Four-year weight losses in the look AHEAD study: Factors associated with long-term success

Thomas A. Wadden, Rebecca H. Neiberg, Rena R. Wing, Jeanne M. Clark, Linda M. Delahanty, James O. Hill, Jonathan Krakoff, Amy Otto, Donna H. Ryan, Mara Z. Vitolins, Frederick L. Brancati, Lee Swartz, Lawrence Cheskin, Jeanne M. Clark, Kerry Stewart, Richard Rubin, Jean Arceci, Suzanne Bau, Jeanne Charleston, Danielle DigginsMia Johnson, Joyce Lambert, Kathy Michalski, Daron Niggetts, Chanchai Sapun, George A. Bray, Kristi Rau, Allison Strate, Frank L. Greenway, Donna H. Ryan, Donald Williamson, Brandi Armand, Jennifer Arceneaux, Amy Bachand, Michelle Begnaud, Betsy Berhard, Elizabeth Caderette, Barbara Cerniauskas, David Creel, Diane Crow, Crystal Duncan, Helen Guay, Carolyn Johnson, Nancy Kora, Kelly LaFleur, Kim Landry, Missy Lingle, Carolyn Thorson, Richard S. Crow, Susan K. Raatz, The Look AHEAD Research Group

Research output: Contribution to journalArticlepeer-review

324 Scopus citations


This report provides a further analysis of the year 4 weight losses in the Look AHEAD (Action for Health in Diabetes) study and identifies factors associated with long-term success. A total of 5,145 overweight/obese men and women with type 2 diabetes were randomly assigned to an intensive lifestyle intervention (ILI) or a usual care group, referred to as Diabetes Support and Education (DSE). ILI participants were provided approximately weekly group or individual treatment in year 1; continued but less frequent contact was provided in years 2-4. DSE participants received three group educational sessions in all years. As reported previously, at year 4, ILI participants lost an average of 4.7% of initial weight, compared with 1.1% for DSE (P 0.0001). More ILI than DSE participants lost 5% (46% vs. 25%, P 0.0001) and 10% (23% vs. 10%, P 0.0001) of initial weight. Within the ILI, achievement of both the 5% and 10% categorical weight losses at year 4 was strongly related to meeting these goals at year 1. A total of 887 participants in ILI lost 10% at year 1, of whom 374 (42.2%) achieved this loss at year 4. Participants who maintained the loss, compared with those who did not, attended more treatment sessions and reported more favorable physical activity and food intake at year 4. These results provide critical evidence that a comprehensive lifestyle intervention can induce clinically significant weight loss (i.e., 5%) in overweight/obese participants with type 2 diabetes and maintain this loss in more than 45% of patients at 4 years.

Original languageEnglish (US)
Pages (from-to)1987-1998
Number of pages12
Issue number10
StatePublished - Oct 1 2011


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