Patrick M O'Neil1, Karen Miller-Kovach2, Peter W Tuerk3,4, Lynne E Becker3, Thomas A Wadden5, Ken Fujioka6, Priscilla L Hollander7, Robert F Kushner8, W Timothy Garvey9,10, Domenica M Rubino11, Robert J Malcolm3, Daniel Weiss12, William J Raum13, Jonny L Salyer14, Kathie L Hermayer15, Stephanie L Rost2, Jan L Veliko2, Nicoleta D Sora15. 1. Department of Psychiatry and Behavioral Sciences, Weight Management Center, Medical University of South Carolina, Charleston, South Carolina, USA. oneilp@musc.edu. 2. Weight Watchers International, New York, New York, USA. 3. Department of Psychiatry and Behavioral Sciences, Weight Management Center, Medical University of South Carolina, Charleston, South Carolina, USA. 4. Mental Health Service, Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA. 5. Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA. 6. Scripps Clinical Research, La Jolla, California, USA. 7. Baylor Endocrine Center, Dallas, Texas, USA. 8. Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. 9. Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA. 10. Birmingham VA Medical Center, Birmingham, Alabama, USA. 11. Washington Center for Weight Management & Research, Arlington, Virginia, USA. 12. Your Diabetes Endocrine Nutrition Group, Mentor, Ohio, USA. 13. Oregon Weight Loss Surgery, Portland, Oregon, USA. 14. Lovelace Scientific Resources, Albuquerque, New Mexico, USA. 15. Division of Endocrinology, Diabetes & Medical Genetics, College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Abstract
OBJECTIVE:Modest weight loss from clinical interventions improves glycemic control in type 2 diabetes (T2DM). Data are sparse on the effects of weight loss via commercial weight loss programs. This study examined the effects on glycemic control and weight loss of the standard Weight Watchers program, combined with telephone and email consultations with a certified diabetes educator (WW), compared with standard diabetes nutrition counseling and education (standard care, SC). METHODS: In a 12-month randomized controlled trial at 16 U.S. research centers, 563 adults with T2DM (HbA1c 7-11%; BMI 27-50 kg/m2 ) were assigned to either the commercially available WW program (regular community meetings, online tools), plus telephone and email counseling from a certified diabetes educator, or to SC (initial in-person diabetes nutrition counseling/education, with follow-up informational materials). RESULTS: Follow-up rate was 86%. Twelve-month HbA1c changes for WW and SC were -0.32 and +0.16, respectively; 24% of WW versus 14% of SC achieved HbA1c <7.0% (P = 0.004). Weight losses were -4.0% for WW and -1.9% for SC (Ps < 0.001). 26% of WW versus 12% of SC reduced diabetes medications (P < 0.001). WW participants had greater reductions in waist circumference (P < 0.001) and C-reactive protein (P = 0.02) but did not differ on other cardiovascular risk factors. CONCLUSIONS: Widely available commercial weight loss programs with community and online components, combined with scalable complementary diabetes education, may represent accessible and effective components of management plans for adults with overweight/obesity and T2DM.
RCT Entities:
OBJECTIVE: Modest weight loss from clinical interventions improves glycemic control in type 2 diabetes (T2DM). Data are sparse on the effects of weight loss via commercial weight loss programs. This study examined the effects on glycemic control and weight loss of the standard Weight Watchers program, combined with telephone and email consultations with a certified diabetes educator (WW), compared with standard diabetes nutrition counseling and education (standard care, SC). METHODS: In a 12-month randomized controlled trial at 16 U.S. research centers, 563 adults with T2DM (HbA1c 7-11%; BMI 27-50 kg/m2 ) were assigned to either the commercially available WW program (regular community meetings, online tools), plus telephone and email counseling from a certified diabetes educator, or to SC (initial in-persondiabetes nutrition counseling/education, with follow-up informational materials). RESULTS: Follow-up rate was 86%. Twelve-month HbA1c changes for WW and SC were -0.32 and +0.16, respectively; 24% of WW versus 14% of SC achieved HbA1c <7.0% (P = 0.004). Weight losses were -4.0% for WW and -1.9% for SC (Ps < 0.001). 26% of WW versus 12% of SC reduced diabetes medications (P < 0.001). WW participants had greater reductions in waist circumference (P < 0.001) and C-reactive protein (P = 0.02) but did not differ on other cardiovascular risk factors. CONCLUSIONS: Widely available commercial weight loss programs with community and online components, combined with scalable complementary diabetes education, may represent accessible and effective components of management plans for adults with overweight/obesity and T2DM.
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