ARS | Publication request: Four-year weight losses in the look AHEAD study: factors associated with long-term success

Submitted to: Obesity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: June 15, 2011
Publication Date: September 28, 2011
Citation: Raatz, S.K. 2011. Four-year weight losses in the look AHEAD study: factors associated with long-term success. Obesity. 1987-1988.

Interpretive Summary: This report provides a further analysis of the year 4 weight losses in the Look AHEAD (Action for Health in Diabetes) study and identifies factors associated with long-term success. A total of 5,145 overweight/obese men and women with type 2 diabetes were randomly assigned to an intensive lifestyle intervention (ILI) or a usual care group, referred to as Diabetes Support and Education (DSE). ILI participants were provided weekly approximately group or individual treatment in year 1; continued but less frequent contact was provided in years 2–4. DSE participants received three group educational sessions in all years. As reported previously, at year 4, ILI participants lost an average of 4.7% of initial weight, compared with 1.1% for DSE (P < 0.0001). More ILI than DSE participants lost =5% (46% vs. 25%, P < 0.0001) and =10% (23% vs 10%, P < 0.0001) of initial weight. Within the ILI, achievement of both the 5% and 10% categorical weight losses at year 4 was strongly related to meeting these goals at year 1. A total of 887 participants in ILI lost =10% at year 1, of whom 374 (42.2%) achieved this loss at year 4. Participants who maintained the loss, compared with those who did not, attended more treatment sessions and reported more favorable physical activity and food intake at year 4. These results provide critical evidence that a comprehensive lifestyle intervention can induce clinically significant weight loss (i.e., =5%) in overweight/obese participants with type 2 diabetes and maintain this loss in more than 45% of patients at 4 years.

Technical Abstract: This report provides the year 4 weight loss results of the Look AHEAD (Action for Health in Diabetes) study and identifies factors associated with success. 5,145 overweight/obese men and women with type 2 diabetes were randomly assigned to an intensive lifestyle intervention (ILI) or a usual care group, Diabetes Support and Education (DSE). ILI participants were provided weekly treatments in year 1 an continued but less frequent treatments in years 2–4. DSE participants received three group educational sessions each year. At year 4, ILI participants lost an average of 4.7% of initial weight, compared with 1.1% for DSE. In ILI, meeting the weight loss goals of the 5% and 10% weight losses at year 4 was strongly related to meeting these goals at year 1. Participants who maintained the loss, , attended more treatment sessions and reported more physical activity and reduced food intake at year 4. These results provide critical evidence that a comprehensive lifestyle intervention can induce clinically significant weight loss in overweight/obese participants with type 2 diabetes and maintain this loss in more than 45% of patients at 4 years.