Objective
The Reach Ahead for Lifestyle and Health (REAL HEALTH)‐Diabetes study assessed the comparative effectiveness of two Look AHEAD (Action for Health in Diabetes)‐adapted lifestyle intervention (LI) arms targeting weight loss in type 2 diabetes compared with medical nutrition therapy (MNT) referral. At 1 year, LI had greater weight loss than MNT. This study reports outcomes at 24 (end of LI) and 36 months.
Methods
Participants (N = 211) with type 2 diabetes and BMI > 25 kg/m2 were randomly assigned to in‐person LI, telephone conference call LI, or MNT. The primary outcome was percentage weight change. Secondary outcomes included 5% and 10% weight loss, glycated hemoglobin (HbA1c), and patient‐reported outcomes.
Results
Participants were 61.7 (SD 10.2) years old; 55% were female; 77% were non‐Hispanic White; and had mean (SD) weight of 98 (18.9) kg and mean (SD) HbA1c of 7.7% (1.2%). Mean (SD) weight change at 24 and 36 months was −4.4% (5.9%) and −4.4% (5.4%) in in‐person LI, −4.0% (5.8%) and −5.3% (6.4%) in telephone LI, and −3.1% (5.2%) and −5.8% (7.1%) in MNT, with no statistically significant difference in weight or HbA1c at 24 and 36 months. Compared with MNT, LI arms had favorable changes in patient‐reported outcomes related to learned dietary skills.
Conclusions
There were no differences in weight outcomes among LI participants compared with referral to MNT at the end of intervention or 1 year after its conclusion.