Behavior-Based Lifestyle Program Enables Sustained Metabolic Syndrome Remission, reveals JAMA study
A new study published in the Journal of the American Medical Association revealed that promoting simple, behavior-focused lifestyle habits emphasizing immediate benefits can lead to sustained remission of metabolic syndrome (MetS) after treatment.
The Enhancing Lifestyles in Metabolic Syndrome (ELM) study, published in 2025, evaluated whether a 6-month, habit-based behavioral program could outperform standard health education and activity monitoring in sustaining MetS remission over 2 years. This clinical trial at 5 U.S. sites between July 2019 and January 2022, analyzing data through May 2025.
The trial screened 14,817 adults, ultimately enrolling 618 participants (mean age 55.5 years; 75% women), all of whom had MetS and were motivated to make lifestyle changes. The participants were divided into a group receiving standard educational materials and an activity tracker, and the other group joined 19 small in-person group sessions over 6 months.
These group sessions focused on developing 4 simple daily habits from eating vegetables at every meal, brisk walking, practicing sensory awareness, to managing emotions. The idea was to embed these behaviors into daily routines by emphasizing immediate, tangible benefits and peer encouragement.
At 6 months, the participants in the habit-based intervention group were more likely to achieve remission from MetS when compared to the education-only group (24.8% vs. 17.9%), with an adjusted odds ratio of 1.64 (95% CI, 1.07–2.53; P = .03). This early success was supported by improvements in waist circumference, triglyceride levels, fasting glucose, body mass index (BMI), hemoglobin A1c, and perceived stress. Also, lifestyle indicators which included vegetable intake, daily step count, and moderate-intensity activity showed measurable gains.
At 24 months, sustained MetS remission remained higher among those who had undergone the habit-based intervention (27.8% vs. 21.2%), with an adjusted odds ratio of 1.46 (95% CI, 1.01–2.14; P < .05). Improvements in fasting glucose levels, vegetable consumption, and daily walking persisted over the 2-year follow-up. Around 84% of participants completed the full 24-month period, which reflected strong engagement and retention.
Overall, the findings highlight that even modest, easily repeatable behaviors can have lasting metabolic benefits when practiced consistently. Unlike many intensive diet or exercise programs that lose impact over time, this approach focused on building sustainable habits reinforced by immediate well-being and social support.
Source:
Powell, L. H., Berkley-Patton, J., Drees, B. M., Karavolos, K., Lohse, B., Masters, K. S., Nicklas, J. M., Rothschild, S. K., Yeh, C., Zimmermann, L. J., Suzuki, S., & ELM Trial Research Group. (2025). Lifestyle intervention for sustained remission of Metabolic Syndrome: A randomized clinical trial: A randomized clinical trial. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2025.5900
