One-year Weight Losses in the Look AHEAD Study: Factors Associated with Success
Wadden, TA, West DS, Neiberg RH, et al. Obesity. 2009;17:713-722.
Objective
To analyze the weight losses of the first year in the Look AHEAD (Action for Health in Diabetes) study and identify factors associated with success.
Method
Total sample size of 5,145 men and women with type 2 diabetes, were randomly assigned to an intensive lifestyle intervention with 42 group and individual sessions of diet and physical activity counseling or a control condition (Diabetes Support and Education (DSE)) with 3 educational sessions. For the first two weeks, participants ate a self-selected diet within their designated energy goal (<250lb 1200-1500 kcals/day and >250lb 1500-1800 kcal/day). During weeks 3-19, participants followed a meal-replacement program (Slim-Fast®, Glucerna®, Optifast®, or HMR®) replacing two meals with a liquid shake and one snack with a bar. Participants were instructed to replace one meal and one snack a day with shakes and bars during months 7-12 for weight maintenance.
Results
At the end of the year, 55.1% of the intensive lifestyle intervention participants lost at least 7% of initial weight compared to only 7% of the DSE participants. Intensive lifestyle intervention participants consumed on average 9.7 ± 5.1 meal replacement products during weeks 3-26 and 4.6 ± 4.1 per week during months 7-12. The number of meal replacement products consumed in the first 6 months was significantly related to weight loss at week 26, as was the total number consumed for the year to weight loss at week 52. Participants with highest use of meal replacements had 4 times greater odds of reaching the 7% initial weight loss goal and 4.1 times greater odds of reaching the 10% goal than did participants with less frequent intake of meal replacements.
Summary
An intensive group lifestyle intervention induced an average of 8.6% of initial weight loss in overweight and obese participants with type 2 diabetes. Greater weight loss is associated with increased physical activity, consumption of meal replacement products, and more frequent treatment attendance.
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