Randomized controlled trial of a nationally available weight control program tailored for adults with type 2 diabetes

O’Neil, Patrick M.; Miller-Kovach, Karen; Tuerk, Peter W.; Becker, Lynne E.; Wadden, Thomas A.; Fujioka, Ken; Hollander, Priscilla; Kushner, Robert F.; Garvey, W. Timothy; Rubino, Domenica; Malcolm, Robert; Weiß, Daniel; Raum, William J.; Salyer, Jonny L.; Hermayer, Kathie L.; Rost, Stephanie; Veliko, Jan L.; Sora, Nicoleta D.

doi:10.1002/oby.21616

Cited by 49 publications

(51 citation statements)

References 34 publications

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“…This digital program exceeded the CDC session requirement in all three cohorts. Depending on the type of cohort analyzed, 23% to 36% of the participants lost 5% or more of their body weight, which is similar to the range of 18% to 34% reported by O'Neil et al who examined the impact of adding telephonic and email counseling from a diabetes educator alongside an in-person commercial weight-loss program (19). The participants in Real Appeal also had similar results reported in a digital DPRP program (21), with the major difference being the size of the study samples being compared.…”

Section: Discussionsupporting

confidence: 69%

“…The ability of Real Appeal to engage with 52,461 weight-loss participants during a 12-month period was remarkable. These participants had outcomes similar to those reported by other commercial weightloss programs (19,20) and digital DPP programs (21). When assessing the effectiveness of a DPP program, the CDC examines the average number of sessions attended by program participants, with an average of nine sessions required to achieve full CDC DPRP recognition (10).…”

Section: Discussionmentioning

confidence: 89%

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Implementing an Online Weight‐Management Intervention to an Employee Population: Initial Experience with Real Appeal

Horstman¹,

Aronne

Wing

et al. 2018

Obesity

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Objective Given the disease burden and economic costs of obesity in the United States, scalable approaches to weight loss and weight management are needed. This study evaluated self‐reported weight‐loss outcomes associated with a commercial intensive lifestyle intervention marketed to employers and delivered electronically to employees. Methods Data were collected for participants who enrolled in an online intensive lifestyle intervention weight‐loss program from July 2015 through June 2016. An intent‐to‐treat analysis of participants who attended at least one session is reported. Results Ninety‐six companies, with approximately 437,215 eligible adult beneficiaries, launched Real Appeal in July 2015. In the first 12 months of the program, 69,598 adults enrolled and 87% met at‐risk criteria for prediabetes, diabetes, or cardiovascular disease. The intent‐to‐treat cohort ( n = 52,461), all of whom attended at least one session, lost an average of 2.8% body weight, with 23% achieving 5% or more weight loss. Active participants ( n = 38,836) lost an average of 3.5% body weight, with 29% achieving 5% weight loss. Program completers ( n = 27,164) lost an average of 4.3% body weight, with 36% of the cohort achieving 5% weight loss. Conclusions This study demonstrated that an employer‐offered, online, behavioral weight‐loss program was an effective, scalable solution for engaging more than 50,000 participants with overweight and obesity.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 89%

Implementing an Online Weight‐Management Intervention to an Employee Population: Initial Experience with Real Appeal

Horstman¹,

Aronne

Wing

et al. 2018

Obesity

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“…Nine trials comprised education alone, the remaining 40 were multicomponent. Participant contacts were quantified in 46 trials, ranging from one contact over 6 months [S18] to 107 contacts over 12 months [38]. Thirty trials described duration of each contact, which ranged from 5 min [41] to 150 min [35,37, S12].…”

Section: Intervention Descriptionmentioning

confidence: 99%

“…All five trials pre-selecting participants showed significant effects on weight/BMI [31,34,36,39,S18]. All five trials providing extra contacts with intervention staff, if required, saw significant effects on weight [38,40,45,S14,S19]. Eight of the nine trials providing personalized feedback showed significant effects on weight/BMI [28,32,39,42,45,S4,S15, S19].…”

Section: Weight and Bmimentioning

confidence: 99%

Educational weight loss interventions in obese and overweight adults with type 2 diabetes: a systematic review and meta‐analysis of randomized controlled trials

et al. 2019

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Aim The worldwide prevalence of type 2 diabetes mellitus is increasing, with most individuals with the disease being overweight or obese. Weight loss can reduce disease‐related morbidity and mortality and weight losses of 10–15 kg have been shown to reverse type 2 diabetes. This review aimed to determine the effectiveness of community‐based educational interventions for weight loss in type 2 diabetes. Methods This is a systematic review and meta‐analysis of randomized controlled trials (RCT) in obese or overweight adults, aged 18–75 years, with a diagnosis of type 2 diabetes. Primary outcomes were weight and/or BMI. CINAHL, MEDLINE, Embase, Scopus and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to June 2019. Trials were classified into specified a priori comparisons according to intervention type. A pooled standardized mean difference (SMD) (from baseline to follow‐up) and 95% confidence intervals (95% CI) between trial groups (difference‐in‐difference) were estimated through random‐effects meta‐analyses using the inverse variance method. Heterogeneity was quantified using I2 and publication bias was explored visually using funnel plots. Results Some 7383 records were screened; 228 full‐text articles were assessed and 49 RCTs (n = 12 461 participants) were included in this review, with 44 being suitable for inclusion into the meta‐analysis. Pooled estimates of education combined with low‐calorie, low‐carbohydrate meal replacements (SMD = –2.48, 95% CI –3.59, –1.49, I2 = 98%) or diets (SMD = –1.25, 95% CI –2.11, –0.39, I2 = 95%) or low‐fat meal replacements (SMD = –1.15, 95%CI –2.05, –1.09, I2 = 85%) appeared most effective. Conclusion Low‐calorie, low‐carbohydrate meal replacements or diets combined with education appear the most promising interventions to achieve the largest weight and BMI reductions in people with type 2 diabetes.

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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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Randomized controlled trial of a nationally available weight control program tailored for adults with type 2 diabetes

Cited by 49 publications

References 34 publications

Implementing an Online Weight‐Management Intervention to an Employee Population: Initial Experience with Real Appeal

Implementing an Online Weight‐Management Intervention to an Employee Population: Initial Experience with Real Appeal

Educational weight loss interventions in obese and overweight adults with type 2 diabetes: a systematic review and meta‐analysis of randomized controlled trials

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

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