Findings are subject to incomplete reporting and heterogeneity of studies included , and confounding because most included studies used pre-post study design s. CONCLUSIONS DPP lifestyle modification programs achieved clinical ly meaningful weight and cardiometabolic health improvements .
Together , these data suggest that additional value is gained from these programs , reinforcing that they are likely very cost-effective
BACKGROUND The Diabetes Prevention Program ( DPP ) study showed that weight loss in high-risk adults lowered diabetes incidence and cardiovascular disease risk .
No prior analyses have aggregated weight and cardiometabolic risk factor changes observed in studies implementing DPP interventions in non research setting s in the United States .
Weight loss and incidence of diabetes with the Veterans Health Administration MOVE! lifestyle change programme: an observational study.
BACKGROUND Programmes for lifestyle change are aim ed at improving health but little is known about their effectiveness in clinical setting s. The Veterans Health Administration ( VA ) MOVE ! lifestyle change programme is the largest in the USA . We investigated whether participation in MOVE ! is associated with reduced incidence of diabetes . METHODS We did a retrospective observational analysis of data from VA data bases in overweight patients and obese patients with a weight-related disorder who had undergone at least 3 years of continuous outpatient care in 2005 - 12 . We used generalised estimating equations to assess characteristics associated with MOVE ! participation , and Cox 's proportional hazards regression to analyse the association between participation and diabetes incidence . FINDINGS Of 1·8 million eligible individuals , 238 540 ( 13 % ) participated in the MOVE ! programme . 19 367 ( 1 % overall , 8 % of participants ) met criteria for intense and sustained participation ( at least eight sessions within 6 months over at least a 4-month span ) , which was associated with greater weight loss at 3 years than low-intensity or no participation ( -2·2 % vs -0·64 % or 0·46 % ) . Compared with non-participation , incidence of diabetes was reduced by intense and sustained participation ( hazard ratio 0·67 , 95 % CI 0·61 - 0·74 ) and low-intensity participation ( 0·80 , 0·77 - 0·83 ) in MOVE!. These patterns were consistent across sex , ethnic origin , and age . Participation was most beneficial in patients with  high BMI or high r and om glucose concentrations at baseline ( both pinteraction<0·0001 ) . INTERPRETATION Participation in the MOVE ! programme  was associated with weight loss and reduced incidence of diabetes , but the rate of participation was low and , therefore , selection bias could have exaggerated these effects . FUNDING US Department of Veterans Affairs , National Institutes of Health
Findings are subject to incomplete reporting and heterogeneity of studies included , and confounding because most included studies used pre-post study design s. CONCLUSIONS DPP lifestyle modification programs achieved clinical ly meaningful weight and cardiometabolic health improvements .
Together , these data suggest that additional value is gained from these programs , reinforcing that they are likely very cost-effective
BACKGROUND The Diabetes Prevention Program ( DPP ) study showed that weight loss in high-risk adults lowered diabetes incidence and cardiovascular disease risk .
No prior analyses have aggregated weight and cardiometabolic risk factor changes observed in studies implementing DPP interventions in non research setting s in the United States .