Intensive behavioral Therapy for weight loss in patients with, or At-Risk of, type 2 Diabetes: Results from the PaTH to health diabetes study

Jennifer L. Kraschnewski, Lan Kong, Cindy L. Bryce, Erica B. Francis, Jennifer M. Poger, Erik B. Lehman, Stephanie Helbling, Taraneh Soleymani, Rebecca E. Mancoll, Victor Villalobos, Hsin Chieh Yeh

Research output: Contribution to journalArticlepeer-review

Abstract

Intensive behavioral therapy (IBT) is an important component of obesity treatment and can reduce the risk of type 2 diabetes (T2DM). Objective was to compare the effectiveness of IBT to usual care in achieving weight loss in two study cohorts within PaTH Network: T2DM and At-Risk of T2DM. The TD2M cohort was defined as age 18 years and older with an indication of T2DM in the EHR based on a validated algorithm and at least 2 outpatient primary care visits. The At-Risk of T2DM cohort was defined by a BMI ≥ 25 kg/m2. The primary outcome was weight change within 1-year of index date. Mixed-effects models assessed the effectiveness of IBT by comparing the changes between study groups. Between 2009 and 2020, a total of 567,908 patients were identified in the T2DM cohort and2,054,256 patients in the At-Risk of T2DM cohort. Both IBT patients and matched non-IBT patients in the T2DM cohort had decreased mean weight (primary outcome) (−1.56 lbs, 95 %CI: −1.88, −1.24 vs −1.70 lbs, 95 %CI: −1.95, −1.44) in 1-year after index date. In the At-Risk of T2DM cohort, both IBT and non-IBT patients experienced weight gain and resultant increased BMI. Patients with more than one IBT visit gained less weight than those with only one visit (1.22 lbs, 95 %CI: 0.82, 1.62 vs 6.72 lbs, 95 %CI: 6.48, 6.97; p < 0.001). IBT was unlikely to result in clinically significant weight loss. Barriers to utilizing IBT require further research to ensure broader adoption of obesity management in primary care.

Original languageEnglish (US)
Article number102099
JournalPreventive Medicine Reports
Volume31
DOIs
StatePublished - Feb 2023

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Health Informatics

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