title: A randomized comparison of a commercially available portion-controlled weight-loss intervention with a diabetes self-management education program.
abstract: OBJECTIVE
  This study examined the efficacy of a commercially available, portion-controlled diet (PCD) on body weight and HbA1c over 6 months in obese patients with type 2 diabetes.
  
  
  METHODS
  One-hundred participants with a mean±s.d. age of 55.6±10.6 year, body weight of 102.9±18.4 kg and HbA1c of 7.7±1.3% were randomly assigned to a 9-session group lifestyle intervention that included a PCD or to a 9-session group program of diabetes self-management education (DSME). Participants in the two groups were prescribed the same goals for energy intake (1250-1550 kcal per day) and physical activity (200 min per week).
  
  
  RESULTS
  While both groups produced significant improvements in weight and HbA1c after 6 months of treatment, PCD participants lost 7.3 kg [95% confidence interval (CI): -5.8 to -8.8 kg], compared with 2.2 kg (95% CI: -0.7 to -3.7 kg) in the DSME group (P<0.0001). Significantly more PCD than DSME participants lost 5% of initial weight (54.0% vs 14.0%, P<0.0001) and 10% (26.0% vs 6.0%, P<0.0001). HbA1c declined by 0.7% (95% CI: -0.4 to -1.0%) in the PCD group, compared with 0.4% (95% CI: -0.1 to -0.7%) in DSME (P<0.026). Across both groups, larger weight losses were associated with greater reductions in HbA1c (r=0.52, P<0.0001).
  
  
  CONCLUSIONS
  These findings demonstrate that a commercially available portion-controlled meal plan can induce clinically meaningful improvements in weight and glycemic control in obese individuals with type 2 diabetes. These data have implications for the management of obesity in primary care, as now provided by the Centers for Medicare and Medicaid Services.
authors.affiliation: Center for Obesity Research and Education, Temple University, Philadelphia, PA, USA.
authors.forename: G D
authors.initials: GD
authors.lastname: Foster
authors.forename: T A
authors.initials: TA
authors.lastname: Wadden
authors.forename: C A
authors.initials: CA
authors.lastname: Lagrotte
authors.forename: S S
authors.initials: SS
authors.lastname: Vander Veur
authors.forename: L A
authors.initials: LA
authors.lastname: Hesson
authors.forename: C J
authors.initials: CJ
authors.lastname: Homko
authors.forename: B J
authors.initials: BJ
authors.lastname: Maschak-Carey
authors.forename: N R
authors.initials: NR
authors.lastname: Barbor
authors.forename: B
authors.initials: B
authors.lastname: Bailer
authors.forename: L
authors.initials: L
authors.lastname: Diewald
authors.forename: E
authors.initials: E
authors.lastname: Komaroff
authors.forename: S J
authors.initials: SJ
authors.lastname: Herring
authors.forename: M L
authors.initials: ML
authors.lastname: Vetter