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Behavioral weight-control therapy may have ripple effects benefiting others beyond the person being treated. New research suggests that the untreated spouses of people undergoing such treatment often gain clinically meaningful improvements due to an increased emphasis on healthy eating in their home environment.
"We're always telling patients to change the home environment," says Amy Gorin, PhD, assistant professor of psychiatry and human behavior at Brown Medical School in Providence, R.I. "It seems to have an effect."
At the annual meeting of The Obesity Society, held October 20–24 in New Orleans, Gorin described an analysis she conducted with her colleagues, in which they analyzed data from the Look AHEAD (Action for Health in Diabetes) study—a randomized controlled multicenter trial of the effects of intentional weight loss on cardiovascular risk factors in people who are obese and have type 2 diabetes.
Participants were randomized to receive "enhanced usual care" that included diabetes support and education (DSE), or a program of "intensive lifestyle intervention" (ILI) that included regular sessions with a dietitian and an exercise therapist.
Three hundred fifty seven couples enrolled in the study. In each couple, one spouse had type 2 diabetes; only that spouse received either the DSE or ILI treatment. Researchers reviewed data on weight, height, health-related behaviors, and the results of an exercise questionnaire for each person. In addition, investigators assessed how much couples exercised in and around the home. They also conducted a household food inventory for each couple.
Compared with baseline, after a year in the study, the untreated spouses of participants in the ILI group lost an average of 2.1 kg (4.6 lb) more than the untreated spouses of those receiving DSE care, according to Gorin.
The difference in weight loss "seems to be driven by dietary changes," she says. "We did not observe any differences in physical activity in either group."
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Untreated spouses in the ILI group ate less fat and consumed fewer snacks than untreated spouses in the DSE group. The observed trends suggest that when one partner in a couple receives intensive intervention, both partners are more likely to share a healthful diet, according to the researchers.
"This is the first study to show that lifestyle interventions can have a clinically significant effect on untreated spouses," Gorin says.
The ripple effect may have been more pronounced in the Look AHEAD patient population, however, because the participants had both obesity and type 2 diabetes. "The additional health threats may have motivated people to make changes," Gorin says.
The researchers are now looking into the influences of gender and ethnicity
on the ripple effect.
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| DOC News | Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |