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 - Funding Information:
The authors acknowledge the participation of their partnering health systems within the PaTH Network and thank all investigators and staff for their efforts. Research reported in this publication was funded through a Patient-Centered Outcomes Research Institute (PCORI) United States Award (PCORI NEN-1509-32304). PCORI had no role in the study design, data collection, interpretation, or writing or approving the manuscript. All authors contributed to the writing, review and editing of the paper. JLK completed funding aquisition, investigation, and conceptualization. JLK, LK, EBL, HCY, and CB contributed to data curation, formal analysis, methodology, and validation. JMP and EBF provided project administration. JLK takes responsibility for the contents of the article. The authors report no conflict of interest to declare. The datasets generated during and/or analyzed during the current study are not publicly available due to data sharing agreements with electronic health record data. However, opportunities exist for collaborations with the PaTH Network.
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 -