Steven E Kahn; William C Knowler; Wei Lang; Cora E Lewis; Maria G Montez; Anne Murillo; David M Nathan; Jennifer Patricio; Anne Peters; Xavier Pi-Sunyer; Henry Pownall; W Jack Rejeski; Renate H Rosenthal; Valerie Ruelas; Katie Toledo; Brent Van Dorsten; Mara Vitolins; Donald Williamson; Rina R Wing; Susan Z Yanovski; Ping Zhang; Look AHEAD Research Group

doi:10.2337/dc13-1928

Impact of intensive lifestyle intervention on depression and health-related quality of life in type 2 diabetes: the Look AHEAD Trial

Richard R Rubin, Thomas A Wadden, Judy L Bahnson, George L Blackburn, Frederick L Brancati, George A Bray, Mace Coday, Scott J Crow, Jeffrey M Curtis, Gareth Dutton, Caitlin Egan, Mary Evans, Lin Ewing, Lucy Faulconbridge, John Foreyt, Sarah A Gaussoin, Edward W Gregg, Helen P Hazuda, James O Hill, Edward S HortonVan S Hubbard, John M Jakicic, Robert W Jeffery, Karen C Johnson, Steven E Kahn, William C Knowler, Wei Lang, Cora E Lewis, Maria G Montez, Anne Murillo, David M Nathan, Jennifer Patricio, Anne Peters, Xavier Pi-Sunyer, Henry Pownall, W Jack Rejeski, Renate H Rosenthal, Valerie Ruelas, Katie Toledo, Brent Van Dorsten, Mara Vitolins, Donald Williamson, Rina R Wing, Susan Z Yanovski, Ping Zhang, Look AHEAD Research Group

Research output: Contribution to journal › Article › peer-review

163 Scopus citations

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.

RESEARCH DESIGN AND 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.

Original language	English (US)
Pages (from-to)	1544-53
Number of pages	10
Journal	Diabetes care
Volume	37
Issue number	6
DOIs	https://doi.org/10.2337/dc13-1928
State	Published - Jun 2014

Keywords

Antidepressive Agents
Depression
Diabetes Mellitus, Type 2
Female
Humans
Life Style
Male
Middle Aged
Obesity
Overweight
Quality of Life
Surveys and Questionnaires
Treatment Outcome
Weight Loss

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Rubin, R. R., Wadden, T. A., Bahnson, J. L., Blackburn, G. L., Brancati, F. L., Bray, G. A., Coday, M., Crow, S. J., Curtis, J. M., Dutton, G., Egan, C., Evans, M., Ewing, L., Faulconbridge, L., Foreyt, J., Gaussoin, S. A., Gregg, E. W., Hazuda, H. P., Hill, J. O., ... Look AHEAD Research Group (2014). Impact of intensive lifestyle intervention on depression and health-related quality of life in type 2 diabetes: the Look AHEAD Trial. Diabetes care, 37(6), 1544-53. https://doi.org/10.2337/dc13-1928

Rubin, RR, Wadden, TA, Bahnson, JL, Blackburn, GL, Brancati, FL, Bray, GA, Coday, M, Crow, SJ, Curtis, JM, Dutton, G, Egan, C, Evans, M, Ewing, L, Faulconbridge, L, Foreyt, J, Gaussoin, SA, Gregg, EW, Hazuda, HP, Hill, JO, Horton, ES, Hubbard, VS, Jakicic, JM, Jeffery, RW, Johnson, KC, Kahn, SE, Knowler, WC, Lang, W, Lewis, CE, Montez, MG, Murillo, A, Nathan, DM, Patricio, J, Peters, A, Pi-Sunyer, X, Pownall, H, Rejeski, WJ, Rosenthal, RH, Ruelas, V, Toledo, K, Van Dorsten, B, Vitolins, M, Williamson, D, Wing, RR, Yanovski, SZ, Zhang, P & Look AHEAD Research Group 2014, 'Impact of intensive lifestyle intervention on depression and health-related quality of life in type 2 diabetes: the Look AHEAD Trial', Diabetes care, vol. 37, no. 6, pp. 1544-53. https://doi.org/10.2337/dc13-1928

