Depressed individuals are frequently excluded from weight loss trials because of fears that weight reduction may precipitate mood disorders, as well as concerns that depressed participants will not lose weight satisfactorily. The present study examined participants in the Look AHEAD study to determine whether moderate weight loss would be associated with incident symptoms of depression and suicidal ideation, and whether symptoms of depression at baseline would limit weight loss at 1 year. Overweight/obese adults with type 2 diabetes (n=5145) were randomly assigned to an Intensive Lifestyle Intervention (ILI) or a usual care group, Diabetes Support and Education (DSE). Of these, 5129 participants completed the Beck Depression Inventory (BDI) and had their weight measured at baseline and 1 year. Potentially significant symptoms of depression were defined by a BDI score ≥10. Participants in ILI lost 8.6±6.9% of initial weight at 1 year, compared to 0.7±4.8% for DSE (P<0.001, effectsize=−1.33), and had a reduction of 1.4±4.7 points on the BDI, compared to 0.4±4.5 for DSE (P<0.001, effectsize=0.23). At 1 year, the incidence of potentially significant symptoms of depression was significantly (RR=0.66, 95%CI=0.5,0.8; P<0.001) lower in the ILI than DSE group (6.3% vs. 9.6%). In the ILI group, participants with and without symptoms of depression lost 7.8±6.7% and 8.7±6.9%, respectively, a difference not considered clinically meaningful. Intentional weight loss was not associated with the precipitation of symptoms of depression, but instead appeared to protect against this occurrence. Mild (or greater) symptoms of depression at baseline did not prevent overweight/obese individuals with type 2 diabetes from achieving significant weight loss.

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Background Discrimination may be adversely associated with abdominal obesity, but few studies have examined associations with abdominal fat. Purpose The purpose of this study was to examine whether discrimination was independently associated with visceral (VAT) and subcutaneous (SAT) fat and whether these associations differed by sex and age. Methods Participants self-reported experiences of everyday and lifetime discrimination. The main reason for and the coping response to these experiences were also reported. VAT and SAT were quantified by computed tomography. Results In fully adjusted models, higher reports of everyday discrimination were associated with greater SAT, but not VAT, volumes in men only: SAT increased by 3.6 (standard error = 1.8)cm3 for each unit increase in the everyday discrimination score. In women, higher reports of lifetime non-racial discrimination were associated with greater VAT (71.6±32.0, P<0.05) and SAT (212.6±83.6, P<0.05), but these relationships were attenuated after controlling for body mass index. Conclusions These cross-sectional findings do not fully support the independent hypothesis of discrimination and abdominal fat. Additional investigations involving longitudinal designs are warranted.