The Rewind program is a three-phase, 2+ year, virtual, multicomponent clinical program designed to reduce weight, and improve glycemic control, cardiometabolic outcomes, and health-related quality-of-life in people with type 2 diabetes or risk factors for diabetes.
of members achieve T2 remission
avg. body weight lost by members
The intervention consists of an initial phase of intensive energy restriction to promote 15% or greater weight loss, followed by education and counseling to support lasting behavior change in diet and physical activity patterns to prevent weight regain.
Initially, patients are asked to consume a very-low energy diet in the form of total diet formula meal replacements, and to participate in low to moderate intensity physical activity for 40 minutes daily.
After 3-4 months, patients are gradually transitioned to a diet of everyday foods with total calorie intake of 1200–1800 kcal/day (based on their metabolic requirements), and encouraged to increase their physical activity intensity and duration to moderate-vigorous for 60 minutes, many days as possible per week.
During their 2+ year enrollment, all patients in the Rewind program will interact in virtual appointments on a regularly scheduled basis with a physician and a registered dietitian, as well as with a cohort of other patient-peers in the program. Dietitian appointments are weekly during the first month, and monthly thereafter; physician appointments are monthly during the total meal replacement phase, and quarterly thereafter. The program requires regular appointment attendance, as well as adherence to provider recommendations regarding medications and physical activity. Beyond the initial phase of total formula meal replacement, the Rewind clinical team partners with patients to develop a dietary meal plan for weight stabilization based on that individual’s food preferences, tolerances/allergies, food access, and social circumstances.
During patient orientation, the Rewind clinical team does address the risks of rapid intentional weight loss including: gallstone development (if gallbladder is still present), kidney stone development (if dehydration occurs), gout flares (if baseline uric acid is elevated), bowel habit changes (particularly constipation), hypoglycemia (if on glucose lowering medications/insulin), hypotension (if on antihypertensive agents). The patient’s physician will review which, if any, of the above risks need to be mitigated with pharmacological intervention or medication adjustments prior to program start and throughout the first phase.
The Rewind program is compatible with most commercial insurance plans, within the markets in which the program is available (currently Michigan and South Carolina). Patients must have insurance to apply to Rewind, and currently Medicare is accepted in SC only. Prospective members can review their individual insurance benefits prior to program start; there may be co-pays, annual deductibles, and/or other appointment costs associated with the program, according to each individual’s insurance plan details. Meal Replacements, which are foundational to the success of the very-low energy diet phase of the program, range from $10-14/day, are not covered by insurance, and will be purchased by the patient from approved vendors directly.
Referred patients will be contacted by the Rewind Care Navigation team to answer questions, confirm eligibility, and provide next steps for enrollment.
Referrals are mandatory only for HMO plans - patients are also able to self-apply at www.joinrewind.com/get-started
Michigan providers may also refer patients through Michigan Medicine:
Call M-LINE: 800-962-3555 (24-hour, toll-free number for referring physicians)
Specialty Clinic Referral: Dr. Amy Rothberg, MEND division (WMP)/Rewind