Looking AHEAD to Weight Loss

One of the biggest and most important diabetes trials is well underway. But so far it hasn’t received much attention. That will change

The Look AHEAD trial began in 2001 and is scheduled to conclude in 2012. In it they randomly assigned 5,145 overweight people with type 2 diabetes to either a lifestyle intervention or to enhanced diabetes support and education.

AHEAD is shorthand for Action for Health and Diabetes. We sure like catchy acronyms, don’t we!

What they are trying to do is to get the participants to lose an average of seven percent of their body weight and encourage them to increase their physical activity to at least 175 minutes of exercise a week. Modest goals, but proven effective.

Here’s how they hope to get them to achieve these goals. The people in the study are attending individual and group sessions. Their diet encourages them to replace some meals and snacks with liquid shakes and meal bars.

Here’s what they want to find out. Does this multi-center, randomized controlled trial show that overweight people with diabetes can live longer with a healthy heart by intentionally losing weight?

Three successful strategies are already emerging from an analysis of the first year of the trial:

1. The most successful strategy was the simplest — weighing at least once a week. When the scientists compared the people in the study by how often they weighed themselves, those that weighed weekly had a lower body mass index (BMI) than those who weighed themselves less than once a month. Feedback works.

2. The second successful strategy is to get them to eat. Not counterintuitive. They wanted them to eat — not skip — breakfast. I reported on the general success of this strategy in an article here exactly two years ago. Participants in the Look AHEAD study who consumed breakfast seven days a week had a lower BMI those who skipped one or more breakfasts.

3. Cutting back on how much they ate at fast-food restaurants also helped the people in the study to lose weight.

But it’s just as important to know what doesn’t work. “The most commonly used weight control practice, increasing fruit and vegetable intake,” the initial report on the study concluded, “was not related to BMI.”

These are some of 23 weight loss strategies under investigation. By the time the study finishes four years from now we will know a lot more about how to take off the excess pounds. But early results of the Look AHEAD study is already giving us a great start.

This article is based on an earlier version of my article published by HealthCentral.