Binge Eating and Weight Loss Outcomes in Individuals with Type 2 Diabetes: 4-Year Results from the Look AHEAD Study

Ariana M Chao, Thomas A Wadden, Amy A Gorin, Jena Shaw Tronieri, Rebecca L Pearl, Zayna M Bakizada, Susan Z Yanovski, Robert I Berkowitz, Ariana M Chao, Thomas A Wadden, Amy A Gorin, Jena Shaw Tronieri, Rebecca L Pearl, Zayna M Bakizada, Susan Z Yanovski, Robert I Berkowitz

Abstract

Objective: This study aims to assess whether an intensive lifestyle intervention (ILI) for weight reduction precipitates binge eating (BE) and whether BE attenuates 4-year weight loss among participants with type 2 diabetes and overweight or obesity.

Methods: Participants (N = 4,901) were from Look AHEAD, a randomized controlled trial that compared ILI to diabetes support and education (DSE). Annual assessments of measured weight and self-reported BE were used. By using the yearly time points when a person endorsed BE, participants were classified as no BE, remitted BE, incident BE, inconsistent BE (2-3 years, including baseline), and consistent BE (≥ 4 years, including baseline). Cox regression and mixed-effects models were used for analyses.

Results: ILI participants were marginally more likely to report incident BE at year 4 than those in DSE (P = 0.06). At year 4, ILI participants with remitted BE lost more weight (4.7 ± 0.8%) than those with consistent BE (1.9 ± 1.0%; P = 0.03). ILI participants with no BE lost more weight (4.6 ± 0.2%) than those with incident BE (3.1 ± 0.6%; P = 0.02) and consistent BE (P = 0.01). DSE participants with remitted BE lost more weight than those with incident and consistent BE.

Conclusions: Preexisting BE did not seem to be a contraindication for ILI, although persistent BE attenuated weight loss. Patients who report new or ongoing BE may need additional treatment.

Trial registration: ClinicalTrials.gov NCT00017953.

Conflict of interest statement

Disclosures: All other authors have no conflicts of interest to declare.

© 2017 The Obesity Society.

Figures

Figure 1
Figure 1
Cumulative hazard ratio for intensive lifestyle intervention (ILI) versus diabetes support and education (DSE) for incidence of BE over 4 years in participants without baseline binge eating (BE).
Figure 2
Figure 2
Percent reduction in initial weight in the intensive lifestyle intervention (ILI) group by binge eating (BE) trajectory. Values shown are mean (±standard error) and weight losses were estimated using linear mixed-effects models controlling for baseline age, race/ethnicity, sex, education level, body mass index, number of previous weight loss attempts, quality of life (physical and mental composite scores), depressive symptoms, number of prescription medications, and weekly alcohol consumption.
Figure 3
Figure 3
Percentage of participants in the intensive lifestyle intervention (a) and diabetes support and education (b) groups who at year 4 met different categorical weight losses.
Figure 3
Figure 3
Percentage of participants in the intensive lifestyle intervention (a) and diabetes support and education (b) groups who at year 4 met different categorical weight losses.
Figure 4
Figure 4
Percent reduction in initial weight in the diabetes support and education (DSE) group by binge eating (BE) trajectory. Values shown are mean (±standard error) and weight losses were estimated using linear mixed-effects models controlling for baseline age, race/ethnicity, sex, education level, body mass index, number of previous weight loss attempts, quality of life (physical and mental composite scores), depressive symptoms, number of prescription medications, and weekly alcohol consumption.

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