Tailored weight management -
Apolzan, Robbie A. Beyl, Frank L. Greenway, Melissa N. Virginia Commonwealth University School of Medicine, Richmond, VA, USA. Jessica Gokee LaRose, Edmond P. Tiffany Bullard, Gary D. Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA. You can also search for this author in PubMed Google Scholar. JWA, JGL, SDA, FLG, TB, and GDF contributed to the development of the study concept and design.
All authors contributed to data acquisition and interpretation. RAB performed the analysis. JWA and MIC contributed to drafting of the manuscript. All authors contributed to critical revision of the manuscript of important intellectual content.
JWA is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Correspondence to John W. JWA: Grants NIH NIDDK and NIMHD, NSF, and USDA. JGL: Grants NIH NIDDK. Grants: NovMeta Pharma. GDF: Employee and Shareholder at WW. MIC: Grants: National Institute of Health NHLBI and NIDDK. Employee at WW International, Inc.
The authors declare no other competing interests. Open Access This article is licensed under a Creative Commons Attribution 4. Reprints and permissions. Apolzan, J. et al. A scalable, virtual weight management program tailored for adults with type 2 diabetes: effects on glycemic control. Diabetes 13 , 3 Download citation.
Received : 27 October Revised : 12 March Accepted : 27 March Published : 06 April Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article.
Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content Thank you for visiting nature. Download PDF. Subjects Obesity Type 2 diabetes.
Abstract Background The objective was to test the efficacy of a scalable, virtually delivered, diabetes-tailored weight management program on glycemic control in adults with type 2 diabetes T2D.
Methods This was a single arm, three-site clinical trial. Conclusions The scalable, virtually delivered T2D-tailored weight management program had favorable and clinically meaningful effects on glycemic control, body weight, and psychosocial outcomes. Introduction Diabetes is a debilitating, deadly, and costly disease [ 1 , 2 ].
Methods This single-arm, three-site trial included Pennington Biomedical Research Center in Baton Rouge, LA, University of Florida in Gainesville, FL, and Virginia Commonwealth University in Richmond, VA.
Also, full exclusion criteria are listed below: Exclusion criteria 1. Participation in a weight control program within the past 3 months 2. Taking prescription or OTC weight loss medications within last 4 weeks 4.
gastroplasty, gastric by-pass, gastrectomy or partial gastrectomy, adjustable banding, gastric sleeve 5. History of major surgery within three months of enrollment 6.
Type 1 diabetes 7. Hemoglobinopathy that interferes with measurement of hemoglobin A1c Unstable heart disease an ongoing workup or treatment for a cardiac symptom such as unstable angina, coronary ischemia Presence of implanted cardiac defibrillator If a potential participant has a BP above the inclusion criteria it is acceptable to re-test this potential participant within one week of the original test History of thyroid disease or current thyroid disease treated with a stable medication regimen for at least 6 months is acceptable Orthopedic limitations that would interfere with ability to engage in regular physical activity Persons with successfully resected non-melanoma carcinoma of the skin may be enrolled illness that is currently unstable or resistant to first-line therapy; substance abuse in the past year History of clinically diagnosed eating disorders including anorexia nervosa or bulimia nervosa Women who are pregnant, lactating, trying to become pregnant or unwilling to use an effective means of birth control Participation in another clinical trial within 30 days prior to enrollment Any other condition or factor which in the opinion of the study physician or investigator makes it inadvisable for the candidate to participate in the trial As noted, specific drug exclusion criteria are as follows: 1 Anti-obesity medications prescription or OTC weight loss medications in the last 4 weeks including bupropion-naltrexone, liraglutide, phentermine, phentermine-topiramate, and orlistat.
Statistical analyses Analyses adhered to the intent-to-treat principle; missing data were accounted for using maximum likelihood estimation. Power calculation The sample size calculation was based on a previous WW study with T2D participants that found a 0. Results The flow of participants from initial screening through week 24 is shown in Fig.
