In trials, subjects who attended the tightly scripted sessions and followed the regimen were far more likely than those who were on their own to reach their weight-loss goals in three months — and to keep that weight off for more than a year. By doing so, they drove down their risk of developing Type 2 diabetes by 58 percent, according to a landmark report published in the New England Journal of Medicine in 2002.
The program, in short, is powerful medicine.
“If you could take it as a pill, it would definitely be commercialized,” said Sean Duffy, a software designer and former Google employee who launched an online version of the program about a month ago.
In June, a panel of physicians and public health experts that advises the Department of Health and Human Services gave the program a mighty push into everyday medical practice. The U.S. Preventive Services Task Force recommended that doctors refer their obese patients to “intensive, multicomponent behavioral interventions” designed to promote weight loss and physical activity. It cited only one that met its strict standards: the Diabetes Prevention Program.
Under the Affordable Care Act, that carries significant weight. Starting in June, most health insurers will be required to make proven weight-loss and behavior-modification programs available without a co-payment to obese customers with a doctor’s referral.
No one yet knows whether expanded coverage of such programs can save money and head off a public health disaster. But without it, experts believe a tidal wave of Type 2 diabetes and heart disease — with a 20-year price tag estimated at $550 billion in the U.S. alone — is a virtual certainty.
For all its promise, the program has remained little more than a good idea — and a pretty expensive one at that — for years. The researchers who developed it at Indiana University pegged the cost of the trial’s intensive 12-week phase and nine months of maintenance at about $1,300 per patient. To make it cheaper and more accessible, they trained a few YMCA chapters to deliver the program.