Weight loss through living well: translating an effective lifestyle intervention into clinical practice

Diabetes Educ. 2009 Mar-Apr;35(2):199-204, 208. doi: 10.1177/0145721709332815.


Purpose: To translate the Diabetes Prevention Program (DPP) lifestyle intervention into a clinical setting and evaluate its effectiveness.

Methods: The authors implemented a group-based version of the DPP lifestyle curriculum in a large academic medicine practice. It is delivered by a nurse educator over 12 weekly sessions with optional reenrollment, available on a self-pay basis, and implemented using existing clinical resources (eg, electronic medical record referrals, scheduling, conference rooms, communication technology). The program was evaluated using a controlled before-after design, including all patients referred between April 1, 2005, and February 1, 2007. Patients with a body mass index (BMI) >or=25 kg/m(2) were eligible if their primary care providers felt the program was medically appropriate and safe. Change in weight (kg) and frequency of achieving >or=7% weight loss were examined.

Results: Referred patients were primarily female (84%), with an average age of 49.91 years (SE, 1.46) and average BMI of 39.65 kg/m(2) (SE, 0.73). Among eligible patients, 93% of enrollees and 80% of nonenrollees had follow-up weights recorded within the evaluation window. Over 1 year, mean weight change was -5.19 kg (95% confidence interval [CI], -7.71 to -2.68) among enrollees and +0.21 kg (CI, -1.0 to 1.93) among nonenrollees (P < .001). A >or=7% loss was found for 27% of enrollees and 6% of nonenrollees (P = .001).

Conclusions: An evidence-based lifestyle intervention can be effectively translated into the clinical setting. Use of existing resources may facilitate patient flow and minimize cost. This provider-integrated preventive care approach may provide a model for incorporating knowledge from behavioral science into clinical care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Counseling
  • Evidence-Based Medicine
  • Female
  • Humans
  • Life Style*
  • Male
  • Middle Aged
  • Obesity / psychology
  • Obesity / rehabilitation*
  • Weight Loss*