Eight-year weight losses with an intensive lifestyle intervention: The look AHEAD study

Objective To evaluate 8-year weight losses achieved with intensive lifestyle intervention (ILI) in the Look AHEAD (Action for Health in Diabetes) study. Design and Methods Look AHEAD assessed the effects of intentional weight loss on cardiovascular morbidity and mortality in 5,145 overweight/obese adults with type 2 diabetes, randomly assigned to ILI or usual care (i.e., diabetes support and education [DSE]). The ILI provided comprehensive behavioral weight loss counseling over 8 years; DSE participants received periodic group education only. Results All participants had the opportunity to complete 8 years of intervention before Look AHEAD was halted in September 2012; 88% of both groups completed the 8-year outcomes assessment. ILI and DSE participants lost (mean +/- SE) 4.7%+/- 0.2% and 2.1 +/- 0.2% of initial weight, respectively (P < 0.001) at year 8; 50.3% and 35.7%, respectively, lost 5% (P < 0.001), and 26.9% and 17.2%, respectively, lost 10% (P < 0.001). Across the 8 years ILI participants, compared with DSE, reported greater practice of several key weight-control behaviors. These behaviors also distinguished ILI participants who lost 10% and kept it off from those who lost but regained. Conclusions Look AHEAD's ILI produced clinically meaningful weight loss (5%) at year 8 in 50% of patients with type 2 diabetes and can be used to manage other obesity-related co-morbid conditions.