Obese diabetic and nondiabetic individuals lose similar amounts of weight in a medically supervised behavioral weight loss program.

Objective: Since 80% of persons with type 2 diabetes are obese, weight loss and maintenance are the most important treatment priorities for many individuals with diabetes. Some reports indicate that those with diabetes have greater difficulty losing weight than those without diabetes.

Method: We rigorously compared weight loss and adherence to behaviors for diabetic (DM) and non-diabetic (non-DM) patients treated in 3 medically supervised very-low and low-energy-diet Health Management Resources™ programs. This is a retrospective review of consecutive patients enrolled in these programs between Jan. 2002 and Jan. 2003. Patients attended weekly classes and were instructed to use a minimum of either 5 shakes daily (500–800 kcal) or 3 shakes plus 2 pre-packaged (~880 kcal/day) and engage in a minimum of 2,000 calories of physical activity weekly. We compared weight loss of all patients enrolled (All) and patients who completed the 12-week core (Completers).

Results: Diabetic individuals lost slightly but not significantly less weight than non-DM patients. Weight losses at 12 weeks for completers were similar for diabetic (14.0% of initial weight) and non-DM (15.2%) patients. Diabetic patients had slightly better compliance with attendance (96.3%) and weekly records (97.6%), and reported slightly higher meal replacement use (41/week) and physical activity (2609 kcal/week) than non-DM. Multiple other comparisons indicated that diabetic patients were slightly more compliant with behavioral procedures but lost slightly, but not significantly, less weight.

Conclusion: These observations indicate that patients with type 2 DM may successfully participate in a medically supervised very-low or low-energy-diet behavioral program and safely lose 18% of their body weight over a 21-week period.