The Look AHEAD Study: A Description of the Lifestyle Intervention and the Evidence Supporting It
Open accessAbstract
The Look AHEAD (Action for Health in Diabetes) study is a multicenter, randomized controlled trial designed to determine whether intentional weight loss reduces cardiovascular morbidity and mortality in overweight individuals with type 2 diabetes. The study began in 2001 and is scheduled to conclude in 2012. A total of 5145 participants have been randomly assigned to a lifestyle intervention or to an enhanced usual care condition (i.e., diabetes support and education). This article describes the lifestyle intervention and the empirical evidence to support it. The two principal intervention goals are to induce a mean loss ≥ 7% of initial weight and to increase participants’ moderately intense physical activity to ≥175 min/wk. For the first 6 months, participants attend one individual and three group sessions per month and are encouraged to replace two meals and one snack a day with liquid shakes and meal bars. From months 7 to 12, they attend one individual and two group meetings per month and continue to replace one meal per day (which is recommended for the study's duration). Starting at month 7, more intensive behavioral interventions and weight loss medication are available from a toolbox, designed to help participants with limited weight loss. In Years 2 to 4, treatment is provided mainly on an individual basis and includes at least one on‐site visit per month and a second contact by telephone, mail, or e‐mail. After Year 4, participants are offered monthly individual visits. The intervention is delivered by a multidisciplinary team that includes medical staff who monitor participants at risk of hypoglycemic episodes.
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Large, long-duration lifestyle intervention randomized controlled trials have employed group counseling sessions for participants, resulting in meaningful weight reduction.
“Large, long‐duration lifestyle intervention randomized controlled trials have also employed group counseling sessions for participants, resulting in meaningful weight reduction [213].”
From Nutritional priorities to support <scp>GLP</scp> ‐1 therapy for obesity: A joint Advisory from the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society (2025) · cites this paper as [213]
The Treatment Frequency and Format section (p. 739) describes group counseling in Look AHEAD’s multiyear intervention, and the Weight Loss Goal section reports meaningful losses in earlier lifestyle-intervention RCTs. But this 2006 paper describes Look AHEAD’s planned intervention and weight-loss goals, not weight reduction achieved by that long-duration trial. (LLM, conf=0.87)
Experimental — accuracy not yet measuredLarge, long-duration lifestyle intervention randomized controlled trials have also employed group counseling sessions for participants, resulting in meaningful weight reduction.
“Large, long-duration lifestyle intervention randomized controlled trials have also employed group counseling sessions for participants, resulting in meaningful weight reduction [204].”
Regular self-monitoring facilitates increased physical activity.
“Regular self-monitoring also facilitates increased physical activity [8–12].”
From The Role of Lifestyle Modification with Second-Generation Anti-obesity Medications: Comparisons, Questions, and Clinical Opportunities (2023) · cites this paper as [11]
Large, long-duration lifestyle intervention randomized controlled trials have employed group counseling sessions for participants, resulting in meaningful weight reduction.
“Large, long-duration lifestyle intervention randomized controlled trials have also employed group counseling sessions for participants, resulting in meaningful weight reduction [213].”
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Self-citationAdherence is a multi-dimensional construct in the POUNDS LOST trial
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- Authors
- The Look AHEAD Research Group
- Affiliations
- University of Pennsylvania (US)
- Corresponding author
- The Look AHEAD Research Group
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2006-05
- Volume
- 14
- Issue
- 5
- Pages
- 737-752
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- PMC
- PMC2613279
- OpenAlex
- W2138652556
- Cited by
- 873
- References
- 94
- Citations by year
- 2026: 39 · 2025: 53 · 2024: 44 · 2023: 60 · 2022: 53 · 2021: 56 · 2020: 57 · 2019: 38 · 2018: 57 · 2017: 58 · 2016: 54 · 2015: 54 · 2014: 45 · 2013: 47 · 2012: 39
- FWCI
- 2.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services
- Massachusetts General Hospital
- University of Pennsylvania
- University of Minnesota
- Joslin Diabetes Center
- University of Pittsburgh
- University of Alabama at Birmingham
- University of Alabama
- National Institutes of Health (5p30dk046204-15)
- Health Science Center, University of Tennessee
- National Institute of Diabetes and Digestive and Kidney Diseases (DK-57171, DK 57136, DK57149, DK 57002, DK57182, DK56990, (DK 046204, DK57008, DK57177, DK 57078, DK57219, U01DK057149, DK-57178, U01DK057151, U01DK057135, U01DK057131, U01DK056990, DK-57135, U01DK057136, DK-56992, DK57154, U01DK057178, U01DK057182, U01DK057078, U01DK057154, U01DK057008, U01DK057171, DK57131, U01DK057002, U01DK057219, U01DK056992, U01DK057177, P30DK048520, DK 57151, P30-DK046204, P30-DK 48520)
- National Center for Research Resources (M01-RR-0021140, M01RR-00051, M01RR002719, M01RR000056, M01RR000051, M0-1-RR-02719, M01RR000211)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 2 diabetes, lifestyle intervention, weight loss, cardiovascular morbidity and mortality, overweight, physical activity, meal replacement, behavioral interventions, anti-obesity drugs, diabetes support and education, multidisciplinary care, hypoglycemia
- MeSH terms
- Cardiovascular Diseases, Diabetes Mellitus, Type 2, Forecasting, Health Promotion, Humans, Life Style, Obesity, Multicenter Studies as Topic, Weight Loss, Health Behavior, Exercise, Randomized Controlled Trials as Topic
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