Weight loss and improved glycaemic control: results from an interdisciplinary group-based weight management program

Abstract

background and aims: Weight management is an important element in diabetes care. However, losing weight is a real challenge for most people, and balancing diabetes and weight issues can be overwhelming. Strategies such as caloric restriction, increased energy expenditure and behaviour modification have been demonstrated to be effective in terms of weight loss and glycemic control among individuals with type 2 diabetes. Group-based weight management programs provide many opportunities for individuals to learn strategies and to identify with others. This study examined weight and A1c changes in individuals participating in a group-based weight management program. Materials and Methods: We studied a cohort of overweight or obese individuals with type 2 diabetes who participated in a group-based weight management program in 2008. Objectives of the program included: 1) weight loss; 2) increased physical activity, 3) improved food choices; and 4) awareness of healthy eating behaviours. The program consisted of 13 weekly group sessions led by a dietitian, kinesiologist or social worker. Data was collected at the beginning and end of the program. results: 37 overweight or obese program participants (14 males, 23 females) of mean age 59.8 ± 8.5 yrs treated with diet alone (5.4%), oral agents alone (40.5%), insulin alone (29.7%) and insulin +oral agents (24.3%) were studied. Their mean weight, BMI, waist circumference and A1C were 108.6 ± 18.4 kg , 37.7 ± 6.6 kg/m, 121.6 ± 13.0 cm and 7.4 ± 0.8, respectively. 15 individuals (41% of cohort) were assessed before and following participation in the group-based weight management program. Compared to baseline, the mean change in weight, BMI, waist and A1C were – 3.6 ± 4.4 kg (p<0.01), -1.4 ± 1.5 kg/m (p<0.005), -2.6 ± 4.7 cm (p=0.051) and – 0.5 ± 0.2 % (p<0.005), respectively. All participants reported feeling more confident in their ability to make changes in physical activity levels, dietary choices, and to cope with emotional triggers to eating. Identified areas of improvement with respect to the program included: 1) regular monitoring and feedback of food diaries; 2) more physical activity; 3) more behaviour modification strategies. conclusion: Participation in an interdisciplinary group-based weight management program which incorporated healthy eating, physical activity and behaviour modification along with diabetes management resulted in significant weight loss and improvement in glycemic control after 13 weeks. Based on program evaluation, the program has added: 1) individual consultations with a dietitian; 2) mandatory 30 minute physical activity with each session; and 3) involvement of a health psychologist.