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Using Psychology Of Eating To Enhance Compliance

July 17th, 2007 at 11:32 am · Allan Showalter, MD · Clinical Info, Enhancements · No Comments

Portion Control Plate for Weight Loss in Obese Patients With Type 2 Diabetes Mellitus - A Controlled Clinical Trial
Sue D. Pedersen, MD, FRCPC; Jian Kang, MSc; Gregory A. Kline, MD, FRCPC, Arch Intern Med. 2007;167:1277-1283.





The Study

The trial was undertaken to evaluate the efficacy of portion control tools to induce weight loss and improve glycemic control in patients with type 2 diabetes mellitus. 130 obese patients with type 2 diabetes mellitus (including 55 patients taking insulin) were randomly assigned to the daily use of a commercially available portion control plate1 for 6 months (intervention group) vs to usual care in the form of dietary teaching (usual care control group).

Results:

Follow-up was 93.8%. Patients in the intervention group lost significantly more weight than control subjects (mean ± SD, 1.8% ± 3.9% vs 0.1% ± 3.0%, P = .006). Compared with controls, more patients in the intervention group required a decrease in their diabetes medications at 6 months (26.2% vs 10.8%, P = .04).

Commentary

While this clinical trial focused directly on compliance, i.e., the impact of portion control plates on the implementation of weight reduction diets and glycemic controls by diabetic patients, it also

  • Reinforces the notion that education alone many be insufficient for compliance but, at least for some patients, education supplemented by aids (e.g., in this case, the portion control plates) leads to successful adherence
  • Raises the possibility that other, non-medical psychological knowledge, whether about eating or other activities, could be useful in enhancing compliance.



Footnotes

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  1. From Dishing out portion control for dieters: The dishes, sold by the Diet Plate Limited of England, are not specifically designed for people who are overweight or have diabetes. For breakfast, subjects used the bowl to measure 200 calories’ worth of cereal and milk - colored rings on the bowl correspond to different types of cereal - but only if they wanted cereal. If not, they were free to eat anything else, with no portion restrictions. The plate, which holds an approximately 800-calorie meal, was to be used during the biggest meal of the day. Its painted lines divvy out sections for grains, cheese, sauce and protein; mixed items such as lasagna were placed in the section that fit their ingredients closest. Vegetables were unlimited as long as they were not covered in oil or fried.↩

Tags: Clinical Info · Enhancements