Lifestyle Change Interventions: Effectiveness of REWIND, a Virtual, Community‐Based Weight Management Program
Amy E. Rothberg, Wen Ye, Nicole Miller, Robert A. RizzaABSTRACT
Importance
Despite the current enthusiasm for anti‐obesity medications, there is a critical need for effective lifestyle interventions that can be broadly implemented.
Objective
To assess the effectiveness of REWIND, an obesity and diabetes treatment program.
Design
Prospective cohort study.
Setting
Virtual, community‐based weight management program.
Participants
Two‐hundred and nineteen participants, BMI ≥ 30 kg/m2, with and without type 2 diabetes (T2D).
Intervention
Three phases: “induction” with meal replacement diet to promote ≥ 15% weight loss; “transition” to everyday foods; and “maintenance” to prevent weight regain. REWIND leveraged teams including community leaders, media personalities, nationally recognized athletes and participants, to disseminate information, and foster belonging, commitment, and resilience.
Main Outcomes
The co‐primary outcomes were the change in weight at 6‐, 12‐, and 18 months. Secondary outcomes were the proportion of patients achieving ≥ 5%, 10%, 15%, and 20% weight loss at 6, 12, and 18 months, and remission rates in T2D at 6‐, 12‐, and 18‐month, respectively.
Results
Two hundred and nineteen participants (mean age 49.1 [SD 10.5] years), 37% men, 12% Black, 26% with T2D. Weight decreased from: 114.4 (20.8) kg to 96.1 (18.4) kg at 6 months, to 98.5 (18.1) kg at 12 months, and to 101.1 (20.5) kg at 18 months. Weight loss percentages at 6, 12, and 18 months were ≥ 5%: 95%, 91%, 84%; ≥ 10%: 79%, 72%, 67%; ≥ 15%: 58%, 46%, 47%; and ≥ 20%: 24%, 25%, 22%. Diabetes remission was achieved by 52% and 43% of participants with T2D at 12‐ and 18‐month, respectively.
Limitations
Single geographic region. Weight was self‐reported.
Conclusion
A virtual community‐based program for individuals with obesity and T2D facilitated substantial weight loss and T2D remission. This model has the potential for wide‐scale implementation in diverse settings.