Efficacy of a Lifestyle Program Designed to Help Indigent, Obese Adult Patients Lose Weight

Abstract

Introduction. Modest weight loss (5 to 7%) reduced the incidence
of type II diabetes in the Diabetes Prevention Program (DDP) trial.
A DPP-inspired lifestyle intervention requiring minimal patient
self-data collection and tailored to low-SES patients through
minimal cost was developed for our indigent, obese patients.

Methods. Obese (BMI ≥ 30 kg/m2), indigent (≤ 200% Federal
Poverty Level) adults (age 18 - 70) were offered a nocost
weight loss intervention as an adjunct to their usual primary
care in a residency outpatient clinic. The intervention
provided options for diet plans and social support. The goal
was to achieve a 5% loss of body weight over six months.

Results. The sample (n = 158) was 86% female and 62% white,
with a median age of 45 and median BMI of 40.9. Two-thirds of
subjects chose the 50% diet; YMCA membership was selected by
all but one. The 5% weight loss goal was met by 12.8%; another
8.7% gained that amount. Subjects who either had pre-existing
YMCA membership or used their provided membership were
successful, relative to those who received but never used their
membership (0.6% loss vs 0.9% gain; p < 0.05). Changes in weight
over six months were observed in the youngest (gain of 3.9 lbs.,
p < 0.05) and the oldest (loss of 4.0 lbs., p < 0.05) age quartiles.

Conclusions. A DPP-inspired lifestyle intervention tailored
to low-SES patients did not lead to overall weight loss, reinforcing
that weight reduction programs must provide a significant
amount of support for participants to see success.
Older age and a behavioral commitment to physical activity
improved the likelihood of success. KS J Med 2016;9(4):83-87.