Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Obesity (Silver Spring). 2011 Oct;19(10):1987-98. doi: 10.1038/oby.2011.230. Epub 2011 Jul 21.
This report provides a further analysis of the year 4 weight losses in the Look AHEAD (Action for Health in Diabetes) study and identifies factors associated with long-term success. A total of 5,145 overweight/obese men and women with type 2 diabetes were randomly assigned to an intensive lifestyle intervention (ILI) or a usual care group, referred to as Diabetes Support and Education (DSE). ILI participants were provided approximately weekly group or individual treatment in year 1; continued but less frequent contact was provided in years 2-4. DSE participants received three group educational sessions in all years. As reported previously, at year 4, ILI participants lost an average of 4.7% of initial weight, compared with 1.1% for DSE (P < 0.0001). More ILI than DSE participants lost ≥ 5% (46% vs. 25%, P < 0.0001) and ≥ 10% (23% vs. 10%, P < 0.0001) of initial weight. Within the ILI, achievement of both the 5% and 10% categorical weight losses at year 4 was strongly related to meeting these goals at year 1. A total of 887 participants in ILI lost ≥ 10% at year 1, of whom 374 (42.2%) achieved this loss at year 4. Participants who maintained the loss, compared with those who did not, attended more treatment sessions and reported more favorable physical activity and food intake at year 4. These results provide critical evidence that a comprehensive lifestyle intervention can induce clinically significant weight loss (i.e., ≥ 5%) in overweight/obese participants with type 2 diabetes and maintain this loss in more than 45% of patients at 4 years.
本报告进一步分析了 LOOK AHEAD（糖尿病患者的健康行动）研究中第 4 年的体重减轻情况，并确定了与长期成功相关的因素。共有 5145 名超重/肥胖的 2 型糖尿病患者被随机分配到强化生活方式干预组（ILI）或常规护理组，即糖尿病支持和教育组（DSE）。ILI 组的参与者在第 1 年接受了大约每周一次的小组或个人治疗；在第 2 至 4 年期间提供了持续但频率较低的联系。DSE 组的参与者在所有年份都接受了三次小组教育课程。正如之前报道的，在第 4 年，ILI 组参与者的体重平均减轻了初始体重的 4.7%，而 DSE 组的体重减轻了 1.1%（P < 0.0001）。ILI 组比 DSE 组有更多的参与者减轻了 ≥ 5%（46%比 25%，P < 0.0001）和 ≥ 10%（23%比 10%，P < 0.0001）的初始体重。在 ILI 中，在第 4 年达到 5%和 10%的体重减轻分类目标与在第 1 年达到这些目标密切相关。ILI 组共有 887 名参与者在第 1 年减轻了 ≥ 10%的体重，其中 374 名（42.2%）在第 4 年达到了这一目标。与未达到减肥目标的参与者相比，保持减肥的参与者参加了更多的治疗课程，并报告了更多的有利的身体活动和食物摄入。这些结果提供了重要证据，表明全面的生活方式干预可以使超重/肥胖的 2 型糖尿病患者减轻临床显著的体重（即 ≥ 5%），并在 4 年内保持超过 45%的患者的减肥效果。
