Can a commercial weight loss program improve psychosocial outcomes in patients with type 2 diabetes?

The aim of this study was the examine whether a weight loss program can improve psychosocial outcomes in patients with type 2 diabetes. Authors reported significant improvements in psychosocial outcomes among patients undergoing the weight loss program when compared to standard care.

Diabetes is a complex, chronic disease that can severely impact quality of life. It is also associated with significant psychosocial impairments. For example, type 2 diabetes more than doubles the risk of depression.  It has been suggested that psychosocial symptoms could be the result of unbalanced glucose (blood sugar) levels. Studies have shown than better glycemic (blood glucose) control is related to better perceived health and psychological well-being. Glycemic control naturally improves with weight loss. However, whether a weight loss program can directly improve psychosocial outcomes in patients with diabetes has not been studied to date.

This study examined the benefits of a weight loss program on psychosocial outcomes in patients with diabetes.

563 overweight patients with type 2 diabetes were randomly assigned to a modified commercial weight loss program (Weight Watchers) or standard care. The weight loss program consisted of weekly meetings as well as phone, email, and online tools (specialized for type 2 diabetes). Standard care consisted of diabetes education and one session of nutritional counseling followed by additional written material. Psychosocial outcomes were assessed at baseline, at 6 months, and at 12 months using a number of questionnaires.

Patients in the weight loss program lost an average of 4% of their body weight. Average weight loss in the standard care group was 1.9% of their body weight. HbA1c levels (a measurement of average blood sugar levels over the past 3 months) were also significantly reduced with the weight loss program compared to standard care.

A diabetes-specific psychosocial measure measured greater reductions in all of its components (emotional burden, physician-, regimen- and interpersonal-related distress) in the weight loss program group compared to standard care. This was particularly pronounced for patients with greater weight loss and HbA1c reductions.

The impact of weight on quality of life was significantly improved in patients undergoing the weight loss program. This included domains such as physical function, sex life and work.

No differences in  health status and health related quality of life were observed. The weight loss program also had no significant effect on a patient-reported measure of depressive symptoms over the preceding 2 weeks.

Authors concluded that a commercial weight loss program was superior to standard care in improving a range of psychosocial outcomes in patients with type 2 diabetes.