Comparison of Commercial and Self-Initiated Weight Loss Programs in People With Prediabetes: A Randomized Control Trial

Marrero, David G.; Palmer, Kelly; Phillips, Erin O’Kelly; Miller-Kovach, Karen; Foster, Gary D.; Saha, Chandan

doi:10.2105/ajph.2015.303035

Cited by 41 publications

(47 citation statements)

References 33 publications

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“…The mean percent weight loss was more than two and a half times higher in the intervention group compared with the control group. As previously reported, the mean percent weight loss in the intervention group was 5.5% at 6-and 12-month, compared to less than 1% 5 in the control group. The maintained weight loss at 18-and 24-months was 92% (5.07% 5 weight loss) and 81% (4.46%) of the 6-and 12-month weight losses, respectively.…”

Section: Cost Effectiveness Analysissupporting

confidence: 82%

“…In 2016, we reported the results of a randomized control trial demonstrating that a nationally available weight loss program, Weight Watchers® (WW), achieved sustained weight loss over a 12-month period among a sample of those with prediabetes, consistent with the weight 5,6 losses in the Diabetes Prevention Program (DPP) study. Here we report weight and glycemic outcomes and cost effectiveness over an 18 and 24 months period to further illuminate the potential for commercial weight loss programs to better meet the need for diabetes prevention programs.…”

mentioning

confidence: 86%

“…To determine prediabetes status, screening sessions were held at community sites to collect HbA1c, CCBG, and the ADA risk assessment following the equipment and protocol 5 described in the first paper.…”

mentioning

confidence: 99%

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The Two-Year Outcomes and Cost Effectiveness of a Commercial Weight Loss Program for the Prevention of Type 2 Diabetes among People with Prediabetes

Palmer¹,

Saha²,

Phillips³

et al. 2018

Endocrinol Diabetes Obes

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Objectives: There is solid evidence that risk for developing type 2 diabetes can be prevented by lifestyle interventions. However, there are few diabetes prevention programs available. Given the increasing prevalence of prediabetes, we sought to investigate if a commercial weight loss program with significant capacity could address this need. This study, conducted in Indianapolis, Indiana in 2014-16, investigated if (Weight Watchers-WW) could cost effectively achieve and sustain sufficient weight loss in persons with prediabetes to reduce diabetes risk for 24 months. Methods:A previous, randomized controlled trial evaluated the effectiveness of the WW program in 225 persons with prediabetes as determined by an HbA1c value ≥5.7% and ≤6.4% or a self-reported history of gestational diabetes with an HbA1c <6.5% and/or casual capillary blood glucose (CCBG) <199 mg/dL on weight and metabolic regulation compared with a self-initiated program developed by the National Diabetes Education Program over a 12-month study period. This continuation study assessed outcomes at 18 and 24 months and also evaluated cost effectiveness at 12 and 24 months from a third-party payer perspective. Since this study used a cross over design in which control subjects were provided access to the WW program from 12-24 months, they were no longer randomized. Results:Intervention participants lost significantly more weight than the controls both at 18 (-5.1% vs -1.8%, p ≤ .008)-and 24-months (-4.5% vs -1.8%, p ≤.032 ). Although both groups showed some improvement in CVD risk factors, the only significant difference between groups was that WW participants had greater reductions than controls in HbA1c at both 18 (-0.27 vs-0.17; p=.03) and 24 months (-0.3 vs -0.2; p=.04). Converting the weight loss into quality adjusted life years saved (QALYs) yielded an incremental cost effectiveness ratio (ICER) of $19,034 per QALY gained for the intervention. Sensitivity analyses showed the ICER was well below commonly accepted thresholds for cost effectiveness. Conclusion:These data suggest that evidence-based, widely available weight management programs have the potential to cost effectively improve health outcomes for patients with prediabetes. Given their affordability and scalability, increasing access could result in a significant public health impact.

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Section: Cost Effectiveness Analysissupporting

confidence: 82%

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confidence: 86%

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The Two-Year Outcomes and Cost Effectiveness of a Commercial Weight Loss Program for the Prevention of Type 2 Diabetes among People with Prediabetes

Palmer¹,

Saha²,

Phillips³

et al. 2018

Endocrinol Diabetes Obes

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“…The current study had three aims: (1) to determine the extent to which adults engaged in weight loss reported WBI; (2) to identify correlates of WBI, including demographic characteristics and specific types of weightstigmatizing experiences; and (3) to compare these correlates between WBI measures (WBIS-M versus WSSQ). These aims were evaluated in a large sample of adults enrolled in WW (the new Weight Watchers), an empirically validated behavioural weight management programme that encourages healthy habits related to food, activity and mindset (19)(20)(21)(22). Given that millions of Americans participate in weight management programmes each year (23), these treatment-seeking adults may represent a more generalizable sample than those from prior smaller, more tightly controlled treatment efficacy studies in clinical settings.…”

