Impact on psychosocial outcomes of a nationally available weight management program tailored for individuals with type 2 diabetes: Results of a randomized controlled trial.
OBJECTIVE
Type 2 diabetes mellitus (T2DM) can substantially decrease quality of life (QOL). This study examined the effects on QOL-relevant psychosocial measures of a widely available commercial weight loss program enhanced for individuals with T2DM.


METHODS
A year-long multi-site randomized clinical trial compared the Weight Watchers (WW) approach, supplemented with phone and email counseling with a certified diabetes educator (CDE), to brief standard diabetes nutrition counseling and education (Standard Care; SC). Participants were 400 women and 163 men (N=279 WW; 284 SC) with T2DM [mean (±SD) HbA1c8.32±1%; BMI=37.1±5.7kg/m2; age=55.1 ± 9.1years]. Psychosocial outcomes were assessed at baseline, month 6, and month 12 using a diabetes specific psychosocial measure (Diabetes Distress Scale [DDS]), Impact of Weight on Quality of Life-Lite scale (IWQOL), a generic QOL measure (SF-36), and a depression screen (PHQ-9).


RESULTS
WW participants showed significantly greater improvements than did SC participants on all DDS subscales and total score and on IWQOL total score and physical function, sex life and work domains (all ps<.05). There was no significant treatment effect on SF-36 scores or PHQ-9.


CONCLUSIONS
WW enhanced for individuals with T2DM was superior to SC in improving psychosocial outcomes most specific to T2DM and obesity. Available commercial WL programs, combined with scalable complementary program-specific diabetes counseling, may have benefits that extend to diabetes-related distress and weight-relevant QOL.
Weight Management Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Suite 410 South, Charleston, SC, 29425. Electronic address: holland@musc.edu.
Lauren
L
Holland-Carter
Weight Management Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Suite 410 South, Charleston, SC, 29425; Mental Health Service, Ralph H. Johnson VA Medical Center, 109 Bee Street, Charleston, SC, 29401. Electronic address: tuerk@musc.edu.
Peter W
PW
Tuerk
Center for Weight and Eating Disorders, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Suite 3029, Philadelphia, PA, 19104. Electronic address: wadden@mail.med.upenn.edu.
Thomas A
TA
Wadden
Scripps Clinical Research, 11025 N. Torrey Pines Road, Suite 200, LaJolla, CA 92037. Electronic address: fujioka.ken@scrippshealth.org.
Ken N
KN
Fujioka
Weight Management Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Suite 410 South, Charleston, SC, 29425. Electronic address: lynne.e.becker@gmail.com.
Lynne E
LE
Becker
Weight Watchers International, 11 Madison Avenue 17th Floor, New York, NY 10010. Electronic address: kmillerkovach@gmail.com.
Karen
K
Miller-Kovach
Baylor Endocrine Center, 3600 Gaston Avenue, Wadley Tower, Suite 656, Dallas, TX 75246. Electronic address: priscilh@baylorhealth.edu.
Priscilla L
PL
Hollander
Department of Nutrition Sciences, 1675 University Blvd, University of Alabama at Birmingham, Birmingham, AL 35294; Birmingham Veterans Administration Medical Center. Electronic address: garveyt@uab.edu.
W Timothy
WT
Garvey
Your Diabetes Endocrine Nutrition Group, 8300 Tyler Blvd Suite 102, Mentor, OH 44060. Electronic address: drdanweiss@ameritech.net.
Daniel
D
Weiss
Washington Center for Weight Management & Research, 2800 S. Shirlington Road, Arlington, VA 22206. Electronic address: drubino@wtmgmt.com.
Domenica M
DM
Rubino
Northwestern University, Feinberg School of Medicine, Rubloff Building 10th Floor, 750 N. Lake Shore Drive, Chicago, IL 60611. Electronic address: rkushner@northwestern.edu.
Robert F
RF
Kushner
Weight Management Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Suite 410 South, Charleston, SC, 29425.
Robert J
RJ
Malcolm
Oregon Weight Loss Surgery, 1040 NW 22nd Avenue, Suite 500, Portland, OR 97210. Electronic address: wraum@oregonwls.com.
William J
WJ
Raum
Division of Endocrinology, Diabetes and Medical Genetics, College of Medicine, Clinical Science Building, 8th Floor, 96 Jonathan Lucas Street, Medical University of South Carolina, Charleston, SC 29425. Electronic address: hermayer@musc.edu.
Kathie L
KL
Hermayer
Weight Watchers International, 11 Madison Avenue 17th Floor, New York, NY 10010. Electronic address: jvelikocde@yahoo.com.
Jan L
JL
Veliko
Weight Watchers International, 11 Madison Avenue 17th Floor, New York, NY 10010. Electronic address: schoemers@gmail.com.
Stephanie L
SL
Rost
Division of Endocrinology, Diabetes and Medical Genetics, College of Medicine, Clinical Science Building, 8th Floor, 96 Jonathan Lucas Street, Medical University of South Carolina, Charleston, SC 29425. Electronic address: sora@musc.edu.
Nicoleta D
ND
Sora
Lovelace Scientific Resources, 2441 Ridgecrest Drive, SE, Albuquerque, NM 87108.
Jonny L
JL
Salyer
Weight Management Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Suite 410 South, Charleston, SC, 29425. Electronic address: oneilp@musc.edu.
Patrick M
PM
O'Neil
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000523:psychology / Q000628:therapy*; D034742:Electronic Mail; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000523:psychology / Q000628:therapy*; D009767:Obesity, Morbid / Q000150:complications / Q000523:psychology / Q000628:therapy; D050177:Overweight / Q000150:complications / Q000523:psychology / Q000628:therapy*; D010353:Patient Education as Topic; D000072858:Psychosocial Support Systems; D011788:Quality of Life; D017216:Telemedicine; D013689:Telephone; D014481:United States; D015431:Weight Loss; D061217:Weight Reduction Programs; D055815:Young Adult
Commercial weight loss programs; Diabetes; Diabetes distress; Psychosocial; Quality of life; Weight loss