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Effectiveness of lifestyle interventions for individuals with severe obesity and type 2 diabetes: results from the Look AHEAD trial.
Diabetes Care 2011; 34(10):2152-7DC

Abstract

OBJECTIVE

Rates of severe obesity (BMI ≥40 kg/m(2)) are on the rise, and effective treatment options are needed. We examined the effect of an intensive lifestyle intervention (ILI) on weight loss, cardiovascular disease (CVD) risk, and program adherence in participants with type 2 diabetes who were severely obese compared with overweight (BMI 25 to <30 kg/m(2)), class I (BMI 30 to <35 kg/m(2)), and class II (BMI 35 to <40 kg/m(2)) obese participants.

RESEARCH DESIGN AND METHODS

Participants in the Action for Health in Diabetes (Look AHEAD) trial were randomly assigned to ILI or diabetes support and education (DSE). DSE participants received a less intense educational intervention, whereas ILI participants received an intensive behavioral treatment to increase physical activity (PA) and reduce caloric intake. This article focuses on the 2,503 ILI participants (age 58.6 ± 6.8 years).

RESULTS

At 1 year, severely obese participants in the ILI group lost -9.04 ± 7.6% of initial body weight, which was significantly greater (P < 0.05) than ILI participants who were overweight (-7.43 ± 5.6%) and comparable to class I (-8.72 ± 6.4%) and class II obese (-8.64 ± 7.4%) participants. All BMI groups had comparable improvements in fitness, PA, LDL cholesterol, triglycerides, blood pressure, fasting glucose, and HbA(1c) at 1 year. ILI treatment session attendance was excellent and did not differ among weight categories (severe obese 80% vs. others 83%; P = 0.43).

CONCLUSIONS

Severely obese participants in the ILI group had similar adherence, percentage of weight loss, and improvement in CVD risk compared with less obese participants. Behavioral weight loss programs should be considered an effective option for this population.

Authors+Show Affiliations

Weight Control and Diabetes Research Center, The Miriam Hospital and Brown Medical School, Providence, Rhode Island, USA. junick@lifespan.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

21836103

Citation

Unick, Jessica L., et al. "Effectiveness of Lifestyle Interventions for Individuals With Severe Obesity and Type 2 Diabetes: Results From the Look AHEAD Trial." Diabetes Care, vol. 34, no. 10, 2011, pp. 2152-7.
Unick JL, Beavers D, Jakicic JM, et al. Effectiveness of lifestyle interventions for individuals with severe obesity and type 2 diabetes: results from the Look AHEAD trial. Diabetes Care. 2011;34(10):2152-7.
Unick, J. L., Beavers, D., Jakicic, J. M., Kitabchi, A. E., Knowler, W. C., Wadden, T. A., & Wing, R. R. (2011). Effectiveness of lifestyle interventions for individuals with severe obesity and type 2 diabetes: results from the Look AHEAD trial. Diabetes Care, 34(10), pp. 2152-7. doi:10.2337/dc11-0874.
Unick JL, et al. Effectiveness of Lifestyle Interventions for Individuals With Severe Obesity and Type 2 Diabetes: Results From the Look AHEAD Trial. Diabetes Care. 2011;34(10):2152-7. PubMed PMID: 21836103.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of lifestyle interventions for individuals with severe obesity and type 2 diabetes: results from the Look AHEAD trial. AU - Unick,Jessica L, AU - Beavers,Daniel, AU - Jakicic,John M, AU - Kitabchi,Abbas E, AU - Knowler,William C, AU - Wadden,Thomas A, AU - Wing,Rena R, AU - ,, Y1 - 2011/08/11/ PY - 2011/8/13/entrez PY - 2011/8/13/pubmed PY - 2012/5/12/medline SP - 2152 EP - 7 JF - Diabetes care JO - Diabetes Care VL - 34 IS - 10 N2 - OBJECTIVE: Rates of severe obesity (BMI ≥40 kg/m(2)) are on the rise, and effective treatment options are needed. We examined the effect of an intensive lifestyle intervention (ILI) on weight loss, cardiovascular disease (CVD) risk, and program adherence in participants with type 2 diabetes who were severely obese compared with overweight (BMI 25 to <30 kg/m(2)), class I (BMI 30 to <35 kg/m(2)), and class II (BMI 35 to <40 kg/m(2)) obese participants. RESEARCH DESIGN AND METHODS: Participants in the Action for Health in Diabetes (Look AHEAD) trial were randomly assigned to ILI or diabetes support and education (DSE). DSE participants received a less intense educational intervention, whereas ILI participants received an intensive behavioral treatment to increase physical activity (PA) and reduce caloric intake. This article focuses on the 2,503 ILI participants (age 58.6 ± 6.8 years). RESULTS: At 1 year, severely obese participants in the ILI group lost -9.04 ± 7.6% of initial body weight, which was significantly greater (P < 0.05) than ILI participants who were overweight (-7.43 ± 5.6%) and comparable to class I (-8.72 ± 6.4%) and class II obese (-8.64 ± 7.4%) participants. All BMI groups had comparable improvements in fitness, PA, LDL cholesterol, triglycerides, blood pressure, fasting glucose, and HbA(1c) at 1 year. ILI treatment session attendance was excellent and did not differ among weight categories (severe obese 80% vs. others 83%; P = 0.43). CONCLUSIONS: Severely obese participants in the ILI group had similar adherence, percentage of weight loss, and improvement in CVD risk compared with less obese participants. Behavioral weight loss programs should be considered an effective option for this population. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/21836103/Effectiveness_of_lifestyle_interventions_for_individuals_with_severe_obesity_and_type_2_diabetes:_results_from_the_Look_AHEAD_trial_ L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&amp;pmid=21836103 DB - PRIME DP - Unbound Medicine ER -