To Nag or Not to Nag, That Is the Question (and Here May Be the Answer...)

An intensive lifestyle intervention focusing on weight loss did not reduce the rate of cardiovascular events in overweight or obese adults with type 2 diabetes, concludes a study published recently in the New England Journal of Medicine.

The study of more than 5,000 overweight diabetics aged 45 to 75 spanning a decade had randomly separated the subjects into two groups. One (the control group) received only standard advice and medications but were then left to manage pretty much on their own, while the other (the intervention group) received "intensive lifestyle intervention" consisting of regular counseling sessions and enforced caloric restrictions and physical exercise.

The study was finally called off when a "futility analysis" (their words) showed no significant difference between the two groups in terms of "the rate of cardiovascular events" after an average of 9.6 years on the program.

In other words, either the control group did the healthy things they needed to do without "intensive lifestyle intervention," or the intervention group was so good at getting around the intensive lifestyle intervention police that the intervention was almost useless or, well, it doesn't really make much difference what you do one way or the other. In any case, it does call into question whether such intensive interventions are effective given what they probably cost.

I'm not ready to say definitely one way or the other, but this sounds like a pretty comprehensive piece of research that can't just be dismissed out of hand. What do you think, dear readers?