Section: Introductionmentioning

confidence: 99%

Weight bias internalization in a commercial weight management sample: prevalence and correlates

Pearl

Himmelstein

Puhl

et al. 2019

Obesity Science & Practice

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Summary Objective Weight bias internalization (WBI) is associated with poor weight‐related health. The purpose of this study was to identify the prevalence and correlates of WBI in a large sample of adults in a commercial weight management programme. Methods WW (the new Weight Watchers) members participated in an online survey. Participants ( N = 18,769) completed the 10‐item Weight Bias Internalization Scale – Modified (WBIS‐M) and the Weight Self‐Stigma Questionnaire (WSSQ). Participants reported details about weight‐stigmatizing experiences, including the onset, frequency and distress, and interpersonal sources of weight stigma. Participants self‐reported their demographics, weight history, and height and weight (to compute body mass index [BMI]). Results Weight bias internalization was relatively high compared with the general population (mean WBIS‐M score = 4.3 ± 1.4; mean WSSQ total score = 35.2 ± 9.7). WBI was higher among participants who were female, younger and had higher BMIs ( p < 0.001) and lower among those who were Black and were widowed or had a romantic partner ( p < 0.001). Onset of weight stigma in childhood and young adulthood, and recent distress due to weight stigma, predicted higher WBI. Extended family and school sources of weight stigma had weaker associations with WBI than did other interpersonal sources. Conclusions Weight bias was internalized by a significant proportion of adults enrolled in a commercial weight management programme. A phenotype of WBI includes demographic characteristics and the timing and sources of weight stigma.

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“…Weight loss management and counseling programs have been validated in obese patients with a multitude of medical conditions and socioeconomic backgrounds. [22][23][24][25] In fact, weight loss was one of the only factors that has been shown to help reduce the rate of medically preventable renal failure. 26 Our study, the first of its kind in a donor nephrectomy population, supports the previous findings in other groups that nutrition and fitness counseling can be important factors in achieving weight loss.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Dru

Fuchs²

2017

Exp Clin Transplant

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Objectives: As the demand for kidney transplant allografts has increased, many centers are expanding the upper limit of acceptable body mass index for kidney donors. However, obesity is a risk factor for developing renal disease. Our goal was to quantify body mass index trends in donor nephrectomy patients and to institute nutrition counseling to promote sustainable weight loss to reduce the risk of metabolic syndrome-derived renal dysfunction. Materials and Methods: Ninety patients who underwent donor nephrectomy between 2007 and 2012consented to having height and weight data collected at multiple time points. After data collection, each patient underwent a standardized nutrition counseling session. One year later, body mass index was reassessed. Results: Preoperatively, 52% of the patients were overweight or obese. The percentage of overweight and obese patients remained stable for 2 years after surgery. However, at 3, 4, and 5 years after surgery, these rates increased to 59%, 69%, and 91%. Each patient was counseled about obesity-related comorbidities and provided information about lifestyle modification. One year later, 94% of previously overweight patients and 82% of previously obese patients had a decrease in mean body mass index from 27.2 ± 4.0 kg/m 2 to 25.1 ± 3.6 kg/m 2 . Conclusions: Living-donor nephrectomy patients are at risk of developing obesity, similar to the adult population. Nutrition counseling may be beneficial to help normalize body mass index in patients who have become overweight or obese to potentially prevent obesity-related comorbidities. All patients were evaluated by a nutrition specialist after surgery to review our donor nephrectomy nutrition brochure. Body mass index monitoring and primary care followup appear to be appropriate surveillance methods.

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Comparison of Commercial and Self-Initiated Weight Loss Programs in People With Prediabetes: A Randomized Control Trial

Abstract: A large weight-management program is effective for achieving lifestyle changes associated with diabetes prevention. Such programs could significantly increase the availability of diabetes prevention programs worldwide making an immediate and significant public health impact.

Cited by 41 publications

References 33 publications

The Two-Year Outcomes and Cost Effectiveness of a Commercial Weight Loss Program for the Prevention of Type 2 Diabetes among People with Prediabetes

The Two-Year Outcomes and Cost Effectiveness of a Commercial Weight Loss Program for the Prevention of Type 2 Diabetes among People with Prediabetes

Weight bias internalization in a commercial weight management sample: prevalence and correlates

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