Skip to main content
SpringerLink
Log in

Sex differences in weight loss among adults with Type II diabetes mellitus

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

The treatment of choice for Type II or non-insulin-dependent diabetes mellitus is a behavioral program for the management of weight. However, compliance with this lifelong dietary regimen is often poor. In the current investigation male and female adults with diagnosed Type II diabetes were randomly assigned to either a behavior modification, a cognitive modification, a cognitive-behavior modification, or a control group. Patients were evaluated in terms of weight, percentage of body fat, and glycosylated hemoglobin measures. Men lost signficantly more weight than women and subjects in the behavior modification group lost more weight and demonstrated greater decreases in diabetes control than subjects in the cognitive-behavior modification, cognitive, and control groups. A significant interaction indicated that diabetic men may benefit more from behavioral weight reduction programs than diabetic women. Several explanations for these findings are considered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Abraham, S. (1983). Obese and overweight adult in the United States, InVital and Health Statistics, Ser. 11, No. 230. Natl. Center Health Stat., DHHS Publ. (PHS) 83-1680.

  • Abrams, D. B., and Follick, M. J. (1983). Behavioral weight-loss intervention at the worksite: Feasibility and maintenance.J. Consult. Clin. Psychol. 51(2): 226–233.

    Google Scholar 

  • Abramson, E. E. (1977). Behavioral approaches to weight control.Behav. Res. Ther. 15: 355–363.

    Google Scholar 

  • American Diabetes Association (1984).Physicians Guide to Type II Diabetes (NIDDM) Diagnosis and Treatment, ADA, New York.

    Google Scholar 

  • Archer, J. A., Gorden, P., and Roth, J. (1975). Defect in insulin binding to receptors in obese man: Amehoration with calorie restriction.J. Clin. Invest. 55: 166–174.

    Google Scholar 

  • Atkins, C. J., Kaplan, R. M., Timms, R. M., Reinsch, S., and Lofback, K. L. (1984). Behavioral exercise programs in the management of chronic obstructive pulmonary disease.J. Consult. Clin. Psychol. 52: 591–603.

    Google Scholar 

  • Barrett-Connor, E., and Wingard, D. L. (1983). Sex differences in diabetes mellitus. In Gold, E. B. (ed.),The Changing Risk of Disease in Women: An Epidemiological Approach. D. C. Heath, Lexington, Mass., Chap. 20.

    Google Scholar 

  • Black, D. R., and Friesen, J. G. (1983). Deposit money: A component in a self-directed minimal intervention program for weight control.Behav. Ther. 14: 333–340.

    Google Scholar 

  • Blackburn, S. L. (1977). Dietary compliance of chronic hemodialysis patients.J. Am. Diet. Assoc. 70: 31–37.

    Google Scholar 

  • Bray, G. A., Davidson, M. B., and Drenick, E. J. (1972). Obesity: A serious symptom.Ann. Intern. Med. 77: 779–795.

    Google Scholar 

  • Burnum, J. F. (1974). Outlook for treating patients with self-destructive habits.Ann. Intern. Med. 81: 387–393.

    Google Scholar 

  • Cohen, S. J. (1979).New Directions in Patient Compliance, D.C. Health, Lexington, Mass.

    Google Scholar 

  • Criqui, M. H., Klauber, M. R., Barrett-Connor, E.,et al. (1982). Adjustment for obesity in studies of cardiovascular disease.Am. J. Epidemiol. 116: 685–691.

    Google Scholar 

  • Dahlkoetter, J., Callahan, E. J., and Linton, L. (1979). Obesity and the unbalanced energy equation: Exercise versus eating habit change.J. Consult. Clin. Psychol. 47(5): 898–905.

    Google Scholar 

  • DiMatteo, M. R., and DiNicola, D. D. (1982).Achieving Patient Compliance: The Psychology of the Medical Practitioner's Role, Pergamon Press, New York.

    Google Scholar 

  • Farrant, P. C., Meville, R. W. J., and Stewart, G. A. (1969). Insulin release in response to oral glucose in obesity: The effect of reduction in body weight.Diabetolgia 5: 198–200.

    Google Scholar 

  • Ferguson, J. (1975a).Habits Not Diets, Bull, Palo Alto, Calif.

    Google Scholar 

  • Ferguson, J. (1975b).Learning to Eat-Behavior Modification for Weight Control, Bull, Palo Alto, Calif.

    Google Scholar 

  • Fisher, E. B., Delameter, A. M., Bertelson, A. D., and Kirkley, B. G. (1982). Psychological factors in diabetes and its treatment.J. Consult. Clin. Psychol. 50(6): 993–1003.

