Weight Loss and Health….

November 6, 2009

Now the good news….

The main reason for my weight loss through lifestyle change is my aim to reduce my risk to develop diabetes in the future.  After a scary 96 mg/dl fasting blood sugar during my annual executive checkup, I pushed myself to achieve my ideal BMI becuase apparently I was overweight.

Now as published in Lancet this October 29, 2009, the long term Diabetes Prevention Program extended study showed long term benefits of modest weight loss through lifestyle as better in preventing the progression of the disease compared to intake of medication called Metformin. 

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Background

In the 2·8 years of the Diabetes Prevention Program (DPP) randomised clinical trial, diabetes incidence in high-risk adults was reduced by 58% with intensive lifestyle intervention and by 31% with metformin, compared with placebo. We investigated the persistence of these effects in the long term.

Methods

All active DPP participants were eligible for continued follow-up. 2766 of 3150 (88%) enrolled for a median additional follow-up of 5·7 years (IQR 5·5—5·8). 910 participants were from the lifestyle, 924 from the metformin, and 932 were from the original placebo groups. On the basis of the benefits from the intensive lifestyle intervention in the DPP, all three groups were offered group-implemented lifestyle intervention. Metformin treatment was continued in the original metformin group (850 mg twice daily as tolerated), with participants unmasked to assignment, and the original lifestyle intervention group was offered additional lifestyle support. The primary outcome was development of diabetes according to American Diabetes Association criteria. Analysis was by intention-to-treat. This study is registered with ClinicalTrials.gov, number NCT00038727.

Findings

During the 10·0-year (IQR 9·0—10·5) follow-up since randomisation to DPP, the original lifestyle group lost, then partly regained weight. The modest weight loss with metformin was maintained. Diabetes incidence rates during the DPP were 4·8 cases per 100 person-years (95% CI 4·1—5·7) in the intensive lifestyle intervention group, 7·8 (6·8—8·8) in the metformin group, and 11·0 (9·8—12·3) in the placebo group. Diabetes incidence rates in this follow-up study were similar between treatment groups: 5·9 per 100 person-years (5·1—6·8) for lifestyle, 4·9 (4·2—5·7) for metformin, and 5·6 (4·8—6·5) for placebo. Diabetes incidence in the 10 years since DPP randomisation was reduced by 34% (24—42) in the lifestyle group and 18% (7—28) in the metformin group compared with placebo.

Interpretation

During follow-up after DPP, incidences in the former placebo and metformin groups fell to equal those in the former lifestyle group, but the cumulative incidence of diabetes remained lowest in the lifestyle group. Prevention or delay of diabetes with lifestyle intervention or metformin can persist for at least 10 years.

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The study clearly shows that weight loss through lifestyle changes can significantly reduce ones risk to develop diabetes by as much as 34%. 

The Intensive lifestyle changes in the study consisted of lowering fat and calories in the diet and increasing regular physical activity to 150 minutes per week.  Most exercise was in a form of walking.  Modest weight loss was around 15 lbs in the first year but overtime regained them all but 5 lbs over the next 10 years.  I guess this shows that lifestyle really is difficult for some to maintain.

What matters most for this study is that lifestyle change through fitness and nutrition really works.  The only problem is how one can maintain to be active throughout ones life and how one can withstand the sight of FOOOOD!!!! 

For me….Its a matter of discipline and focus… The two main ingredients to achieving success through behavioral modification.  Clinically, the measure of success is when one is able to maintain the weight loss beyond 1 year of intervention.  Losing weight in 6 months is good…but gaining them back in the next 6 months is bad…..

The Facts are here… the Benefits are known… The rest now depends on YOU!

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4 Responses to “Weight Loss and Health….”

  1. Dr. Nilda Manalo Says:

    Hi.. I really admire you sir for doing that.. to lose weight significantly to prevent development of diabetes. Honestly, how many patients and even doctors can actually do that. I wish they can find your website.I wish you can inspire them too. I wish they can fully understand how diet and exercise be an important part of a healthy lifestyle..

  2. Dr. Nilda Manalo Says:

    Hi Doc Gerry, just can’t remember in what article did I read about you saying that of all topical beauty agents it was only Olay which has a research improving our skin… evidence based baga.. I beleived you and it’s really worked. I think I don’t need to see Derma already. They should be grateful that you mentioned their product ha ha ha. Regards..


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