TY - JOUR
T1 - Intensive behavioral Therapy for weight loss in patients with, or At-Risk of, type 2 Diabetes
T2 - Results from the PaTH to health diabetes study
AU - Kraschnewski, Jennifer L.
AU - Kong, Lan
AU - Bryce, Cindy L.
AU - Francis, Erica B.
AU - Poger, Jennifer M.
AU - Lehman, Erik B.
AU - Helbling, Stephanie
AU - Soleymani, Taraneh
AU - Mancoll, Rebecca E.
AU - Villalobos, Victor
AU - Yeh, Hsin Chieh
N1 - Publisher Copyright:
© 2023 The Authors
PY - 2023/2
Y1 - 2023/2
N2 - 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.
AB - 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.
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U2 - 10.1016/j.pmedr.2022.102099
DO - 10.1016/j.pmedr.2022.102099
M3 - Article
C2 - 36820381
AN - SCOPUS:85146011650
SN - 2211-3355
VL - 31
JO - Preventive Medicine Reports
JF - Preventive Medicine Reports
M1 - 102099
ER -