Group learning sessions are conducted each week for the initial 12 weeks. Each session covers a different topic that is relevant to weight management and diabetes. They last for 60 minutes and are lead by the diabetologist, EP, RD, or psychologist on the team. Participants also receive handouts for future reference.
Cognitive Behavioral Intervention
Group behavioral support sessions are conducted during the initial 12 weeks of the program. A clinical psychologist leads each session, which incorporates key components of cognitive-behavioral therapy for weight loss already validated in other clinical trials. These components include:
- Self-monitoring of eating and exercise
- Behavioral goal setting
- Stimulus control techniques
- Cognitive restructuring
- Assertive communication skills
- Stress management
- Relapse prevention
An exercise physiologist (EP) designs an individualized exercise plan for you, based on your health status and exercise capacity. The plan includes a balanced mix of aerobic exercise (cross and interval training), resistance exercise (circuit and superset training), and flexibility exercise (stretching).
The exercise plan includes a weekly 60-minute exercise session under the supervision of the EP. In addition, the EP gives each participant exercises to do independently at home throughout the week.
Our participants progress gradually during the 12 weeks until they reach the target of 60 minutes 6 days/week.
The nutrition component of the Why WAIT program includes using meal replacement shakes for breakfast and lunch for the first few weeks, plus a selection from 17 dinner menus for the evening meal. We provide snack lists for use in between meals.
The menus and meal replacement shakes have a nutrient breakdown of about 40% carbohydrate, 30% fat, and 30% protein, according to the Joslin Nutrition Guidelines. Participants keep food records, which are evaluated each week by the registered dietician. At the six-week mark of the program, we give participants breakfast and lunch menus, which they may use in place of meal replacement shakes.
Intensive and Interactive Medication Adjustments
The Why WAIT program’s diabetologist will change or adjust diabetes medications to reduce or eliminate medications that might contribute to weight gain.
We try to prescribe medications that have little or no impact on body weight, or even those with proven weight-loss potential, as long as they are not contraindicated and are covered by medical insurance. Insulin therapy may be reduced during the program.
We provide all participants with a glucose meter and ask them to monitor blood glucose more frequently. Based on monitoring results, medications are adjusted weekly by a diabetes nurse practitioner and a certified diabetes educator.