The efficacy of a weight management program to improve health-related quality of life (HRQOL) was tested in the randomized multi-site clinical Look AHEAD trial. A total of 5,145 patients were randomly assigned to an intensive lifestyle intervention (ILI) program or to diabetes support and education (DSE) and followed for one year. HRQOL improved in the ILI arm compared to the DSE arm [physical component summary (PCS) and Beck Depression Inventory II (BDI-II) scores]. The greatest impact was on the PCS score, and the greatest HRQOL improvements were observed in subjects with the lowest baseline HRQOL levels (poorest quality of life at baseline). Treatment effects related to BDI-II score were partially mediated by changes in fitness and physical symptoms and completely mediated by changes in body weight. However, changes in body weight, physical fitness and physical symptoms explained only some of the changes in PCS scores, suggesting that other factors may be involved in the improvement of HRQOL that occurs with successful lifestyle management programs.
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