Lifestyle Interventions Prove Effective for Patients with Severe Obesity and Type 2 Diabetes

woman pushing a cart full of healthy foodsRates of severe obesity and type 2 diabetes are climbing at an alarming pace. Living an overall healthy lifestyle can help treat and prevent many cases of obesity and type 2 diabetes, but what specific lifestyle treatments work best for these patients?

In a recent study, US researchers looked at the impact of an intensive lifestyle intervention (ILI) on weight loss, cardiovascular disease (CVD) risk, and program adherence in patients who have type 2 diabetes and who are severely obese (body mass index [BMI] ≥40) compared with:

  • overweight participants (BMI of 25 to <30)
  • class I obese participants (BMI of 30 to <35)
  • class II obese participants (BMI of 35 to <40)

The results of the study were published in the October 2011 issue of Diabetes Care in an article called “Effectiveness of lifestyle interventions for individuals with severe obesity and type 2 diabetes: results from the Look AHEAD trial.”

Participants in the Action for Health in Diabetes (Look AHEAD) trial were included in this study. They were randomly assigned to the ILI group or diabetes support and education (DSE) group.

The ILI participants received intensive behavioral treatment to decrease caloric intake and increase physical activity, and the DSE study participants received a less intense educational intervention. This study primarily focused on the 2,503 ILI participants (58.6 years old ± 6.8 years) involved in the trial.

ILI treatment session attendance was excellent, and it did not differ among the various weight categories (severe obesity: 80% vs others: 83%; p=0.43).

The study found that at 1 year, severely obese participants in the ILI group lost -9.04 ± 7.6% of their starting body weight; this was significantly greater than (p<0.05) ILI study participants who were overweight (-7.43 ± 5.6%), and it was comparable to class I obese participants (-8.72 ± 6.4%) and class II obese participants (−8.64 ± 7.4%).

It was noted that at 1 year, all BMI groups had comparable improvements in the following areas:

  • fitness
  • physical activity
  • low-density lipoprotein cholesterol
  • triglycerides
  • blood pressure
  • fasting blood glucose levels
  • A1c levels

At the end of the study, researchers found that severely obese study participants in the ILI group had similar adherence, percentage of weight loss, and improvement in CVD risk compared with study participants who were less obese. They concluded that behavioral weight loss programs should be considered an effective treatment option for this population.

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