Efficacy of the holistic, psychonutritional approach of in the management of type 2 diabetes among patients with obesity and dysfunctional eating.

Purpose: Dysfunctional eating is strongly associated with obesity and worsens type 2 diabetes (T2DM) outcomes. The aim of this study was to investigate the effectiveness of the psycho-nutritional treatment (PNT) of " of Città della Pieve on weight loss and glucose management in dysfunctional eaters with obesity and T2DM.

Methods: PNT includes psychotherapeutical, nutritional, physical and social activities. Subjects with obesity, T2DM and dysfunctional eating habits who completed the 8 weeks residential program between 2010 and 2019 were compared with obese, T2DM, dysfunctional eaters who underwent to a conventional, hospital-based, nutritional treatment (CT). Anthropometric variables, glucolipid panel, and body composition were assessed at baseline and at the end of the program. Weight and HbA1c were also measured after one year from the completion.

Results: Sixty-nine patients completed the PNT and reduced weight (-7 ± 3.2%;  < 0.001), BMI (-7 ± 3.1%;  < 0.001), and triglycerides, AST, GGT and ALT ( ≤ 0.008); glycemic control improved (HbA1c: -1.1 ± 1.5%, mean fasting glucose: -41 ± 46 mg/dl,  < 0.001). Eleven% of subjects requiring diabetes medications at baseline discontinued the therapy. In the insulin treated group (49%), mean daily units were halved (-32.6 ± 26.0,  < 0.001). At one year, weight loss (-6 ± 7.4%,  < 0.001) and HbA1c reduction (-0.52 ± 1.4%, p = 0.029) persisted. Fifty-five patients completed the CT: HbA1c reduced (p = 0.02), but weight (-0.6 ± 3.7%), BMI (-0.7 ± 3.8%), and insulin units' reduction (-2.5 ± 11.7, p = 0.20) were lower compared to the PNT.

Conclusion: PNT is effective in improving T2DM management in patients with obesity and dysfunctional eating.