Weight Loss Impact on Change in Depression in Type 2 Diabetes Mellitus: Study to Help Improve Early Evaluation and Management of Risk Factors Leading to Diabetes (SHIELD)

Objectives: This study evaluated the association between weight loss and change in depression among patients with type 2 diabetes mellitus (T2DM). Methods: Weight change from 2008 to 2009 among respondents (with and without T2DM) in the Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD) was calculated. Change in depression was calculated as change from 2008 to 2009 in Patient Health Questionnaire-9 (PHQ-9) scores. Respondents with weight loss (>1%, >3%, >5%) were compared with respondents with weight gain (≥1%). Multivariate regression adjusted for baseline characteristics. Results: Among those with T2DM, more respondents with weight loss (n = 779) improved their depression scores, compared with respondents with weight gain (n = 731): 32.9%, 36.9%, 39.8% for >1%, >3%, and >5% weight loss, respectively, vs. 28.7% for weight gain (p<0.05). More respondents with weight loss improved the severity level of depression compared with respondents with weight gain (p < 0.05). After adjustment, T2DM respondents with weight loss had significantly greater improvement in depression scores (p < 0.05) and had 2 - 3 times higher odds of improving depression severity than T2DM respondents with weight gain (OR: 2.22 for >1%, 2.96 for >3%, and 3.31 for >5% weight loss, p < 0.01). Similar improvement in depression scores and severity of depression related to weight loss was observed among all SHIELD respondents (with and without T2DM). Conclusions: Our findings demonstrate an association between weight loss and improvement in depression over a 1-year period in adults with T2DM, and suggest the need for further investigation with respect to causality.