Diabetes Prevention & Weight Loss
The Diabetes Prevention Program Weight
Loss Study
The Diabetes Prevention Program recently showed that a 7 percent decrease
in initial weight reduced the risk of developing type 2 diabetes by 58
percent in persons with impaired glucose tolerance (1). Weight loss was
achieved by modest caloric restriction, increased physical activity, and
the use of behavioral principles (provided by registered dietitians in
individuals visits). These data provide the strongest evidence to date
of the health benefits of modest weight loss, combined with increased
physical activity.
Weight Regain
Weight regain, however, remains the Achilles heel of all behavioral interventions.
Patients typically regain one-third of lost weight in the year after treatment
and two-thirds by year 3. Long-term patient-provider contact, whether
on site or by telephone or e-mail, facilitates the maintenance of lost
weight (2). Patients are taught to adopt behaviors practiced by members
of the US National Weight Control Registry (3). These individuals have
lost a minimum of 14 kg and maintained the loss for 1 or more years. Long-term
use of meal replacements and portion-controlled foods also improves weight
maintenance (4).
Weight Loss Medication
Weight loss medication also may be of benefit with select patients (ie,
with a BMI > 30 kg/m2 who have failed to reduce using diet and exercise).
Patients treated by sibutramine (5), as well as orlistat (6), have been
shown to lose 7 percent-10 percent of initial weight and to maintain this
loss at 1 to 2 years. The best results are likely to be obtained when
anti-obesity agents are combined with cognitive-behavioral strategies
to facilitate medication adherence and modification of eating and exercise
habits (7).
Lifestyle Modification & Obesity
In summary, lifestyle modification for obesity does work and works long-term
with continued patient-provider contact. Translational research is now
needed on methods to make treatment available to the vast numbers of persons
who need it.
Source: Thomas A Wadden, PhD. University
of Pennsylvania School of Medicine (2003)
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