Can weight loss be maintained after a diabetes prevention program?: Three year follow up of the Sydney Diabetes Prevention Program (#195)
To assess if participants who completed a 12-month lifestyle modification diabetes prevention program, reduce, increase or maintain weight three years after program is completion.
Participants who completed the Sydney Diabetes Prevention Program (the 'program') where followed up annually for an additional three years. The program targeted 50-65 year olds at high-risk of type 2 diabetes with a 12-month lifestyle modification program aimed at improving nutrition (decreasing total fat and saturated fat, increasing fibre), increasing physical activity and 5% weight loss (n = 1238). The mean weight loss of those who completed the program (n=850) was 2 kgs. Participants who had begun the program at least four years ago were contacted annually by computer assisted telephone interview to self-report their diet, physical activity and weight.
Of the 546 participants (mean age 59.4, 68% female) eligible to be contacted the mean weight at program completion was 86.9 kg. Follow up response rates at the yearly follow ups were all above 85%. The mean weight at one-year follow up was 83.1kg, two year follow up 85.1kg and three year follow up 84.9 kg. There were no significant differences in weight between the four time points or gender differences. At the one-year follow up participants reported they were eating less fat and more fibre, however physical activity had not changed. This pattern was maintained at two and three year follow up.
Diabetes prevention programs which target individuals at high-risk of type 2 diabetes can maintain modest weight loss. More intensive interventions may be required to increase weight loss and reduce or prevent weight gain in this population. In addition, policy and environmental changes that facilitate healthy eating and encourage physical activity would assist participants who are seeking to maintain weight loss.