Depression, stress, and weight loss in individuals with metabolic syndrome in SHINE, a DPP translation study - PubMed (original) (raw)

Randomized Controlled Trial

. 2014 Dec;22(12):2532-8.

doi: 10.1002/oby.20916. Epub 2014 Sep 24.

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Randomized Controlled Trial

Depression, stress, and weight loss in individuals with metabolic syndrome in SHINE, a DPP translation study

Paula M Trief et al. Obesity (Silver Spring). 2014 Dec.

Abstract

Objective: To examine the relationships between elevated depression symptoms (EDS) or stress and weight loss in SHINE, a telephonic, primary-care based, translation of the Diabetes Prevention Program.

Methods: N = 257 adults with metabolic syndrome were randomized to individual (IC) or group (CC) phone participation. Weight, depression, anti-depressant use (ADMs), and stress (baseline, 6 months, 1 and 2 years) were assessed. Univariate analyses used linear and logistic regression, t tests for continuous variables and exact tests for categorical variables. Stratified analyses assessed modifiers of effects of depression/stress on weight loss.

Results: Approximately 35% reported EDS, with no change over time. Approximately 28% of all participants used ADMs. Participants with EDS had lower mean % weight loss and a smaller % who achieved ≥5% weight loss. Participants with EDS were less likely to be "completers" (40.1% vs. 61.5%, P = 0.002), coached (48.0% vs. 60.7%, P = 0.049), or log diet/activity (19.4% vs. 42.7%, P < 0.001), behaviors related to weight loss. Results were similar for high stress. ADM use had no independent effect on weight loss.

Conclusions: Individuals with metabolic syndrome and EDS and/or high stress were less likely to lose significant weight. Pre-intervention depression and stress screening to intervene may improve weight loss.

Trial registration: ClinicalTrials.gov NCT00749606.

© 2014 The Obesity Society.

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Figures

Figure 1

Figure 1

Percent of subjects achieving 5% weight loss stratified by CES-D category who were “completers” (completed ≥ 9 educator sessions) vs. not completers, years 1 and 2. *** P < .001

Figure 2

Figure 2

Percent of subjects achieving ≥ 5% weight loss stratified by CES-D category who were “coached” (completed ≥ 3 coaching sessions) vs. not coached, years 1 and 2. *P < .05

Figure 3

Figure 3

Percent of subjects achieving ≥ 5% weight loss stratified by CES-D category who logged more (logged diet/activity ≥ 17 weeks) vs. logged less, years 1 and 2. ** P < .01 *** P < .001

Figure 4

Figure 4

Percent of subjects achieving ≥ 5% weight loss stratified by PSS category who were “completers” (completion of ≥ 9 educator sessions) vs. not completers, years 1 and 2. ** P < .01

Figure 5

Figure 5

Percent of subjects achieving ≥ 5% weight loss stratified by PSS category who were “coached” (completed ≥ 3 coaching sessions) vs. not coached, years 1 and 2. *P < .05

Figure 6

Figure 6

Percent of subjects achieving ≥ 5% weight loss stratified by PSS category who logged more (logged diet/activity ≥ 17 weeks) vs. logged less, years 1 and 2. ** P < .01 *** P < .001

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