Commercial Weight Loss Programs May Benefit Patients With Type 2 Diabetes

The standard Weight Watchers program, combined with telephone and email consultations with a certified diabetes educator (CDE), may benefit overweight or obese patients receiving physician treatment for uncontrolled type 2 diabetes. 

A new study presented at ObesityWeek 2016, which evaluated the effects on glycemic control and weight loss with the standard Weight Watchers program, showed that this program helped participants lose more weight and achieve better control of their blood sugar. In addition, many of the participants were able to reduce the amount of diabetes medication they were taking.

“It is important to note that all participants were under the care of a physician for their diabetes, and all but 5% were on 1 or more diabetes medications. In spite of this, none had HbA1c in the target range (<7.0%) at the start of the study,” said lead study investigator Patrick O’Neil, PhD, director of the Weight Management Center and professor in the department of psychiatry and behavioral sciences at the Medical University of South Carolina in  Charleston. “Throughout the 1-year study, participants in the enhanced Weight Watchers program had greater improvements in their glycemic control (HbA1c and fasting blood glucose) and lost more weight than did participants receiving standard nutrition counseling.”

Dr O’Neil presented the study findings, which were simultaneously published in Obesity. The researchers conducted a 12-month randomized, controlled trial at 16 US research centers. The study included 563 adults with type 2 diabetes (HbA1c: 7% to 11%; BMI: 27 to50 kg/m²). All participants were assigned to either the commercially available Weight Watchers program, which included regular community meetings and online tools, along with telephone and email counseling from a CDE, or standard care. Standard care included initial in-person diabetes nutrition counseling/education with a registered dietitian, with follow-up informational materials.

The study, which was funded by a grant from the commercial weight loss program Weight Watchers, showed that after 1 year, those in the Weight Watchers group had an average weight loss of about 4% of their starting weight compared with 2% for the standard care group. In addition, 34.3% of the participants in the weight watchers group lost at least 5% of their body weight compared with only 18.1% of standard care participants.

As endocrinologists know, diabetes is a growing problem. Dr O’Neil said the rate jumped from about 9% to 12% between 2002 and 2012. He said modest weight loss from clinical interventions such as obesity medications or multidisciplinary intensive lifestyle change programs has been shown to help improve glycemic control in type 2 diabetes. However, there are little data on the effects of weight loss with commercial weight loss programs.

“The combination of an available commercial weight loss program with scalable complementary diabetes education may represent another effective and accessible component of diabetes management,” Dr O’Neil told Endocrinology Advisor. “When combined with a modest level of counseling by a certified diabetes counselor, Weight Watchers or other similar commercial weight loss programs may be a useful component of the management of type 2 diabetes.”

He said the 12-month HbA1c change for Weight Watchers group was −0.32%. However, for the standard care group, it was +0.16%. In addition, 24% of Weight Watchers group vs 14% of standard care achieved HbA1c lower than 7.0%. Among the weight watchers group, 26% reduced diabetes medications vs  12% in the standard care group. The participants in the Weight Watchers group also experienced greater reductions in waist circumference and C-reactive protein levels.

“Longer-term follow-ups would indicate the duration of the benefits we saw throughout the year of this study. Another future research idea would be examination of this enhanced Weight Watchers program for newly diagnosed diabetics,” said Dr O’Neil. 

He noted that Weight Watchers has centers all over the country, including sites in small towns with limited or no medical facilities. So, theoretically it is a program that could help many obese and overweight patients with type 2 diabetes who face significant barriers to optimal care.

References

1. O’Neil PM, Miller-Kovach K, Tuerk PW, et al. Randomized controlled trial of a nationally available weight control program tailored for adults with type 2 diabetes. Obesity. 2016 Nov 2. doi:10.1002/oby.21616 [Epub ahead of print].
2. O’Neil PM. Randomized controlled trial of a nationally available weight control program tailored for adults with type 2 diabetes. Presented at: ObesityWeek 2016; October 31-November 4, 2016; New Orleans, LA.