Psychological status and weight variability over eight years: Results from Look AHEAD.

OBJECTIVE: Cross-sectional studies suggest an association between weight cycling and psychological status. Although this is often interpreted as suggesting that weight cycles "cause" psychological distress, the relationship could be bidirectional. This study provides a prospective analysis of the bidirectional association between weight variability and psychological status over an 8-year period in overweight/obese adults with Type 2 diabetes.

METHOD: Data were from the first 8 years of Look AHEAD, a randomized controlled trial comparing health outcomes in individuals with Type 2 diabetes assigned to an intensive lifestyle intervention designed to produce weight loss or a diabetes education and support control group. Psychological status (mental health, depressive symptoms, binge eating) was assessed via surveys and were examined in relation to weight variability at both baseline and year 8. Weight variability was derived from 8 possible annual measurements from participants who had a minimum of 3 consecutive body weight measurements (N = 4,774) and operationalized as the number of year-to-year cycles and the coefficient of variation across all available weight measurements.

RESULTS: Controlling for study group, higher baseline scores on mental health (Short Form-36 Mental Component Summary) and lower levels of depressive symptomatology (Beck Depression Inventory) and binge eating (Questionnaire on Eating and Weight Patterns) were associated with significantly less subsequent weight variability. The prospective association between weight variability and psychological status at year 8 was less robust.

CONCLUSIONS: These results suggest that the cross-sectional relationship between weight variability and psychological status is due primarily to poorer psychological function preceding greater weight instability. (PsycINFO Database Record