Look AHEAD: Action for Health in Diabetes

Inclusion Criteria: * Type 2 diabetes * Overweight * BMI of 25 kg/m2 or greater * If on insulin, BMI of 27 kg/m2 or greater * Blood pressure less than 160/100 mmHg * HbA1c less or equal to 11% * Triglycerides less than 600 mg/dl * Willingness to participate Exclusion Criteria: * Unable or unwilling to give informed consent or communicate with local study staff. * Current diagnosis of schizophrenia, other psychotic disorders, or bipolar disorder. * Hospitalization for depression in past six months. * Self-report of alcohol or substance abuse within the past twelve months. * Current consumption of more than 14 alcoholic drinks per week. * Current acute treatment or rehabilitation program for these problems. * Plans to relocate to an area not served by Look AHEAD or travel plans that do not permit full participation in the study. * Lack of support from primary care health provider or family members. * Failure to complete the two-week run-in for dietary intake and exercise. * Weight loss exceeding 10 lbs. in past three months. * Current use of medications for weight loss. * Self reported inability to walk two blocks. * History of bariatric surgery, small bowel resection, or extensive bowel resection. * Chronic treatment with systemic corticosteroids. * Another member of the household is a participant or staff member in Look AHEAD. * Currently pregnant or nursing. * Cancer requiring treatment in the past five years, except for non-melanoma skin cancers or cancers that have clea…