New, remote weight-loss method helped slash pounds

July 14, 2020

CHICAGO --- Losing weight during the COVID-19 pandemic has increasing urgency because obesity increases the risk of severe disease and death. Two-thirds of U.S. adults are overweight or obese, according to the Centers for Disease Control and Prevention.

A new Northwestern Medicine remote weight-loss program, called Opt-IN, provides maximum weight loss for the lowest cost and with much less hassle than the gold-standard National Diabetes Prevention Program (DPP), the most successful behavioral non-drug treatment currently available. According to a new study, the Opt-IN program helped participants in a clinical trial lose 11 to 13 pounds, which is equivalent to the DPP's success rate.

The study findings were published today (July 14) in the journal Obesity, the primary obesity publication.  

"This matches the gold standard, so it's as good as it gets," said senior study author Bonnie Spring, director of the Institute for Public Health and Medicine's Center for Behavior and Health at Northwestern University Feinberg School of Medicine.  "What's novel is how participants get there."

Compared to the DPP treatment - a year-long program costing around $1,500 that requires weekly 90-minute in-person meetings with highly trained and paid medical professionals - the Opt-IN program is cheaper and much less burdensome, Spring said. Opt-IN is fully remote and costs participants between $324 and $427, depending on their package.

Spring said while there has been a lot of effort made in the U.S. to try to make the DPP treatment more accessible and affordable, like offering it in YMCAs, uptake has been minimal. She cited reasons such as users having a hard time getting to the in-person meetings because of childcare or transportation challenges.

"All these traditional treatments have not been scalable because they're not accessible," said Spring, who also is the chief of behavioral medicine in the department of preventive medicine at Feinberg.  "And they're expensive and burdensome. The direction we've gone in with Opt-IN is to meet people where they are, and these days - especially during the COVID-19 pandemic - that means in their homes.

The higher rate of severe cases of COVID-19 among young adults in the U.S. than other countries like China, Spain and Italy seems to be because obesity is much more common here, Spring said.

"To tackle the obesity behemoth, we are going to need to make obesity treatment much more accessible and affordable," Spring said. "The Opt-IN study demonstrates how we could do that."

The study had 562 Chicago-area adult participants who were overweight or obese begin a bare-minimum "core" program to achieve weight loss: goals, online lessons and a custom-designed weight-loss intervention app. Similar to commercial weight-loss apps on the market, this app helps users predetermine how many calories are in a food before they eat it and helps track their caloric intake and exercise throughout the day. Unlike other apps, however, this one sends the user's data directly to their coach, which Spring said helps keep users accountable.

Spring and her team then layered on and tested other treatment components added to the basic core program. The most cost-effective treatment package included 12 health-coaching calls, progress reports sent to the person's primary care physician and a "buddy" who was trained to help support weight loss. 

The study tested more expensive treatment components, like 24 coaching calls instead of 12 and meal replacement products, but they were left out of the final Opt-IN program, because results showed that they didn't increase weight loss.  

How much weight did they lose?

At $427 per person, the Opt-IN method produced an average weight loss of 13.4 pounds after six months, with 51.8% of the sample losing 7% of their initial body weight. The comparable DPP treatment also produces weight loss of 7% of initial body weight in 50% of enrollees, but at a much greater burden and cost. 

A cheaper treatment package for $324 that includes only the core app and online lessons plus 12 coaching calls resulted in an estimated 11.5-pound average weight loss, or at least 5% weight loss for more than 50% of participants over six months.

"Not fixing our national obesity problem invites the oncoming tsunami of diabetes, heart disease, some cancers and other chronic diseases for which obesity heightens risk, yet preventive services, including obesity treatment, are woefully lacking from our current health care delivery system," Spring said. "We hope our study helps to convince payers to cover, employers to offer and individuals to engage in preventive care."
-end-
Other Northwestern study authors include Drs. Angela Pfammatter, Tammy Stump, Juned Siddique, Neil Jordan and graduate student Sara Marchese. 

The study was funded by National Institutes of Health grant R01DK097364.

Northwestern University

Related Diabetes Articles from Brightsurf:

New diabetes medication reduced heart event risk in those with diabetes and kidney disease
Sotagliflozin - a type of medication known as an SGLT2 inhibitor primarily prescribed for Type 2 diabetes - reduces the risk of adverse cardiovascular events for patients with diabetes and kidney disease.

Diabetes drug boosts survival in patients with type 2 diabetes and COVID-19 pneumonia
Sitagliptin, a drug to lower blood sugar in type 2 diabetes, also improves survival in diabetic patients hospitalized with COVID-19, suggests a multicenter observational study in Italy.

Making sense of diabetes
Throughout her 38-year nursing career, Laurel Despins has progressed from a bedside nurse to a clinical nurse specialist and has worked in medical, surgical and cardiac intensive care units.

Helping teens with type 1 diabetes improve diabetes control with MyDiaText
Adolescence is a difficult period of development, made more complex for those with Type 1 diabetes mellitus (T1DM).

Diabetes-in-a-dish model uncovers new insights into the cause of type 2 diabetes
Researchers have developed a novel 'disease-in-a-dish' model to study the basic molecular factors that lead to the development of type 2 diabetes, uncovering the potential existence of major signaling defects both inside and outside of the classical insulin signaling cascade, and providing new perspectives on the mechanisms behind insulin resistance in type 2 diabetes and possibly opportunities for the development of novel therapeutics for the disease.

Tele-diabetes to manage new-onset diabetes during COVID-19 pandemic
Two new case studies highlight the use of tele-diabetes to manage new-onset type 1 diabetes in an adult and an infant during the COVID-19 pandemic.

Genetic profile may predict type 2 diabetes risk among women with gestational diabetes
Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions.

Maternal gestational diabetes linked to diabetes in children
Children and youth of mothers who had gestational diabetes during pregnancy are at increased risk of diabetes themselves, according to new research published in CMAJ (Canadian Medical Association Journal).

Two diabetes medications don't slow progression of type 2 diabetes in youth
In youth with impaired glucose tolerance or recent-onset type 2 diabetes, neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the body's ability to make insulin, according to results published online June 25 in Diabetes Care.

People with diabetes visit the dentist less frequently despite link between diabetes, oral health
Adults with diabetes are less likely to visit the dentist than people with prediabetes or without diabetes, finds a new study led by researchers at NYU Rory Meyers College of Nursing and East Carolina University's Brody School of Medicine.

Read More: Diabetes News and Diabetes Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.