A systematic review of commercial weight loss programmes’ effect on glycemic outcomes among overweight and obese adults with and without type 2 diabetes mellitus

Chaudhry, Zoobia W; Doshi, Ruchi S.; Mehta, Ankur; Jacobs, David K.; Vakil, Rachit M.; Lee, Clare J.; Bleich, Sara N.; Kalyani, Rita R.; Clark, Jeanne M.; Gudzune, Kimberly A.

doi:10.1111/obr.12423

Cited by 14 publications

(11 citation statements)

References 59 publications

(83 reference statements)

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“…Mediterranean-style, DASH, and plant-based diets, sometimes with prescribed energy restriction, are recommended, but effectiveness data are limited [ 7 ] and low fat diets have not been shown to be superior for weight loss [ 10 ]. Commercially available weight loss programs have demonstrated short-term success in glycemic control, but continued success at 1 year is uncommon [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study

McKenzie²,

et al. 2018

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IntroductionCarbohydrate restriction markedly improves glycemic control in patients with type 2 diabetes (T2D) but necessitates prompt medication changes. Therefore, we assessed the effectiveness and safety of a novel care model providing continuous remote care with medication management based on biometric feedback combined with the metabolic approach of nutritional ketosis for T2D management.MethodsWe conducted an open-label, non-randomized, controlled, before-and-after 1-year study of this continuous care intervention (CCI) and usual care (UC). Primary outcomes were glycosylated hemoglobin (HbA1c), weight, and medication use. Secondary outcomes included fasting serum glucose and insulin, HOMA-IR, blood lipids and lipoproteins, liver and kidney function markers, and high-sensitivity C-reactive protein (hsCRP).Results349 adults with T2D enrolled: CCI: n = 262 [mean (SD); 54 (8) years, 116.5 (25.9) kg, 40.4 (8.8) kg m2, 92% obese, 88% prescribed T2D medication]; UC: n = 87 (52 (10) years, 105.6 (22.15) kg, 36.72 (7.26) kg m2, 82% obese, 87% prescribed T2D medication]. 218 participants (83%) remained enrolled in the CCI at 1 year. Intention-to-treat analysis of the CCI (mean ± SE) revealed HbA1c declined from 59.6 ± 1.0 to 45.2 ± 0.8 mmol mol−1 (7.6 ± 0.09% to 6.3 ± 0.07%, P < 1.0 × 10−16), weight declined 13.8 ± 0.71 kg (P < 1.0 × 10−16), and T2D medication prescription other than metformin declined from 56.9 ± 3.1% to 29.7 ± 3.0% (P < 1.0 × 10−16). Insulin therapy was reduced or eliminated in 94% of users; sulfonylureas were entirely eliminated in the CCI. No adverse events were attributed to the CCI. Additional CCI 1-year effects were HOMA-IR − 55% (P = 3.2 × 10−5), hsCRP − 39% (P < 1.0 × 10−16), triglycerides − 24% (P < 1.0 × 10−16), HDL-cholesterol + 18% (P < 1.0 × 10−16), and LDL-cholesterol + 10% (P = 5.1 × 10−5); serum creatinine and liver enzymes (ALT, AST, and ALP) declined (P ≤ 0.0001), and apolipoprotein B was unchanged (P = 0.37). UC participants had no significant changes in biomarkers or T2D medication prescription at 1 year.ConclusionsThese results demonstrate that a novel metabolic and continuous remote care model can support adults with T2D to safely improve HbA1c, weight, and other biomarkers while reducing diabetes medication use.ClinicalTrials.gov IdentifierNCT02519309.FundingVirta Health Corp.Electronic supplementary materialThe online version of this article (10.1007/s13300-018-0373-9) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study

McKenzie²,

et al. 2018

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“…Table 3 summarizes outcomes with Weight Watchers, Jenny Craig, and Nutrisystem, which typically comprise the majority market share in the commercial weight loss industry ( 31 , 36 – 41 ). Both Weight Watchers and Jenny Craig have had randomized, controlled trials (RCTs) documenting their long-term weight loss efficacy, and Jenny Craig has demonstrated long-term glycemic benefits among patients with diabetes ( 3 , 42 – 44 ).…”

Section: Approaching the Weight Loss Discussionmentioning

confidence: 99%

Treatment of Obesity in Patients With Diabetes

2017

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IN BRIEF More than 90% of patients with diabetes have overweight or obesity. Whereas weight gain and obesity worsen insulin resistance, weight loss slows the progression of diabetes complications. Given the elevated risk for diabetes complications in patients with obesity, clinicians must understand how to treat obesity in their patients with diabetes, including providing counseling and behavioral management, referral to weight loss programs, and medication management. This article summarizes guidelines for diagnosing and managing obesity in people with diabetes.

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“…Our outcomes included mean change in the following: systolic blood pressure (SBP), diastolic blood pressure (DBP), LDL-c, HDL-c, triglycerides, and total cholesterol. These CVD risk factors were pre-specified secondary outcomes of our review, and we have previously reported programs’ effect on our primary outcomes of weight loss, adherence, and harms (20), and another reports glycemic outcomes (22). …”

Section: Methodsmentioning

confidence: 99%

Benefits of commercial weight-loss programs on blood pressure and lipids: a systematic review

Mehta

Doshi

Chaudhry

et al. 2016

Preventive Medicine

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Our objective was to compare the effect of commercial weight-loss programs on blood pressure and lipids to control/education or counseling among individuals with overweight/obesity. We conducted a systematic review by searching MEDLINE and Cochrane Database of Systematic Reviews from inception to November 2014 and references identified by the programs. We included randomized, controlled trials ≥12 weeks duration. Two reviewers extracted information on study design, interventions, and mean change in systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglycerides, and total cholesterol and assessed risk of bias. We included 27 trials. Participants’ blood pressure and lipids were normal at baseline in most trials. At 12 months, Weight Watchers showed little change in blood pressure or lipid outcomes as compared to control/education (2 trials). At 12 months, Atkins’ participants had higher HDL-c and lower triglycerides than counseling (4 trials). Other programs had inconsistent effects or lacked long-term studies. Risk of bias was high for most trials of all programs. In conclusion, limited data exist regarding most commercial weight-loss programs’ long-term effects on blood pressure and lipids. Clinicians should be aware that Weight Watchers has limited data that demonstrate CVD risk factor benefits relative to control/education. Atkins may be a reasonable option for patients with dyslipidemia. Additional well-designed, long-term trials are needed to confirm these conclusions and evaluate other commercial programs.

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A systematic review of commercial weight loss programmes’ effect on glycemic outcomes among overweight and obese adults with and without type 2 diabetes mellitus

Cited by 14 publications

References 59 publications

Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study

Effectiveness and Safety of a Novel Care Model for the Management of Type 2 Diabetes at 1 Year: An Open-Label, Non-Randomized, Controlled Study

Treatment of Obesity in Patients With Diabetes

Benefits of commercial weight-loss programs on blood pressure and lipids: a systematic review

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