The long-term objective of the project continues to be the development of an effective behavioral weight control program for obese patients with type II diabetes. A second goal, added in the current submission, is to determine whether behavioral techniques can also be successfully applied in those at risk for type II diabetes, namely obese individuals with a family history of diabetes. The proposed project is designed to investigate the effects of a structured exercise program and a structured very low calorie diet, used singly or in combination, within the context of a long-term behavioral treatment program. Previous studies evaluating diet and exercise interventions have had small sample size, included only short periods of structured exercise (thus potentially underestimating the effectiveness of exercise) and focused entirely on calorie restriction (rather than also attempting to modify the fat content of the diet). The current study will improve the methodology and the treatment interventions and will determine which type of intervention is most effective in producing weight loss, improving glycemic control, and reducing coronary heart disease risk factors in those with diabetes and in those at risk for the disease. We propose to recruit 200 obese type II diabetic patients and 200 obese subjects who have a family history of diabetes. These subjects will be randomly assigned to Usual Care, or to Behavioral Weight Control Programs focusing on Diet Only, Exercise Only, or the Combination. All treatments win be conducted over a 2 year. period with intervention meetings held over this entire period. Weight, glucose and insulin responses to an oral glucose load, HbA1, lipids, blood pressure, fitness, and eating and exercise habits will be assessed at baseline, 1 year and 2 years. This study will provide important information on whether diet, exercise, or the combination is the most effective intervention for type 11 diabetic patients and those who are obese and have a family history of the disease. In addition, treating diabetic individuals and those at risk within the same study will allow us to determine whether these two groups differ in adherence to the programs and/or in their physiological responses to treatment, and whether the same intervention is most effective for both groups.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK029757-12
Application #
3229018
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1981-08-01
Project End
1996-07-31
Budget Start
1992-08-01
Budget End
1993-07-31
Support Year
12
Fiscal Year
1992
Total Cost
Indirect Cost
Name
University of Pittsburgh
Department
Type
Schools of Medicine
DUNS #
053785812
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Williams, K V; Mullen, M; Lang, W et al. (1999) Weight loss and leptin changes in individuals with type 2 diabetes. Obes Res 7:155-63
Jakicic, J M; Wing, R R (1998) Differences in resting energy expenditure in African-American vs Caucasian overweight females. Int J Obes Relat Metab Disord 22:236-42
Wing, R R; Venditti, E; Jakicic, J M et al. (1998) Lifestyle intervention in overweight individuals with a family history of diabetes. Diabetes Care 21:350-9
Jakicic, J M; Wing, R R; Lang, W (1998) Bioelectrical impedance analysis to assess body composition in obese adult women: the effect of ethnicity. Int J Obes Relat Metab Disord 22:243-9
Williams, K V; Mullen, M L; Kelley, D E et al. (1998) The effect of short periods of caloric restriction on weight loss and glycemic control in type 2 diabetes. Diabetes Care 21:2-8
Wing, R R (1997) Insulin sensitivity as a predictor of weight regain. Obes Res 5:24-9
Polley, B A; Jakicic, J M; Venditti, E M et al. (1997) The effects of health beliefs on weight loss in individuals at high risk for NIDDM. Diabetes Care 20:1533-8
Venditti, E M; Wing, R R; Jakicic, J M et al. (1996) Weight cycling, psychological health, and binge eating in obese women. J Consult Clin Psychol 64:400-5
Wing, R R (1995) Use of very-low-calorie diets in the treatment of obese persons with non-insulin-dependent diabetes mellitus. J Am Diet Assoc 95:569-72;quiz 573-4
Guare, J C; Wing, R R; Grant, A (1995) Comparison of obese NIDDM and nondiabetic women: short- and long-term weight loss. Obes Res 3:329-35

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