Full size image. Table 1 Change in hemoglobin A1c, body weight, waist circumference, and blood pressure with a 24 week scalable, virtually delivered diabetes-tailored weight management program. Full size table. Table 2 Change in diabetes distress scale, hunger, and quality of life with a 24 week scalable, virtually delivered diabetes-tailored weight management program.
Discussion The WW virtual weight loss and wellness program tailored for diabetes resulted in HbA1c reductions and improvements in diabetes distress similar to in-person trials [ 5 , 18 ].
Limitations These promising results await replication in a randomized controlled trial. References Wright AK, Kontopantelis E, Emsley R, Buchan I, Sattar N, Rutter MK, et al. Article PubMed Google Scholar American Diabetes A.
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Article PubMed Google Scholar Lenters-Westra E, Schindhelm RK, Bilo HJ, Groenier KH, Slingerland RJ. Patients in the phenotype-guided diet and exercise program lost twice as much weight as patients who were on the Mayo Clinic diet. They also saw a greater decrease in waist circumference, fat mass, gastric emptying, anxiety score and triglycerides level.
This finding can reach far beyond patients who are obese and also help those who are overweight and trying to lose weight that creeps up year over year. A one-size-fits-all treatment for obesity will not work for many patients due to the complexity, heterogeneity and multifactorial nature of the disease.
Using precision medicine to target treatments for individuals based on the causes behind their disease is providing better outcomes than traditional guidance.
Using personalized approaches to treating disease has become much more common as we have gained a deeper understanding of diseases. Consider how our understanding of cancer treatment has evolved over time.
Each case is unique to the individual and needs to be treated as such — the same goes for obesity. We have been calling obesity a disease for more than a decade, and until now, we have not been able to explain to a patient why they are suffering from this disease. We have a lot more to discover about phenotyping, and there are ongoing studies to examine different drug responses and outcomes as they relate to obesity treatment and phenotypes.
We are also looking at other procedure interventions and how phenotyping could improve outcomes. By using obesity phenotyping to understand exactly why patients have not been able to lose weight in the past, we are able to set patients up for success in weight loss and improve their overall health.
Healio News Gastroenterology Practice Management. Issue: November By Andres Acosta, MD, PhD. Fact checked by Heather Biele.
Read more. Our overarching goal is to promote the health of people with disabilities. As the result of obtaining successful outcomes from these projects demonstrating weight loss in people with physical disabilities, this proposal aims to develop a web-based Personalized Online Weight and Exercise Response System POWERS , an intelligent individualized weight management coaching solution and clinical decision support system designed specifically for individuals with disabilities.
Its target users are health promotion specialists working in clinical centers, disability and health professionals working in public health programs, rehabilitation professionals, and fitness professionals, who would serve as telehealth coaches to assist individuals with disabilities achieve weight loss and improve their health promotion behaviors improved nutrition and increased physical activity.
Participants in the POWERS-supported program are expected to have 1 greater increase in physical activity and nutritional behaviors; 2 greater reduction in the number of barriers to physical activity and healthy eating patterns; 3 greater improvement in attitudes toward physical activity and healthy nutrition; and ultimately 4 greater reduction in weight and Body Mass Index.
This Phase I project has three specific aims: 1 collect feedback from 24 stakeholders on system features, usability design, and perceived usefulness via focus groups and interviews;2 extend the POWERS prototype with a user- centric design process including two formal usability tests involving 12 health professionals and 12 individuals with disabilities; and 3 conduct a pilo randomized study to study the efficacy and feasibility ofthis approach with 60 subjects.
POWERS will support researchers, health professionals and eventually family members in providing individualized tailored support for addressing obesity in people with disabilities.
Skip to main content. You are here Home. Award Information. Agency: Department of Health and Human Services. Branch: National Institutes of Health. Contract: 1R43DK
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