Saturday, April 27, 2013

After all those well-intentioned New Year’s resolutions have yielded to the force of habit, many of the nation’s 79 million obese adults will have a day of reckoning with their primary care physicians. Lose weight and get active, the doctor will order, or risk developing diabetes. Then the MD will scribble a prescription. For most patients, the prescribed treatment will not be a pill. It will be a 12-week program aimed at preventing Type 2 diabetes by getting obese adults to shed as little as 10 pounds and exercise for a little more than 20 minutes a day. That regimen — the Diabetes Prevention Program — may soon become the blockbuster prescription medicine you’ve never heard of. In 2013, it is poised to become the envy of pharmaceutical companies, a new rival to programs such as Weight Watchers, and a target of opportunity for healthcare entrepreneurs. Led by a trained coach, it is a testament to the power of a mentor and of setting modest goals in spurring healthful behavior. And it may be a crucial first test of the Affordable Care Act’s focus on preventive health. In nearly 30 clinical trials, scientists have established that the program is far more effective at helping people lose weight and prevent or delay the onset of diabetes than “usual care” — essentially, a doctor telling a patient to slim down and get active, and then sending him on his way. But the program hasn’t been packaged in a form that healthcare providers can simply and cheaply offer to patients, said Dr. Jun Ma of the Palo Alto Medical Foundation Research Institute, who studies diabetes prevention. The Diabetes Prevention Program is not rocket science. In 12 weekly sessions, a coach teaches obese subjects at high risk of developing diabetes to set goals for losing 5% to 7% of their body weight, limit the fat and calories they consume, track their food intake, get at least 150 minutes of exercise each week, and devise strategies to avoid gaining back lost pounds. In trials, subjects who attended the tightly scripted sessions and followed the regimen were far more likely than those who were on their own to reach their weight-loss goals in three months — and to keep that weight off for more than a year. By doing so, they drove down their risk of developing Type 2 diabetes by 58%, according to a landmark report published in the New England Journal of Medicine in 2002. The program, in short, is powerful medicine. “If you could take it as a pill, it would definitely be commercialized,” said Sean Duffy, a software designer and former Google employee who launched an online version of the program about a month ago… Read the entire article via Weight-loss regimen a preferred choice for countering diabetes – latimes.com.

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