Binge Eating and Weight Loss Outcomes in Overweight and Obese Individuals With Type 2 Diabetes Results From the Look AHEAD Trial

Context: Binge eating ( BE) is common in overweight and obese individuals with type 2 diabetes mellitus, but little is known about how BE affects weight loss in this population. Objective: To determine whether BE was related to 1-year weight losses in overweight and obese individuals with type 2 diabetes participating in an ongoing clinical trial. Design, Setting, and Participants: The Look AHEAD ( Action for Health in Diabetes) trial is a randomized controlled trial examining the long-term effect of intentional weight loss on cardiovascular disease in overweight and obese adults with type 2 diabetes. A total of 5145 overweight and obese individuals aged 45 to 76 years with type 2 diabetes participated in this study. Interventions: Participants were randomly assigned to an intensive lifestyle intervention or to enhanced usual care ( a diabetes support and education control condition). Main Outcome Measures: At baseline and 1 year, participants had their weight measured and completed a fitness test and self-report measures of BE and dietary intake. Four groups were created based on BE status at baseline and 1 year ( yes/yes, no/no, yes/no, and no/yes). Analyses controlled for baseline differences between binge eaters and non-binge eaters. Results: Most individuals ( 85.4%) did not report BE at baseline or 1 year (no/no), 7.5% reported BE only at baseline ( yes/no), 3.7% reported BE at both times ( yes/yes), and 3.4% reported BE only at 1 year ( no/ yes), with no differences between intensive lifestyle intervention and diabetes support and education conditions ( P=.14). Across intensive lifestyle intervention and diabetes support and education, greater weight losses were observed in participants who stopped BE at 1 year ( mean [ SE] weight loss, 5.3 [ 0.4] kg) and those who reported no BE at either time ( mean [ SE] weight loss, 4.8 [ 0.1] kg) than in those who continued BE ( mean [ SE] weight loss, 3.1 [ 0.6] kg) and those who began BE at 1 year ( mean [ SE] weight loss, 3.0 [ 0.6] kg) ( P <. 001). Post hoc analyses suggested that these differences were due to changes in caloric intake. Conclusion: Overweight and obese individuals with type 2 diabetes who stop BE appear to be just as successful at weight loss as non-binge eaters after 1 year of treatment.