Rena Wing is well known for her research on behavioral treatment of obesity and particularly its application to type II diabetes. She has published over 200 peer-reviewed articles on these topics. Currently, she is the principal investigator on the Diabetes Prevention Program and has developed the lifestyle intervention being used in all 27 centers in that study. In addition, she is principal investigator at The Miriam Hospital site for a 15-center trial entitled, Study of Health Outcomes of Weight Loss and serves as chair of this multi-site study. Wing is a member of the council for National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and serves on the NIDDK Task Force on the Prevention and Treatment of Obesity.

Rena Wing's research focuses on behavioral treatment of obesity and addresses the following questions:

1. What are the health benefits of modest weight loss?

She was responsible for developing and implementing the lifestyle intervention that was used in the Diabetes Prevention Program (DPP). DPP was a randomized, controlled trial testing whether lifestyle intervention or metformin (a diabetes medication) could delay the onset of type 2 diabetes. More than 3,000 overweight patients with impaired glucose tolerance, recruited at 27 centers nationwide, participated and were randomly assigned to placebo, metformin, or intensive lifestyle intervention. The DPP showed that modest weight losses (14 pounds on average) reduced the risk of developing diabetes by 58% compared to placebo, whereas metformin reduced risk by only 31%. This study is the most compelling evidence to date of the health benefits of weight loss.

Currently, Dr. Wing is examining whether weight loss improves urinary incontinence in over 330 overweight women with this disorder.

Most importantly, she is currently chair of Look AHEAD, an ongoing study funded by National Institutes of Health (NIH) testing whether weight loss reduces cardiovascular morbidity or mortality in over 5,000 overweight individuals with type 2 diabetes. Participants are recruited from 16 centers across the United States with a center at the Miriam Hospital. Although weight loss is known to have positive short-term (1 year) effects on diabetes, this study is the first to examine the long-term (12 years) health impact.

2. How can we improve behavioral treatment of obesity?

Rena Wing has been studying ways to improve behavioral approaches to obesity for many years. She had approached this topic by conducting randomized clinical trials comparing different strategies that might be included in behavioral programs. She has shown, for example, that higher exercise goals and structured approaches to diet can improve weight loss outcomes. She has conducted studies evaluating the role of involving overweight spouses, using financial incentives, encouraging taking breaks from dieting, and creating intra-group and inter-group competitions. Current studies are investigating the effects of reducing variety in the diet and examining the effect of modifying the home environment.

Recently, this research has expanded to include studies to increase the dissemination of behavioral techniques by using the internet. Randomized trials have evaluated various approaches using human e-mail counseling or automated counseling.

3. Is it possible to prevent weight gain and subsequent obesity?

A third focus has been on key time periods where prevention of weight gain might be most effective. These periods have included childhood, the period surrounding pregnancy, and the menopausal transition. Working with Leonard Epstein, Rena Wing did a number of clinical trials of behavioral treatments for obese children aged 8-12 and their overweight parent(s). Current approaches target younger children (ages 4-8) and adolescents.

Rena Wing participated in a single center clinical trial of weight loss during menopause and showed that the lifestyle intervention successfully reduced weight gain and the increases in LDL-cholesterol that are typically seen in middle-aged women.

4. What are the characteristics of successful weight loss maintainers?

A key issue in the treatment of obesity is the maintenance of weight loss. Her research incorporates several different approaches to this problem. First, she is a founder of the National Weight Control Registry, a registry of over 5,000 people who have lost over 30 pounds (mean = 70 pounds) and kept it off at least one year (mean = 5.7 years). Self-reported data from these successful weight losers has been used to provide information about the behaviors associated with long-term maintenance of weight loss.

In addition, she has shown that it is possible to teach the strategies of successful weight losers to others and thereby improve their maintenance of weight loss. In a project called STOP Regain, she has found that a self-regulation intervention delivered via internet or face-to-face can reduce the risk of weight regain.

A current study by Rena Wing compares successful weight losers with normal weight controls and obese controls on both behavioral measures and brain responses to food cues. The question being addressed is whether successful weight losers who have reduced to normal weight now respond to food cues as always-normal weight controls, or whether they continue to respond as if obese.

CURRENT SUPPORT:

National Heart, Lung, and Blood Institute (NHLBI): R01 HL65132-02 "Peer-based Skills Training to Enhance Teen Weight Loss"
Total Direct Costs (TDC) 9/30/99-8/31/07 $1,828,243
(Co-Investigator, 5% effort)

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK): 1 U01 DK56992-01 "Study of Health Outcomes of Weight Loss (SHOW) Trial"
TDC 9/30/99-9/29/08
(Principal Investigator, 30% effort)

NIDDK 'Weight Reduction for Incontinence Treatment Network"
9/30/2003 – 6/30/2008 $1,749,164
(Principal Investigator 12% effort)

NIDDK "Long-term weight loss maintenance"
02/1/2004-12/31/2007 $1,431,399
(Principal Investigator 11.5% effort)

NHLBI "Modifying Obesogenic Homes: Impact on Weight Maintenance"
5/1/2004-4/30/2008 $2,065,702
(Co-Investigator 11.5% effort)

American Diabetes Association "Obesity treatment in young children targeting specific behaviors"
07/01/2005 – 06/30/2007 $747,914
(Co-Investigator 5% effort)

NIDDK "Childhood obesity treatment targeting specific behaviors"
08/01/2005-7/31/2007 $220,500
(Co-Investigator 5% effort)

