TABLE 10.2 Look AHEAD: Key Results at 4 Years19 Type 2 diabetes clinical outcomes


Weight loss, % initial body weight Improvements in treadmill fitness Improvements in HbA1c Improvements in systolic BP Improvements in diastolic BP Improvements in HDL cholesterol Triglycerides


a P = .001. b P = .01.


Abbreviations: BP, blood pressure; HbA1c, hemoglobin A1c; HDL, high-density lipoprotein.


ƒ Relative to the DSE group, the ILI group demonstrated sustained benefits for high-density lipoprotein cholesterol levels. Other studies have shown a strong association between increases in high-density lipoprotein choles- terol levels and reduced heart disease.


ƒ The intensive lifestyle intervention was shown to produce sustained weight loss and improvements in treadmill fitness, glycemic control, and CVD risk factors.


A further analysis of the 4-year weight losses in the Look AHEAD study iden- tified factors associated with long-term success.20


The analysis showed that a 5%


or 10% weight loss in the first year by participants in the ILI group was strongly associated with maintaining this weight loss at 4 years. In addition, participants who maintained the weight loss (compared to those who did not) attended more treatment sessions and reported substantially greater physical activity and sub- stantially lower energy intake.


Eight-Year Results


All participants in the Look AHEAD study had the opportunity to complete 8 years of intervention before the trial was halted in September 2012. Key findings at 8 years included the following21


:


ƒ Eighty-eight percent of both groups completed the 8-year outcomes assessment.


ƒ ILI participants lost a mean of 4.7% of their initial weight at 8 years, com- pared with a loss of 2.1% for the DSE group; this difference is statistically significant (P <.001).


ƒ Over the 8 years, ILI participants, compared with DSE participants, reported greater practice of several key weight-control behaviors, including:


Intensive lifestyle intervention −6.15% +12.74% −0.36% −5.33 mm Hg −2.92 mm Hg +3.67 mg/dL −25.56 mg/dL


Diabetes support and education −0.88%a +1.96%a −0.09%a −2.97 mm Hga −2.48 mm Hgb +1.97 mg/dLa −19.75 mg/dLa


178 SECTION 3: Interventions for the Treatment of Overweight and Obesity


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