Look AHEAD to Wellness

The long-running Look AHEAD (Action for Health in Diabetes) trial randomly divided more than 5,000 overweight or obese people between 45 and 76 years old who had type 2 diabetes. One group was assigned to receive strong support for eating better and exercising more. These participants were seen weekly for the first six months, then gradually tapering to contact at least once a month. Group classes were available, as well as support by phone or e-mail. The other group members got a more typical approach: They were invited to three group sessions a year in which they heard about diet, physical activity, and social support.

Both groups were assessed annually. In the intensive intervention group, people lost more weight each year than in the other group. After four years, they maintained a weight loss averaging 6.15 percent of their body weight, compared with 0.88 percent in the group getting less education and support.

“You could argue that lifestyle intervention is the way to go for everyone. The problem is, clearly it is much easier to have a great effect on weight by lifestyle [changes] when you have followup from a dietitian, an exercise physiologist, a support team, and a lot of resources,” Cagliero said.

Insurers typically don’t pay for this level of support, he said.

“Perhaps we should rethink our strategies” on health care, he said. “If Look AHEAD shows less cardiovascular disease, you could argue that instead of using the money to pay for drugs, instead of having to pay for heart attacks or bypass surgery or stents, you could put health care dollars into more preventive efforts.”

We praise that sort of forward and rational thinking.  Please share articles and studies you find that support physical activity participation and other non-drug wellness interventions for those with type 2 Diabetes.  The more we can get the word out the more attention we can bring to alternatives that not only work with targeted individuals, but also inspire a culture of wellness among families and the greater community.

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