Arch Intern Med. 2009 Jan 26;169(2):163-71. doi: 10.1001/archinternmed.2008.544.

Impact of a weight management program on health-related quality of life in overweight adults with type 2 diabetes.

Williamson DA, Rejeski J, Lang W, Van Dorsten B, Fabricatore AN, Toledo K; Look AHEAD Research Group.

Collaborators (357)

Brancati FL, Honas J, Cheskin L, Clark JM, Stewart K, Rubin R, Charleston J, Horak K, Bray GA, Rau K, Strate A, Armand B, Greenway FL, Ryan DH, Williamson D, Bachand A, Begnaud M, Berhard B, Caderette E, Cerniauskas B, Creel D, Crow D, Guay H, Kora N, LaFleur K, Landry K, Lingle M, Perault J, Shipp M, Smith M, Tucker E, Lewis CE, Thomas S, Safford M, DiLillo V, Bragg C, Dobelstein A, Gilbert S, Glasser S, Hannum S, Hubbell A, Jones J, Lee D, Luketic R, Marshall K, Oden LC, Raines J, Roche C, Truman J, Webb N, Wrenn A, Nathan DM, Turgeon H, Schumann K, Cagliero E, Delahanty L, Hayward K, Anderson E, Bissett L, Ginsburg R, Goldman V, Harlan V, McKitrick C, McNamara A, Michel T, Poulos A, Steiner B, Tosch J, Horton ES, Jackson SD, Hamdy O, Caballero AE, Bain S, Bovaird E, Goebel-Fabbri A, Lambert L, Ledbury S, Malloy M, Ovalle K, Blackburn G, Mantzoros C, Day K, McNamara A, Hill JO, Miller M, Phillipp J, Schwartz R, Van Dorsten B, Regensteiner J, Benchekroun S, Coelho L, Cohrs P, Daeninck E, Fields A, Green S, Hamilton A, Hamilton J, Leshchinskiy E, McDermott M, Munkwitz L, Rome L, Wallace K, Worley T, Foreyt JP, Reeves RS, Pownall H, Balasubramanyam A, Jones P, Burrington M, Chen CH, Clark A, Gee M, Griggs S, Hamilton M, Holley V, Joseph J, Pace P, Palencia J, Satterwhite O, Schmidt J, Volding D, White C, Saad MF, Sengardi SG, Chiu KC, Botrous M, Chan M, Konersman K, Perpetua M, Johnson KC, Gresham C, Connelly S, Brewer A, Coday M, Jones L, Lichtermann L, Vosburg S, Taylor JL, Kitabchi AE, Lambeth H, Clark D, Crisler A, Cunningham G, Green D, Force D, Kores R, Rosenthal R, Smith E, Sun M, Soberman J, Jeffery RW, Thorson C, Bantle JP, Redmon JB, Crow RS, Crow S, Raatz SK, Brelje K, Campbell C, Carls J, Carmean-Mihm T, Finch E, Fox A, Hoelscher E, James LD, Maddy VA, Ockenden T, Rice BI, Skarphol T, Tucker AD, Voeller MS, Walcheck C, Pi-Sunyer X, Patricio J, Heshka S, Pal C, Allen L, Hirsch D, Holowaty MA, Wadden TA, Maschak-Carey BJ, Schwartz S, Foster GD, Berkowitz RI, Glick H, Kumanyika SK, Brock J, Chomentowski H, Clark V, Crerand C, Davenport R, Diamond A, Fabricatore A, Hesson L, Krauthamer-Ewing S, Kuehnel R, Lipschutz P, Mullen M, Womble L, Iqbal N, Kelley DE, Wesche-Thobaben J, Kuller L, Kriska A, Bonk J, Danchenko R, Edmundowicz D, Klem ML, Yamamoto ME, Elnyczky B, Grove GA, Harper P, Krulia J, Mancino J, Mathews A, Murray TY, Ritchea JR, Rush J, Vujevich K, Wolf D, Wing RR, Bright R, Pera V, Jakicic J, Tate D, Gorin A, Gallagher K, Bach A, Bancroft B, Bertorelli A, Carey R, Charron T, Chenot H, Chula-Maguire K, Coward P, Cronkite L, Currin J, Daly M, Egan C, Ferguson E, Foss L, Gauvin J, Kieffer D, Lessard L, Maier D, Massaro JP, Monk T, Nicholson R, Patterson E, Phelan S, Raynor H, Raynor D, Robinson N, Robles D, Tavares J, Haffner SM, Montez MG, Lorenzo C, Kahn S, Montgomery B, Knopp R, Lipkin E, Maciejewski ML, Trence D, Barrett T, Bartell J, Greenberg D, Murillo A, Richmond BA, Thomas A, Knowler WC, Bolin P, Killean T, Manus C, Krakoff J, Curtis JM, Glass J, Michaels S, Bennett PH, Morgan T, Begay S, Fallis B, Hermes J, Hollowbreast DF, Johnson R, Meacham M, Nelson J, Percy C, Poorthunder P, Sangster S, Scurlock N, Shovestull LA, Smiley J, Toledo K, Tomchee C, Tonemah D, Peters A, Ruelas V, Sengardi SG, Graves K, Konersman K, Serafin-Dokhan S, Espeland MA, Bahnson JL, Wagenknecht L, Reboussin D, Rejeski WJ, Bertoni A, Lang W, Miller G, Lefkowitz D, Reynolds PS, Ribisl P, Vitolins M, Booth M, Dotson KM, Hodges A, Williams CC, Barnes JM, Feeney PA, Griffin J, Harvin L, Herman W, Hogan P, Jaramillo S, King M, Lane K, Neiberg R, Ruggiero A, Speas C, Walkup MP, Wall K, Ward M, West DS, Windham T, Nevitt M, Ewing S, Hayashi C, Maeda J, Palermo L, Rahorst M, Schwartz A, Shepherd J, Marcovina SM, Strylewicz G, Prineas RJ, Alexander T, Billings L, Campbell C, Hall S, Hensley S, Li Y, Zhang ZM, Mayer-Davis EJ, Moran R, Foushee R, Hall NJ.

