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Diabetes Prevention and Weight Loss
Weight Loss Study of Diabetics
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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

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