Abstract
Problems posed by obesity-related endocrine diseases embody a national health crisis.
Caloric excess and sedentary lifestyle from which they develop also pose significant
challenges for rehabilitation providers. Almost two thirds of the U.S. population
are currently overweight or obese, a number that has increased by >10% within the
last decade and is expected to grow. An overweight body habitus is strongly associated
with clinical hazards, including cardiometabolic syndrome, diabetes hypertension,
and coronary artery disease. The component health risks of the cardiometabolic syndrome
include coalescing of risk factors that predict a health calamity unless effective
interventions can be developed and widely adopted. Obesity by itself is now considered
an American Diabetes Association–qualified disability, but it is also disturbingly
prevalent in other physical disability groupings of adults and children. This monograph
describes successes of the Diabetes Prevention Program (DPP), a National Institutes
of Health multisite randomized controlled trial that reported significant weight reduction
and a 58% decreased incidence of type-2 diabetes accompanying 1 year of structured
lifestyle intervention. This treatment benefit (1) exceeded that of metformin pharmacotherapy,
(2) was so powerful that the trial was closed before reaching endpoints, and (3) was
judged cost-effective for the patient and society. The DPP roadmap incorporating physical
activity, diet, and behavioral approaches has been widely adapted to specific community,
faith, racial, ethnic, school, and national populations with excellent outcomes success.
The lockstep physical activity approach, activity prescription, and long-term success
of the program are described and compared with other programs to illustrate effective
countermeasures for the pandemics of obesity and obesity-related cardioendocrine disease.
We will illustrate adaptation of the DPP for a cohort of persons with disability from
spinal cord injury and the benefits observed.
Keywords
List of abbreviations:
DPP (Diabetes Prevention Program), HRQOL (health-related quality of life), T2DM (type 2 diabetes mellitus)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 12, 2016
Footnotes
Supported by Spinal Cord Injury Research Program Clinical Trial Award W81XWH10-1-1044 from the U.S. Department of Defense.
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
