Skill Checkup: A 36-Year-Old Man With Type 2 Diabetes Is Struggling to Lose Weight

Anne L. Peters, MD


June 01, 2022

The Look AHEAD trial had, as its primary endpoint, a reduction in cardiovascular events. However, this study did not show that the intensive lifestyle intervention reduced cardiovascular events in adults with type 2 diabetes and overweight or obesity. Nevertheless, it did confirm several beneficial effects of intensive lifestyle intervention: It confirmed the feasibility of achieving and maintaining long-term weight loss in patients with type 2 diabetes. In the intensive lifestyle intervention group, mean weight loss was 4.7% at 8 years. Approximately 50% of intensive lifestyle intervention participants lost and maintained ≥ 5% of their initial body weight; and about 27% lost and maintained ≥ 10% of their initial body weight at 8 years; in these patients, a reduction in cardiovascular endpoints was seen. Participants assigned to the intensive lifestyle group required fewer glucose-, blood pressure–, and lipid-lowering medications than those randomly assigned to standard care.


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