    Google Scholar 

  • Foreyt, J. P., Mitchell, R. E., Garner, D. T., Gee, M., Scott, L. W., and Gotto, A. M. (1982). Behavioral treatment of obesity: Results and limitations.Behav. Ther. 13: 153–163.

    Google Scholar 

  • Forster, J. L., and Jeffery (1984). Gender differences related to weight history, eating patterns, efficacy expectations, self-esteem, and weight loss among participants in a weight reduction program. Unpublished, University of Minnesota, Minneapolis.

    Google Scholar 

  • Gabbay, K. H., Hasty, K., Breslow, J. L., and Ellison, R. C. (1977). Glycosylated hemoglobins and long-term blood glucose control in diabetes mellitus.J. Clin. Endocrinol. Metabol. 44: 859–864.

    Google Scholar 

  • Graham, L. E., Taylor, B., Hovell, M. F., and Siegel, W. (1983). Five-year follow-up to a behavioral weight-loss program.J. Consult. Clin. Psychol. 51(2): 322–323.

    Google Scholar 

  • Hagen, R. L., Foreyt, J. P., and Durham, T. W. (1976). The dropout problem: Reducing attrition in obesity research.Behav. Ther. 7: 463–471.

    Google Scholar 

  • Haynes, R. B., Taylor, D. W., and Sackett, D. L. (1979).Compliance in Health Care, Johns Hopkins University Press, Baltimore.

    Google Scholar 

  • Heitzmann, C. A., and Kaplan, R. M. (1984). Sex by social support interaction in diabetes mellitus.J. Consult. Clin. Psychol. 52(6): 1087–1089.

    Google Scholar 

  • James, J. E., and Hampton, B. A. M. (1982). The relative efficacy of directive and non-directive treatment in behavioral weight control.Behav. Ther. 13: 463–475.

    Google Scholar 

  • Jeffery, R. W., Wing, R. R., and Stunkard, A. J. (1976). Behavioral treatment of obesity: The state of the art.Behav. Ther. 9: 189–199.

    Google Scholar 

  • Jeffery, R. W., Folsom, A. R., Luekper, R. V., Jacobs, D. R., Gillam, R. F., Taylor, H. L., and Blackburn, (1984). Prevalence of overweight and weight loss experience.Am. J. Publ. Health 74: 349–352.

    Google Scholar 

  • Kaplan, R. M., and Atkins, C. J. (1985). The behavioral management of type II diabetes mellitus. In Kaplan, R. M., Criqm, M. H. (eds.),Behavioral Epidemiology and Disease Prevention, Plenum, New York.

    Google Scholar 

  • Kaplan, R. M., Bush, J. W., and Berry, C. C. (1976). Health status: Types of validity and index of well-being.Health Serv. Res. 11(4): 478–507.

    Google Scholar 

  • Kaplan, R. M., Chadwick, M. W., and Schimmel, L. E. (1985). Social learning intervention to promote metabolic control in Type 1 diabetes mellitus: Pilot experiment results.Diabetes Care 8: 152–155.

    Google Scholar 

  • Leon, G. R. (1976). Current directions in the treatment of obesity.Psychol. Bull. 83: 557–558.

    Google Scholar 

  • Mahoney, M., and Mahoney, K. (1976).Permanent Weight Control, W. W. Norton, New York.

    Google Scholar 

  • Marcus, A. C., and Seeman, T. E. (1981). Sex differences in health statistics: A re-examination of the nurturant role hypothesis.Am. Social. Rev. 46: 119–123.

    Google Scholar 

  • Marquis, K., and Ware, J. E. (1979). New measures of diabetic patient knowledge, behavior, and attitudes. Rand Corporation, Santa Monica.

    Google Scholar 

  • Marston, M. V. (1970). Compliance with medical regimens: A review of the literature.Nursing Res. 19: 312–323.

    Google Scholar 

  • Martin, J. E., Dubbert, P. M., Katell, A. D., Thompson, J. K., Raczynski, J. R., Lake, M., Smith, P. O., Webster, J. S., Sikora, T., and Cohen, R. E. (1984). Behavioral control of exercise in sedentary adults: studies 1 through 6.J. Consult. Clin. Psychol. 52: 795–811.

    Google Scholar 

  • Morbidity and Mortality Weekly Report (1984). Center for Disease Control, April 24.

  • Nathan, D. M., Singer, D. E., Hurxthal, K., and Goodson, J. D. (1984). The clinical information value of the glycosylated hemoglobin assay.N. Engl. J. Med. 310(6): 341–346.