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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.RESEARCH DESIGN AND 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.",

keywords = "Antidepressive Agents, Depression, Diabetes Mellitus, Type 2, Female, Humans, Life Style, Male, Middle Aged, Obesity, Overweight, Quality of Life, Surveys and Questionnaires, Treatment Outcome, Weight Loss",

author = "Rubin, {Richard R} and Wadden, {Thomas A} and Bahnson, {Judy L} and Blackburn, {George L} and Brancati, {Frederick L} and Bray, {George A} and Mace Coday and Crow, {Scott J} and Curtis, {Jeffrey M} and Gareth Dutton and Caitlin Egan and Mary Evans and Lin Ewing and Lucy Faulconbridge and John Foreyt and Gaussoin, {Sarah A} and Gregg, {Edward W} and Hazuda, {Helen P} and Hill, {James O} and Horton, {Edward S} and Hubbard, {Van S} and Jakicic, {John M} and Jeffery, {Robert W} and Johnson, {Karen C} and Kahn, {Steven E} and Knowler, {William C} and Wei Lang and Lewis, {Cora E} and Montez, {Maria G} and Anne Murillo and Nathan, {David M} and Jennifer Patricio and Anne Peters and Xavier Pi-Sunyer and Henry Pownall and Rejeski, {W Jack} and Rosenthal, {Renate H} and Valerie Ruelas and Katie Toledo and {Van Dorsten}, Brent and Mara Vitolins and Donald Williamson and Wing, {Rina R} and Yanovski, {Susan Z} and Ping Zhang and {Look AHEAD Research Group}",

note = "{\textcopyright} 2014 by the American Diabetes Association.",

year = "2014",

month = jun,

doi = "10.2337/dc13-1928",

language = "English (US)",

volume = "37",

pages = "1544--53",

journal = "Diabetes care",

issn = "0149-5992",

publisher = "American Diabetes Association Inc.",

number = "6",

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TY - JOUR

T1 - Impact of intensive lifestyle intervention on depression and health-related quality of life in type 2 diabetes

T2 - the Look AHEAD Trial

AU - Rubin, Richard R

AU - Wadden, Thomas A

AU - Bahnson, Judy L

AU - Blackburn, George L

AU - Brancati, Frederick L

AU - Bray, George A

AU - Coday, Mace

AU - Crow, Scott J

AU - Curtis, Jeffrey M

AU - Dutton, Gareth

AU - Egan, Caitlin

AU - Evans, Mary

AU - Ewing, Lin

AU - Faulconbridge, Lucy

AU - Foreyt, John

AU - Gaussoin, Sarah A

AU - Gregg, Edward W

AU - Hazuda, Helen P

AU - Hill, James O

AU - Horton, Edward S

AU - Hubbard, Van S

AU - Jakicic, John M

AU - Jeffery, Robert W

AU - Johnson, Karen C

AU - Kahn, Steven E

AU - Knowler, William C

AU - Lang, Wei

AU - Lewis, Cora E

AU - Montez, Maria G

AU - Murillo, Anne

AU - Nathan, David M

AU - Patricio, Jennifer

AU - Peters, Anne

AU - Pi-Sunyer, Xavier

AU - Pownall, Henry

AU - Rejeski, W Jack

AU - Rosenthal, Renate H

AU - Ruelas, Valerie

AU - Toledo, Katie

AU - Van Dorsten, Brent

AU - Vitolins, Mara

AU - Williamson, Donald

AU - Wing, Rina R

AU - Yanovski, Susan Z

AU - Zhang, Ping

AU - Look AHEAD Research Group

PY - 2014/6

Y1 - 2014/6

N2 - 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.RESEARCH DESIGN AND 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.

AB - 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.RESEARCH DESIGN AND 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.

KW - Antidepressive Agents

KW - Depression

KW - Diabetes Mellitus, Type 2

KW - Female

KW - Humans

KW - Life Style

KW - Male

KW - Middle Aged

KW - Obesity

KW - Overweight

KW - Quality of Life

KW - Surveys and Questionnaires

KW - Treatment Outcome

KW - Weight Loss

U2 - 10.2337/dc13-1928

DO - 10.2337/dc13-1928

M3 - Article

C2 - 24855155

SN - 0149-5992

VL - 37

SP - 1544

EP - 1553

JO - Diabetes care

JF - Diabetes care

IS - 6

ER -

Impact of intensive lifestyle intervention on depression and health-related quality of life in type 2 diabetes: the Look AHEAD Trial

Abstract

Keywords

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