Population-Level Weight Maintenance Programs Could Help Prevent Diabetes, Study Finds

A recent study indicated that strategies to promote weight loss or maintenance across an entire population could be more effective in preventing type 2 diabetes than programs specifically targeting obese people at high risk of developing the disease.

In a collaboration between the University of Cambridge’s Epidemiology Unit and Sweden’s Umeå University, researchers used information from the Västerbotten Intervention Programme, which collected data from 33,184 middle-aged Swedes at 2 health exams 10 years apart. They collected information on changes in body weight and diabetes occurrence between the baseline and follow-up appointments, then extrapolated these changes to the population level after controlling for confounding factors. The findings were announced in a press release from Umeå University.

The researchers found that the 53.9% of participants that gained more than 1 kg/m² over the 10 years had a 52% higher risk of developing diabetes compared to the people who had maintained their weight. They estimated that 21.9% of type 2 diabetes cases in the population could have been prevented if every participant’s weight remained level over this time instead of climbing, regardless of their baseline weight.

Based on prior studies, the researchers also estimated that a commercial weight management program targeting high-risk individuals with a body mass index (BMI) over 30 kg/m² would have only prevented 8.2% of diabetes cases at the population level.

“We have shown that a population-based strategy that promotes prevention of weight gain in adulthood has the potential to prevent more than twice as many diabetes cases as a strategy that only promotes weight loss in obese individuals at high risk of diabetes,” lead author Adina Feldman, PhD, of the University of Cambridge, said in a statement.

However, they cautioned that population-level weight management was not a be-all, end-all solution to prevent diabetes, instead calling for it to be utilized in conjunction with other proven interventions.

“When it comes to body weight and diabetes, from a public health perspective it would be advisable to consider both high-risk and population-based strategies for diabetes prevention,” co-author Patrik Wennberg, MD, PhD, of Umeå University, said in the statement.

A prominent US example of a risk-based intervention is the Medicare Diabetes Prevention Program, which requires that beneficiaries have a BMI of 25 kg/m² (or 23 kg/m² if Asian) and elevated A1C or glucose levels to participate. Studies of this program’s effectiveness have demonstrated that it can reduce the risk of progression from prediabetes to type 2 diabetes by 58%.