Keys to Keeping Weight Off When You Have Prediabetes


People with prediabetes who are overweight or obese can lower their risk of progressing to type 2 diabetes by losing weight. But shedding pounds for good isn’t easy. Findings from a 15-year study reported last year in the Annals of Internal Medicine show what might help.

At the start of the Diabetes Prevention Program in 1996, researchers randomly assigned 3,234 people with prediabetes to make intensive lifestyle changes (healthy diet and increased physical activity) or take the diabetes drug metformin or a placebo pill. After a year, 1,066 participants lost at least 5 percent of their starting weight. Most (63 percent) were in the lifestyle group, 28.5 percent were in the metformin group, and 13 percent were in the placebo group.

But a surprising picture emerged when researchers looked at the groups more than a decade later. Although more participants in the lifestyle group than in the metformin group lost at least 5 percent of their weight in the first year, the medication users had greater success in maintaining the lost weight over the long term, 49 percent and 56.5 percent, respectively. Also, greater one-year weight loss predicted long-term weight loss—regardless of strategy. Another key finding: Those who lost at least 5 percent of their weight in the first year and kept it off were less likely to have developed diabetes over the next 14 years.

Bottom line: Metformin may help maintain weight loss, but it’s still important to make healthy lifestyle changes to improve your overall health.