    Google Scholar 

  • National Diabetes Data Group (1979). Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance.Diabetes 28: 1039–1057.

    Google Scholar 

  • Pfieffer, E. F., (1974). Obesity, islet function and diabetes mellitus.Norm Metab. Res. Suppl. 4: 143–152.

    Google Scholar 

  • Rainwater, N., Ayllon, T., Fredriksen, I. W., Moore, E. J., and Bonar, J. R. (1982). Teaching self-management skills to increase diet compliance in diabetes. In Stuart, R. B. (ed.),Adherence, Compliance, and Generalization in Behavioral Medicine, Brunner/Mazel, New York.

    Google Scholar 

  • Rifkin, H. (1984). The state of the art: Type II diabetes.Diabetes Forecast 37(4): 30–32, 67.

    Google Scholar 

  • Skyler, J. S. (1979). Diabetes and exercise: Clinical implications.Diabetes Care 2: 307–311.

    Google Scholar 

  • Stern, M. P., Farquhar, J. W., Macoby, N., and Russell, S. H. (1976). Results of a two-year health education campaign on dietary behavior.Circulation 54(5): 826–833.

    Google Scholar 

  • Straw, M. K., and Terre, C. (1983). An evaluation on individualized behavioral obesity treatment and maintenance strategies.Behav. Ther. 13: 255–266.

    Google Scholar 

  • Stuart, R. B. (1971). A three dimensional program for treatment of obesity.Behav. Res. Ther. 9: 177–186.

    Google Scholar 

  • Stuart, R. B., and Jacobson (1979). Sex differences in obesity. In Gomberg, E., and Franks, V. (eds.),Gender and Disorder, Brunner/Mazel, New York.

    Google Scholar 

  • Stunkard, A. J. (1979). Behavioral medicine and beyond: The example of obesity. In Pomerleau, O. F., and Brady, J. P. (eds.),Behavioral Medicine: Theory and Practice, Williams & Wilkins, Baltimore.

    Google Scholar 

  • Stunkard, A. J., and McLaren-Hume, M. (1959). The results of treatment of obesity.Arch. Intern. Med. 103: 79–85.

    Google Scholar 

  • Surwit, R., and Feinglos, M. (1982). Current behavioral research in Diabetes Mellitus. Presented at the meeting of the society of Behavioral Medicine, Chicago, March.

  • Verbrugge, L. M. (1976). Females and illness: Recent trends in sex diffeences in the United States.J. Health Soc. Behav. 17: 387–403.

    Google Scholar 

  • Watts, F. N. (1980). Behavioral aspects of the management of diabetes mellitus: Education, self-care and metabolic control.Behav. Res. Ther. 18: 171–180.

    Google Scholar 

  • Wilkerson, H. L. C., and Krall, L. P. (1947). Diabetes in a New England town: A study of 3576 persons in Oxford, Mass.JAMA 135: 209–216.

    Google Scholar 

  • Wilson, D. K., Kaplan, R. M., Heitzmann, C. A., and Sandler, J. (1985). Correlates of weight reduction for patients with Type II diabetes mellitus.Diabetes 34: 206A.

    Google Scholar 

  • Wing, R. (1984). Behavioral approaches to weight control. Presented at the meeting of the American Diabetes Association, Las Vegas, June.

  • Wing, R. R., Epstein, L. H., Nowalk, M. P., Koeske, R., and Hagg, S. (1985). Behavior change, weight loss, and physiological improvements in Type II diabetic patients.J. Consult. Clin. Psychol. 53(1): 111–122.

    Google Scholar 

  • Wingard, D. L. (1982). The sex differential in mortality rates: Demographic and behavioral factors.Am. J. Epidemiol. 115: 205–216.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Arizona State University, 85287, Tempe, Arizona

    Carma A. Heitzmann

  2. Center for Behavioral Medicine, San Diego State University, 92182, San Diego, California

    Robert M. Kaplan & Dawn K. Wilson

  3. San Diego, California

    Jeffery Sandler

Authors
  1. Carma A. Heitzmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert M. Kaplan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dawn K. Wilson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jeffery Sandler
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This work was supported by Grants K04 HL 00809 and R01 AM 27901 from the National Institutes of Health to Robert M. Kaplan.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Heitzmann, C.A., Kaplan, R.M., Wilson, D.K. et al. Sex differences in weight loss among adults with Type II diabetes mellitus. J Behav Med 10, 197–211 (1987). https://doi.org/10.1007/BF00846426

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00846426

Key words

Search

Navigation