Randomized controlled trial of a nationally available weight control program tailored for adults with type 2 diabetes.
Modest weight loss from clinical interventions improves glycemic control in type 2 diabetes (T2DM). Data are sparse on the effects of weight loss via commercial weight loss programs. This study examined the effects on glycemic control and weight loss of the standard Weight Watchers program, combined with telephone and email consultations with a certified diabetes educator (WW), compared with standard diabetes nutrition counseling and education (standard care, SC).



In a 12-month randomized controlled trial at 16 U.S. research centers, 563 adults with T2DM (HbA1c7-11%; BMI 27-50 kg/m2) were assigned to either the commercially available WW program (regular community meetings, online tools), plus telephone and email counseling from a certified diabetes educator, or to SC (initial in-person diabetes nutrition counseling/education, with follow-up informational materials).



Follow-up rate was 86%. Twelve-month HbA1cchanges for WW and SC were -0.32 and +0.16, respectively; 24% of WW versus 14% of SC achieved HbA1c<7.0% (P = 0.004). Weight losses were -4.0% for WW and -1.9% for SC (Ps < 0.001). 26% of WW versus 12% of SC reduced diabetes medications (P < 0.001). WW participants had greater reductions in waist circumference (P < 0.001) and C-reactive protein (P = 0.02) but did not differ on other cardiovascular risk factors.



Widely available commercial weight loss programs with community and online components, combined with scalable complementary diabetes education, may represent accessible and effective components of management plans for adults with overweight/obesity and T2DM.
Department of Psychiatry and Behavioral Sciences, Weight Management Center, Medical University of South Carolina, Charleston, South Carolina, USA. oneilp@musc.edu.
Patrick M
PM
O'Neil
Weight Watchers International, New York, New York, USA.
Karen
K
Miller-Kovach
Department of Psychiatry and Behavioral Sciences, Weight Management Center, Medical University of South Carolina, Charleston, South Carolina, USA.|Mental Health Service, Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA.
Peter W
PW
Tuerk
Department of Psychiatry and Behavioral Sciences, Weight Management Center, Medical University of South Carolina, Charleston, South Carolina, USA.
Lynne E
LE
Becker
Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Thomas A
TA
Wadden
Scripps Clinical Research, La Jolla, California, USA.
Ken
K
Fujioka
Baylor Endocrine Center, Dallas, Texas, USA.
Priscilla L
PL
Hollander
Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Robert F
RF
Kushner
Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA.|Birmingham VA Medical Center, Birmingham, Alabama, USA.
W
W
Timothy Garvey
Washington Center for Weight Management & Research, Arlington, Virginia, USA.
Domenica M
DM
Rubino
Department of Psychiatry and Behavioral Sciences, Weight Management Center, Medical University of South Carolina, Charleston, South Carolina, USA.
Robert J
RJ
Malcolm
Your Diabetes Endocrine Nutrition Group, Mentor, Ohio, USA.
Daniel
D
Weiss
Oregon Weight Loss Surgery, Portland, Oregon, USA.
William J
WJ
Raum
Lovelace Scientific Resources, Albuquerque, New Mexico, USA.
Jonny L
JL
Salyer
Division of Endocrinology, Diabetes & Medical Genetics, College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Kathie L
KL
Hermayer
Weight Watchers International, New York, New York, USA.
Stephanie L
SL
Rost
Weight Watchers International, New York, New York, USA.
Jan L
JL
Veliko
Division of Endocrinology, Diabetes & Medical Genetics, College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Nicoleta D
ND
Sora
D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000628:therapy; D002784:Cholesterol / Q000097:blood; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D034742:Electronic Mail; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006266:Health Education; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy; D050177:Overweight / Q000628:therapy; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013689:Telephone; D055105:Waist Circumference; D061217:Weight Reduction Programs; D055815:Young Adult
D001786:Blood Glucose; D002097:C-Reactive Protein; D002784:Cholesterol; D006442:Glycated Hemoglobin