Journal of General Internal Medicine

, Volume 28, Issue 12, pp 1620–1628 | Cite as

Weight Loss Success in Metabolic Syndrome by Telephone Interventions: Results from the SHINE Study

  • Ruth S. Weinstock
  • Paula M. Trief
  • Donald Cibula
  • Philip C. Morin
  • Linda M. Delahanty
Original Research

ABSTRACT

BACKGROUND

The Diabetes Prevention Program (DPP) intensive lifestyle intervention resulted in significant weight loss, reducing the development of diabetes, but needs to be adapted to primary care provider (PCP) practices.

OBJECTIVES

To compare a DPP-translation using individual (IC) vs. conference (CC) calls delivered by PCP staff for the outcome of percent weight loss over 2 years.

DESIGN

Randomized clinical trial.

SETTING

Five PCP sites.

PARTICIPANTS

Obese patients with metabolic syndrome, without diabetes (IC, n = 129; CC, n = 128).

INTERVENTION

Telephone delivery of the DPP Lifestyle Balance intervention [16-session core curriculum in year 1, 12-session continued telephone contact in year 2 plus telephone coaching sessions (dietitians).

MAIN MEASURES

Weight (kg), body mass index (BMI), and waist circumference.

KEY RESULTS

Baseline data: age = 52 years, BMI = 39 kg/m2, 75 % female, 85 % non-Hispanic White, 13 % non-Hispanic Black, and 48 % annual incomes <$40,000/year. In the intention-to-treat analyses at year 2, mean percent weight loss was −5.6 % (CC, p < 0.001) and −1.8 % (IC, p = 0.046) and was greater for CC than for IC (p = 0.016). At year 2, mean weight loss was 6.2 kg (CC) and 2.2 kg (IC) (p < 0.001). There was similar weight loss at year 1, but between year 1 and year 2 CC participants continued to lose while IC participants regained. At year 2, 52 % and 43 % (CC) and 29 % and 22 % (IC) of participants lost at least 5 % and 7 % of initial weight. BMI also decreased more for CC than IC (−2.1 kg/m2 vs. −0.8 kg/m2 p < 0.001). Waist circumference decreased by 3.1 cm (CC) and 2.4 cm (IC) at year 2. Completers (≥9 of 16 sessions; mean 13.3 sessions) lost significantly more weight than non-completers (mean 4.3 sessions).

CONCLUSIONS

PCP staff delivery of the DPP lifestyle intervention by telephone can be effective in achieving weight loss in obese people with metabolic syndrome. Greater weight loss may be attained with a group telephone intervention.

KEY WORDS

obesity health behavior prevention 

Notes

Acknowledgments

Contributors

We thank our participants, their primary care providers, the health care professionals who served as educators and our dietitian coaches. We also thank Julie J. Stone, RN, for performing the participant assessments and Jane D. Bulger, MS, CCRC, and Michael J. Wade, MS, for facilitating data collection and data entry.

Funders

This study was supported by grant R18-DK078553 from the National Institutes of Health (NIDDK; Trief and Weinstock PIs).

Prior presentations

Some of these findings were published in abstract form and presented in oral sessions at the annual meeting of the American Diabetes Association meeting in June 2012 and June 2013.

Conflict of Interest

The authors declare that they do not have any conflicts of interest.

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Copyright information

© Society of General Internal Medicine 2013

Authors and Affiliations

  • Ruth S. Weinstock
    • 1
  • Paula M. Trief
    • 1
  • Donald Cibula
    • 1
  • Philip C. Morin
    • 1
  • Linda M. Delahanty
    • 2
  1. 1.SUNY Upstate Medical UniversitySyracuseUSA
  2. 2.Massachusetts General Hospital and Harvard Medical SchoolBostonUSA

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