Will a Commercial Weight Loss Program Solve Our Diabetes Problem?

Type 2 diabetes, obesity, weight loss
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The single greatest risk factor for Type 2 diabetes is excess body weight. There are many options for losing weight – from self-help books to medical services – but which is best when one also needs to control blood sugar? Commercial weight loss programs, such as Jenny Craig and Weight Watchers, are being studied in a clinical trial based out of UC San Diego School of Medicine to see how effective these are for those who are overweight plus have the co-morbidity of Type 2 diabetes.

Type 2 diabetes affects the way the body is able to use glucose (sugar) for energy. Biologically, the body breaks down carbohydrates from food into glucose. This is released into the blood stream where insulin, a hormone made by the pancreas, helps shuttle the glucose into the cells where it is used as fuel for metabolic process. For those with Type 2 diabetes, the insulin produced is not effective in getting the glucose to the cells where it needs to be, so the sugar continues to circulate in the blood. Over time, hyperglycemia (the state of having too high a level of blood sugar) damages body systems and leads to complications such as heart disease, blindness, and kidney failure.

The American Diabetes Association notes that there is an estimated 25.8 million children and adults in the United States with diabetes. In addition, there are about 79 million people who have prediabetes, a condition of high blood sugar that typically comes before the clinical diagnosis of Type 2 diabetes.

Healthcare costs for this disease is astounding. The ADA notes that the average medical expenditure among people with diagnosed diabetes was 2.3 times higher than those not affected. The nation spent $116 billion dollars in direct medical costs in 2007.

The primary treatment for Type 2 diabetes is diet modification and exercise. Normally, a patient will be referred to a Diabetes Educator (either a Registered Nurse or a Registered Dietitian) who help design a meal plan for the patient to follow. Unfortunately, there is a high rate of dropout from these programs.

Would a commercial weight loss program be more effective in helping diabetic patients bring blood sugar levels back to normal? Cheryl Rock, PhD, RD, professor in the Department of Family and Preventive Medicine at the UC San Diego School of Medicine, hopes to find out.

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“We know that commercial weight loss programs can contribute to weight loss. Now we ask if they can have an impact on diabetes,” she says. “We want to find out if participants using a weight loss program do better than those who receive individualized dietary counseling with a registered dietitian.”

A UK study last year found that commercial weight loss programs were more effective and cheaper than primary-care based services led by specially trained staff. Researchers with the University of Birmingham found that a 12-week Weight Watchers program helped patients achieve an average 4.4 kg (9.7 pound) weight loss versus a general practice one-on-one program where the average loss was only 1.4 kg (3.1 pounds).

A separate study found that the Weight Watchers program was effective in preventing Type 2 diabetes in those with pre-diabetes.

The UC San Diego program “Take Charge” will be a study that will utilize the Jenny Craig system for evaluating effects on Type 2 diabetic patients who are either overweight or obese. For the trial, volunteers will be divided into three groups. Group one will receive dietary counseling including menu planning and exercise advice from a Registered Dietitian. The other two groups will receiving dietary counseling at a commercial facility and receive pre-packaged meals coinciding with the assigned diet. Outcomes to be measured in addition to blood sugar levels will include waist circumference, cardiovascular fitness, and feelings and quality of life.

Until the results are in, the best advice for those with either pre-diabetes or Type 2 diabetes is to find a program that works with your particular needs. Group settings such as Weight Watchers meetings are often helpful because they combine social support with weight loss advice. Church groups have also been found to be successful. Be sure to find one that not only focuses on diet, but also on increased physical activity.

With any chronic medical condition, it is very important to check with your doctor first and to keep him or her apprised of your progress.

Source: University of California, San Diego Health Sciences

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