Source

Health Psychology Department, Pennington Biomedical Research Center, Louisiana State University System, 6400 Perkins Rd, Baton Rouge, LA 70808-4124, USA. WilliaDA@pbrc.edu

Abstract

BACKGROUND:

Inconsistent findings have been reported regarding improved health-related quality of life (HRQOL) after weight loss. We tested the efficacy of a weight management program for improving HRQOL in overweight or obese adults diagnosed as having type 2 diabetes mellitus.

METHODS:

We conducted a randomized multisite clinical trial at 16 outpatient research centers with 2 treatment arms and blinded measurements at baseline and the end of year 1. A total of 5145 participants (mean [SD] age, 58.7 [6.9] years; mean [SD] body mass index [calculated as weight in kilograms divided by height in meters squared], 36.0 [5.9]; 59.5% women; 63.1% white) were randomized to an intensive lifestyle intervention (ILI) or to diabetes support and education (DSE). Main outcome measures included the 36-Item Short-Form Health Survey physical component summary (PCS) and mental health component summary (MCS) scores and Beck Depression Inventory II (BDI-II) scores. Baseline mean (SD) scores were 47.9 (7.9) for PCS, 54.0 (8.1) for MCS, and 5.7 (5.0) for BDI-II.

RESULTS:

Improved HRQOL was demonstrated by the PCS and BDI-II scores (P < .001) in the ILI arm compared with the DSE arm. The largest effect was observed for the PCS score (difference, -2.91; 99% confidence interval, -3.44 to -2.37). The greatest HRQOL improvement occurred in participants with the lowest baseline HRQOL levels. Mean (SD) changes in weight (ILI, -8.77 [8.2] kg and DSE, -0.86 [5.0] kg), improved fitness, and improved physical symptoms mediated treatment effects associated with the BDI-II and PCS.

CONCLUSIONS:

Overweight adults diagnosed as having type 2 diabetes experienced significant improvement in HRQOL by enrolling in a weight management program that yielded significant weight loss, improved physical fitness, and reduced physical symptoms.