OBJECTIVE: To evaluate 8-year weight losses achieved with intensive lifestyle intervention (ILI) in the Look AHEAD (Action for Health in Diabetes) study. DESIGN AND METHODS: Look AHEAD assessed the effects of intentional weight loss on cardiovascular morbidity and mortality in 5,145 overweight/obese adults with type 2 diabetes, randomly assigned to ILI or usual care (ie, diabetes support and education (DSE)). The ILI provided comprehensive behavioral weight loss counseling over 8 years; DSE participants received periodic group education only. RESULTS: All participants had the opportunity to complete 8 years of intervention before Look AHEAD was halted in September 2012; >= 88% of both groups completed the 8-year outcomes assessment. ILI and DSE participants lost (mean +/- SE) 4.7% +/- 0.2% and 2.1 +/- 0.2% of initial weight, respectively (p < 0.001) at year 8; 50.3% and 35.7%, respectively, lost >= 5% (p < 0.001), and 26.9% and 17.2%, respectively, lost >= 10% (p < 0.001). Across the 8 years ILI participants, compared with DSE, reported greater practice of several key weight-control behaviors. These behaviors also distinguished ILI participants who lost >= 10% and kept it off from those who lost but regained. CONCLUSIONS: Look AHEAD's ILI produced clinically meaningful weight loss (>= 5%) at year 8 in 50% of patients with type 2 diabetes and can be used to manage other obesity-related co-morbid conditions.

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