National Institutes of Health (NIH)/ NIDDK "Economic Analysis of EPRIDE"
08/01/2005 - 07/31/2009 $782,824
(Co-Investigator 4% effort)

NIDDK "Long-term weight loss maintenance: Functional Imaging"
10/01/2005 – 09/30/2006 $150,000
(Principal Investigator 4% effort)

PAST SUPPORT:

NIDDK: 1 R01 DK57413 "Study to Prevent Regain (STOP Regain)"
TDC 7/01/00-6/30/05
(Principal Investigator, 15% effort)

NIH: R01 NR07960-01 "Role of home environment in weight loss maintenance"
TDC: 8/15/01-5/31/05 $422,308
(Co-Investigator, 5% effort)

NIH: R01 DK60058-01 "Enhanced Internet Behavior Therapy for Obesity Treatment"
TDC 5/1/02 – 4/30/06 $2,265,083
(Co-Investigator, 5% effort)

Wing, R. R., & Phelan, S. (in press). Behavioral treatment of obesity. In R. H. Eckel (Ed.), Obesity: An academic basis for clinical evaluation and treatment. Lippincott Williams, & Wilkins.

Wing, R. R., & Gorin, A. A. (in press). Obesity. In Oxford textbook of primary medical care. Oxford University Press.

Wing, R. R. (in press). Behavioral approaches to the treatment of obesity. In G. Bray, C. Bouchard & P. T. James. Handbook of obesity (2nd ed.). New York: Marcel Dekker, Inc.

Polley, B. A., & Wing, R. R. (in press). Randomized controlled trial to prevent excessive weight gain in pregnant women. International Journal of Obesity.

Phelan, S., & Wing, R. R. (in press). Treatment approaches for obesity. National Cancer Institute.

Wyatt, H. R., Grunwald, G. K., Mosca, C. L., Klem, M. L., Wing, R. R., & Hill, J. O. (2002). Long-term weight loss and breakfast in the National Weight Control Registry. Obesity Research, 10, 78-82.

Wing, R. R., & Tate, D. F. (2002). Behavioral treatment of obesity. In J. Caro (Ed.), Obesity and nutrition (chap. 17). Retrieved November 25, 2002, from http://www.endotext.org/obesity/obesity17/obesityframe17.htm.

Wing, R. R., Phelan, S., & Tate, D. F. (2002). The role of adherence in mediating the relationship between depression and health outcomes. Journal of Psychosomatic Research, 53, 877.

Wing, R. R., & Klem, M. (2002). Characteristics of successful weight maintainers. In C. G. Fairburn & K. D. Brownell (Eds.), Eating disorders and obesity (2nd ed.). New York: Guilford Press.

Wing, R. R. (2002). Treatment of obesity in patients with type 2 diabetes. In C. G. Fairburn & K. D. Brownell (Eds.), Eating disorders and obesity (2nd ed.). New York: Guilford Press.

Wing, R. R. (2002). Improving weight loss and maintenance in patients with diabetes. In B. J. Anderson & R. R. Rubin (Eds.), Practical psychology for diabetes clinicians. American Diabetes Association.

Wing, R. R. (2002). Exercise and weight control. In N. Rudeima, F. Delvin, & S. Schneider (Eds.), Handbook of exercise in diabetes. American Diabetes Association.

Wing, R. R. (2002). Behavioral weight control. In T. A. Wadden & A. J. Stunkard (Eds.), Handbook of obesity treatment. New York: Guilford Press.

Wing, R. R., & Polley, B. A. (2001). Obesity. In A. Baum, T. Revensons, & S. Singer (Eds.), Handbook of health psychology (pp. 263-279). Lawrence Erlbaum Associates.

Wing, R. R., & Jeffery, R.W. (2001). Food provision as a strategy to promote weight loss. Obesity Research, 9, 271S-275S.

Wing, R. R., & Hill, J. O. (2001). Successful weight loss maintenance. Annual Review of Nutrition, 21, 323-341.

Wing, R. R., Gorin, A. A., & Tate, D. F. (2001). Changing behavior for a healthier lifestyle. In B. A. Bowman, R. M. Russell, & R. Russell (Eds.), Present knowledge in nutrition (8th ed.). Washington, DC: International Life Sciences Institute Press.

Wing, R. R. (2001). Weight loss in the management of type 2 diabetes. In H. H. R. Gerstein (Ed.), Evidence based diabetes care (pp. 252-276). Ontario, Canada: Decker, Inc.

Wing, R. R. (2001). Behavioral treatment of obesity. In T. A. Wadden & A. J. Stunkard (Eds.), Obesity handbook (pp. 455-462). New York: Guilford Press.

Tate, D. F., Wing, R. R., & Winett, R. A. (2001). Using Internet technology to deliver a behavioral weight loss program. Journal of the American Medical Association, 285, 1172-1177.

McCaffery, J. M., Pogue-Geile, M. F., Muldoon, M. F., Debski, T. T., Wing, R. R., & Manuck, S. B. (2001). The nature of the association between diet and serum lipids in the community: A twin study. Health Psychology, 20, 341-350.

Honors

TOPS Award for Outstanding Achievement, North Atlantic Association for the Study of Obesity (NAASO), 2001

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Council Member, 1999

Society of Behavioral Medicine
North America Society for the Study of Obesity (NAASO)
American Diabetes Association