Cognitive-Behavioral Therapy and Exercise Training in Adolescents At-Risk for Type 2 Diabetes

Inclusion Criteria: * Female * Age 12-17 years * Body Mass Index (BMI)\>= 85 for age and sex * Type 2 Diabetes (T2D) first-or second-degree relative * Center for Epidemiologic Studies Depression Scale (CES-D) total score \>=21 Exclusion Criteria: * T2D/ Type 1 Diabetes (T1D) or any major medical condition (e.g. cardiovascular, renal) that would prohibit the ability to participate in exercise training * Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) conduct disorder, substance abuse/ dependence, obsessive compulsive disorder, panic attacks, post-traumatic stress disorder, anorexia/bulimia, \& schizophrenia * Insulin sensitizers, weight loss medications \& chronic steroids * Structured weight loss treatment or bariatric surgery * Pregnancy, nursing