How type 2 can lose weight and keepit off

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How Type 2s Can Lose Weight, Keep It Off: Study

An intensive lifestyle change program helped people with Type 2 diabetes

lose weight and keep it off, a new study shows. Intensive lifestyle change

program

yielded better results than support group. Diabetes control and

cardiovascular risks were sustained over four years..

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An intensive lifestyle intervention program designed to achieve and maintain

weight loss improves diabetes control and cardiovascular disease risk

factors

in overweight and obese individuals with Type 2 diabetes, according to

four-year results of the Look AHEAD study, funded by the National Institutes

of

Health and the Centers for Disease Control and Prevention.

Look AHEAD (Action for Health in Diabetes) is a multi-center, randomized

clinical trial investigating the effects of an intensive lifestyle

intervention

program. It will evaluate the effect of reduced caloric intake and increased

physical activity on the incidence of major cardiovascular events such as

heart attack, stroke, and cardiovascular-related death.

At study entry, 5,145 participants at 16 centers across the United States

were randomly assigned to one of two interventions. Those in a so-called

intensive

lifestyle intervention group met regularly with a lifestyle counselor in a

combination of group and individual sessions. They were given specific

caloric

consumption and exercise goals, were encouraged to maintain a diet and

exercise diary, and were taught behavioral skills such as problem solving

and goal

setting. After the first year, participants were seen individually at least

once monthly, had at least one additional phone or email contact each month,

and were invited to attend additional group classes. Those in the diabetes

support and education group were invited to group sessions each year focused

on diet, physical activity, or social support. They were not weighed at

these sessions or counseled on behavioral strategies.

At the time of enrollment, participants were between 45 and 76 years of age.

Most were obese with a mean body mass index (BMI) of 36. BMI is a measure of

weight in relation to height. A BMI of 18.5 to 24.9 is considered healthy, a

BMI of 25 to 29.9 is overweight, and 30 or more is obese. Thirty-seven

percent

of participants were from racial and ethnic minority groups, and

approximately 60 percent were women. Over 94 percent of participants remain

involved after

four years and will continue to be followed for up to 13.5 years.

Over the first four years of Look AHEAD, participants in both groups showed

positive changes in their health. On average, across all four years,

participants

in the intensive lifestyle group lost significantly more weight than

participants in the support and education group. On average, members of the

lifestyle

group lost 6.2 percent of their initial body weight, and members of the

support and education group lost 0.9 percent of their initial body weight.

The

intensive intervention group also experienced greater improvements in

fitness, diabetes control, blood pressure, HDL (good) cholesterol, and

triglycerides.

The diabetes support group showed larger reductions in LDL (bad)

cholesterol, a change associated with the increased use of

cholesterol-lowering medications.

The study results do not break down results by demographic groups such as

gender, age, race or ethnicity.

Longer-term follow-up of Look AHEAD participants will determine whether

improvements in risk factors including blood pressure, lipids and glucose

control

can be sustained -- independently and as a consequence of continued weight

loss -- and whether the intensive lifestyle intervention is effective in

reducing

the incidence of illness and death due to cardiovascular disease. Other

important study objectives include understanding the impact of weight loss

and

improved fitness on diabetes complications, general health, quality of life,

and psychological outcomes. Researchers also will evaluate the cost and

cost-effectiveness

of the intensive lifestyle intervention compared to diabetes support and

education.

Find more information about the Look AHEAD trial (NCT00017953) at

www.lookaheadtrial.org

.. For a list of centers enrolling patients for diabetes or obesity trials,

search for keywords " diabetes " or " obesity " at

www.clinicaltrials.gov.

Archives of Internal Medicine. Sept 27, 2010

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