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Binge Eating and Weight Loss Outcomes in Overweight and Obese Individuals With Type 2 DiabetesResults From the Look AHEAD Trial
Amy A. Gorin, PhD;
Heather M. Niemeier, PhD;
Patricia Hogan, MS;
Mace Coday, PhD;
Cralen Davis, MS;
Vicki G. DiLillo, PhD;
Marci E. Gluck, PhD;
Thomas A. Wadden, PhD;
Delia S. West, PhD;
Donald Williamson, PhD;
Susan Z. Yanovski, MD; for the Look AHEAD Research Group
Arch Gen Psychiatry. 2008;65(12):1447-1455.
Context Binge eating (BE) is common in overweight and obese individuals with type 2 diabetes mellitus, but little is known about how BE affects weight loss in this population.
Objective To determine whether BE was related to 1-year weight losses in overweight and obese individuals with type 2 diabetes participating in an ongoing clinical trial.
Design, Setting, and Participants The Look AHEAD (Action for Health in Diabetes) trial is a randomized controlled trial examining the long-term effect of intentional weight loss on cardiovascular disease in overweight and obese adults with type 2 diabetes. A total of 5145 overweight and obese individuals aged 45 to 76 years with type 2 diabetes participated in this study.
Interventions Participants were randomly assigned to an intensive lifestyle intervention or to enhanced usual care (a diabetes support and education control condition).
Main Outcome Measures At baseline and 1 year, participants had their weight measured and completed a fitness test and self-report measures of BE and dietary intake. Four groups were created based on BE status at baseline and 1 year (yes/yes, no/no, yes/no, and no/yes). Analyses controlled for baseline differences between binge eaters and non–binge eaters.
Results Most individuals (85.4%) did not report BE at baseline or 1 year (no/no), 7.5% reported BE only at baseline (yes/no), 3.7% reported BE at both times (yes/yes), and 3.4% reported BE only at 1 year (no/yes), with no differences between intensive lifestyle intervention and diabetes support and education conditions (P = .14). Across intensive lifestyle intervention and diabetes support and education, greater weight losses were observed in participants who stopped BE at 1 year (mean [SE] weight loss, 5.3 [0.4] kg) and those who reported no BE at either time (mean [SE] weight loss, 4.8 [0.1] kg) than in those who continued BE (mean [SE] weight loss, 3.1 [0.6] kg) and those who began BE at 1 year (mean [SE] weight loss, 3.0 [0.6] kg) (P < .001). Post hoc analyses suggested that these differences were due to changes in caloric intake.
Conclusion Overweight and obese individuals with type 2 diabetes who stop BE appear to be just as successful at weight loss as non–binge eaters after 1 year of treatment.
Trial Registration clinicaltrials.gov Identifier: NCT00017953
Author Affiliations: Department of Psychology, Center for Health, Intervention, and Prevention, University of Connecticut, Storrs (Dr Gorin); Brown Medical School, The Miriam Hospital, Providence, Rhode Island (Dr Niemeier); Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina (Ms Hogan and Mr Davis); Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis (Dr Coday); Department of Psychology, Ohio Wesleyan University, Delaware (Dr DiLillo); Obesity and Diabetes Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona (Dr Gluck); Department of Psychiatry, University of Pennsylvania, Philadelphia (Dr Wadden); Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock (Dr West); Pennington Biomedical Research Center, Louisiana State University, Baton Rouge (Dr Williamson); and Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland (Dr Yanovski).
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