Monday, January 25, 2021

Superiority of Lifestyle Intervention for Weight Loss in a Group Setting

The CDC’s National Diabetes Prevention Program (DPP) uses group sessions to deliver the prevention program. The primary goal of the group sessions is weight loss. The desired outcome is delaying or preventing diabetes. The National DPP is based on the diabetes prevention study in which the coaches met one-on-one with each study participant. The results were that intensive lifestyle intervention, focusing on weight loss, lowered the risk of diabetes by 58%.

However, researchers felt that the program was not sustainable, because the cost to deliver the program was too high. So, the program was modified so that it could be delivered in a group setting, which is how the current National DPP is delivered. But some may still question the group delivery approach.

The original Diabetes Prevention Program study ended in 2001. And for several years after the end of the study, translational research was done to determine if the original DPP study's one-on-one lifestyle intervention could be effective in a group setting. One of the translational investigations was done by researchers at the Indiana University School of Medicine.

The researchers concluded that using weight loss as the goal in lifestyle intervention could indeed be effective in a group setting. Participants in the lifestyle intervention group lost 6% of their weight compared to 2% for the participants in the control group.

And a more recent study has, again, demonstrated the effectiveness of lifestyle intervention in a group setting. In fact, the researchers suggested that group lifestyle intervention is actually superior to one-on-one delivery for weight loss. According to the researchers, “Group multi-component lifestyle interventions are superior for weight loss compared to one-to-one interventions with respect to adult weight management.”

So, providers should consider group settings for weight loss and weight maintenance. The providers should also consider group settings for other chronic disease treatments. The actions could increase patient health. 

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Tags: , , , , bariatric medicine, obesity medicine, medical practice start up, bariatric industry analysis, weight loss industry analysis, weight management industry analysis

Sunday, January 24, 2021

Diet Can Cause an Increase in Ghrelin

Ghrelin is sometimes called the  hunger gene. It is called the hunger gene because it plays a large role in regulating appetite. The hormone is produced in the gastrointestinal system -- mainly in the stomach. Ghrelin can cause feelings of hunger and fullness, and it can cause our bodies to store fat. In fact, controlling ghrelin in our body and the ghrelin production  can enable us to lose weight and maintain weight loss.

Ghrelin is very important in weight management. And one study has shown that weight loss resulting from diet can cause an increase in ghrelin, thereby, producing weight regain. It has been known for some time that one of the reasons that some types of weight loss surgery are effective is because the surgeries reduce the size of the stomach, limiting the production of ghrelin. But anything that increases ghrelin may cause weight gain.

The ghrelin-related study was a post hoc analysis, associated with a study called the Diabetes Remission Clinical Trial or DiRECT. The study was done in Scotland. The aim of the DIRECT was to “assess the effect of weight loss on type 2 diabetes remission.” The aim of the post hoc analysis was to “To investigate whether appetite-related hormones were predictors of weight regain in the Diabetes Remission Clinical Trial (DiRECT)." In the post hoc analysis, the researchers looked at the hormones leptin, ghrelin, GLP-1 and PYY. The researchers looked at these hormones at baseline, and at 5, 12 and 24 months.

For the post hoc analysis, 253 participants were included. The intervention group consisted of 144 participants and the control group consisted of 99 participants. The researchers concluded that “the rise in ghrelin (but not any other measured hormone) during the diet -induced weight loss was a predictor of weight regain during follow-up, and concentrations remain elevated over time, suggested a small but significant compensatory drive to regain weight. Attenuating the effects of ghrelin may improve [weight-loss maintenance].”

These are important findings, and, again, the findings confirm the role that ghrelin plays in weight loss and weight gain. Further, by finding ways to lower the amount of ghrelin in our bodies, we stand a good chance of losing weight and maintaining weight loss.

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Tags: , , , , bariatric medicine, obesity medicine, medical practice start up, bariatric industry analysis, weight loss industry analysis, weight management industry analysis

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