Promoting weight loss and distress reduction in patients with type 2 diabetes: a randomized controlled trial of a combined well-being and lifestyle intervention

Introduction: Current lifestyle interventions for the treatment of type 2 diabetes and weight loss show limited effects, while the promotion of psychological well-being has shown preliminary benefits in reducing psychological distress and improving self-care behaviors in type 2 diabetes and weight loss. Objectives: The aim of this study was to evaluate the feasibility, acceptability, and superiority of a 4-month combined well-being and lifestyle intervention for weight loss and distress reduction among adult patients with type 2 diabetes and overweight/obesity compared to lifestyle intervention alone. Primary efficacy outcomes included changes in weight, psychological distress, and well-being, while secondary efficacy outcomes included changes in lifestyle and physiological parameters. Methods: In this multicenter RCT, 58 consecutive patients were recruited from two outpatient endocrinology clinics and randomized to either a combined WBT-lifestyle group, receiving the combined well-being and lifestyle intervention (n=30), or a lifestyle alone group, receiving a lifestyle intervention only (n=28). Data were collected at baseline (T0), at immediate post-intervention (T1), and at a 6-month follow-up (T2). Results: The study intervention was shown to be feasible and acceptable. Compared to the lifestyle alone group, the combined WBT-lifestyle group showed significantly greater improvements in levels of depression, hostility, and personal growth at T1 and in levels of physical activity at T2. There were no significant differences between treatment groups in measures of weight and other physiological parameters at any assessment points. However, significant improvements were observed from T0 to T2 in weight in both treatment groups, and in blood pressure in the combined WBT-lifestyle group. Conclusions: The findings suggest that a well-being intervention can be a valuable addition to lifestyle interventions in improving short-term psychological outcomes and promoting healthy changes in physical activity at a 6-month follow-up.