Diabetes? Weight Loss Can Help You Live Better If Not Longer

sharma-obesity-lookahead-studyRegular readers may recall the previous post that the rather ambitious LookAHEAD trial, designed to study whether or not intensive lifestyle intervention targeting weight loss in patients with type 2 diabetes would save lives, was abandoned due to futility – in other words, the study was discontinued because it was deemed unlikely to meet its primary objective, i.e. to show survival benefits.

The paper describing this main outcome (or rather lack of it) is now published in the New England Journal of Medicine and is certain to once again spawn a barrage of media reports claiming that weight loss was useless in patients with type 2 diabetes.

This, in fact is not true. Indeed, the LookAHEAD trial, despite rather modest weight loss, very clearly demonstrated important quality of life benefits for participants in the intervention arm.

In addition, diabetic patients who lost weight benefitted from lowered HbA1c, reduced medications, increased physical fitness, less depression, as well as improved urinary incontinence, increased mobility, improved sleep apnea and improved sexual function.

Furthermore, participants who lost weight were more likely to experience remission of their type 2 diabetes over the four years of the trial.

While none of these benefits may be impressive to researchers, payers and regulators who would rather count body bags, these improvements are very real and substantial for the patients concerned.

Thus, while “body-bag enthusiasts” may deem the results of LookAHEAD as negative or “inconclusive”, I would look at LookAHEAD as a clear indication that intensive lifestyle intervention aimed at weight loss in patients with type 2 diabetes may well be a worthwhile endeavour.

Let’s never forget that life is not just about quantity – for some people quality counts too.

Edmonton, AB