"What drives behavior change is relationships," says Duffy. "It's about humans connecting with each other, supporting each other, and feeling accountable
to each other."
Whether through inspiration, competition, or a sense of mutual responsibility, Prevent seems to work. In a 230-person pilot study, participants lost on
average 6.4 percent of their weight in 16 weeks -- enough to significantly reduce their risk of developing diabetes.
Dr. Anne Peters, director of the Clinical Diabetes Program at the University of Southern California and an advisor to Omada Health, calls Prevent "a
considered system for effective social bonding." Unprompted, many participants in the pilot study began meeting in person with other group members. Months
after "graduating" from the program, many continue to visit the website regularly. And 40 of the program's alumni have already applied to serve as health
coaches for future participants.
Duffy believes there is unique value in progressing through a structured curriculum as part of a community. "There isn't a curriculum behind [traditional]
weight loss programs," he says. "With Prevent, there is a journey, and there is a destination."
The real test of the program's success, of course, will be the persistence of results. Omada is continuing to track weight trends among Prevent alumni.
Says Peters, "They have good early data; we'll need to see what the one-year data show. I see the program ideally lasting for a lifetime, with out-years
There is also the issue of cost: most DPPs are not covered by insurance. This could change if the Medicare Diabetes Prevention Act of 2012 passes; Medicare would then cover DPPs, paving the
way for private insurers to follow suit. Until then, the need to pay out of pocket ($120 per month for Prevent) may deter many prediabetics from signing
"It's hard to get patients to change something when they are asymptomatic," says Peters. "Especially if they have to pay for it."
After receiving his diagnosis, Tracy Jordan straps a "practice" wheel to his foot and, with painstaking effort, wheels toward a bowl of candy.
The recipe for diabetes prevention could not be simpler; yet even with the right ingredients, the challenge of change looms large.
"People are ready when they're ready," says Peters. "Those in the pre-contemplative stage need something else to get them to a point where they want to
engage in a program." For DPPs to be most impactful, then, changes will also need to occur in primary care, in education, in policy, and elsewhere.
In the meantime, programs like Prevent offer hope that the diabetes trend, startling as it has been, can still be reversed -- so long as people come
together to make it happen.