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Predictors of Weight Loss in the Healthy Living Partnership to Prevent Diabetes: A Randomized Control Trial

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abstract
Type 2 diabetes affects 8.3% of the U.S. adult population and is the leading cause of kidney failure nondramatic lower limb amputation and blindness (CDC, 2011). With the continuing increase in the prevalence of the disease, clinicians and researchers have focused on preventing diabetes in those who are at high risk for developing diabetes (i.e. prediabetic). Although research has been successful at inducing weight loss to prevent the onset of diabetes in those who are prediabeti, there is still a large variability in those who succeeded at losing weight in previous studies. Therefore the purpose of this study was to examine social cognitive predictors of weight change. More specifically, the present study tested whether changes in social cognitive variables following the intensive phase (6-months) of a lifestyle weight loss intervention predict 6- and 12-month changes in body weight in adults high at risk of developing diabetes. Three hundred and one pre-diabetics (Mean (SD) age = 58 (9.5) years; BMI=32.7(4.0) m/kg2; fasting blood glucose = 105.5 (11.3) mg/dL) were randomly assigned to either a lifestyle weight loss intervention (LWL) or receiving the enhanced usual care condition (UCC). The goal of the LWL was to induce ≥7% weight loss through creating energy deficit by increasing physical activity and reducing caloric intake. The intervention consisted of weekly group meetings for 6 months and then monthly meetings for 18 months administered by Community Health Workers. The UCC comprised of two individual meetings with a registered dietician and a monthly newsletter. Potential predictors were measured from baseline to 6 months through self-report psychosocial physical activity and dietary surveys and weight change was examined as a continuous variable at 12 months. Multiple regression analyses revealed that baseline to six month changes in satisfaction with physical appearance (p<.0001) exercise self-efficacy (p=.0004) caloric intake (p=.0005) and weight loss self-efficacy (p=.0054) were significant predictors of 6-month weight change. The analyses additionally revealed satisfaction with physical appearance (p<.0001) exercise self-efficacy (p=.0366) weight loss self-efficacy (p=.0315) and caloric intake (p=.0427) were significant predictors of 12 month weight change. These results demonstrate that individuals who increase their self-efficacy for exercise and weight loss, improve their satisfaction with physical appearance, and decrease their caloric intake will have greater short and long term weight loss. Therefore adapting a social cognitive weight loss program in a community based translation of the DPP and focusing on self-efficacy and satisfaction could potentially increase the number of patients that are successful at maintaining weight loss.
subject
community
diabetes prevention
predictors
psychosocial
translation
weight loss
contributor
Squires, Leah (author)
Katula, Jeff A (committee chair)
Miller, Gary (committee member)
Rejeski, Jack (committee member)
date
2012-06-12T08:35:51Z (accessioned)
2014-06-12T08:30:08Z (available)
2012 (issued)
degree
Health and Exercise Science (discipline)
embargo
2014-06-12 (terms)
identifier
http://hdl.handle.net/10339/37266 (uri)
language
en (iso)
publisher
Wake Forest University
title
Predictors of Weight Loss in the Healthy Living Partnership to Prevent Diabetes: A Randomized Control Trial
type
Thesis

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