The Lifestyle Education About Prediabetes (Leap) Study

Inclusion Criteria:

• overweight, defined as BMI >= 25 kg/m2 >= 23 kg/m2 if of Asian descent

• HbA1c between 5.7% - 6.4% verified at baseline

• willingness to participate in group-based sessions

• able to engage in at least light physical activities such as walking

• willingness to follow a prescribed diet, be randomized, self-weight, track diet, andreport physical activity minutes

• physician approval to participate

Exclusion Criteria:

• history of type 1 diabetes or type 2 diabetes

• use of anti-obesity medications or participation in another weight loss program orintervention

• use of glucose lowering medications other than metformin

• pregnant or planning to become pregnant during the intervention period

• breastfeeding

• use of oral corticosteroids

• previous bariatric surgery or planning to have bariatric surgery during the studyperiod

• blood disorders that influence HbA1c, including frequent blood transfusions,phlebotomy, anemia, hemoglobinopathy, polycythemia

• any condition for which the study team deems participation to be unsafe orinappropriate

• inability to read, write, or speak English

• inability to provide informed consent

• adherence to a vegan or vegetarian diet

• adherence to a very low-carbohydrate (keto) diet

• difficulty chewing or swallowing

• no influence over what foods are purchased, prepared, and/or served

• above weight limit for DEXA (500 pounds)

• untreated eating disorder or mental health conditions, such as depression withsuicidal ideation, bipolar or schizophrenia with psychosis

• use of warfarin

• chronic kidney disease, stage 4 or higher

• use of loop diuretics: 20mg or higher of furosemide or equivalent (Lasix (furosemide), Bumex (bumetanide), Ederin or Sodium Edecrin (ethacrynic acid),Demadex or Soaanz (torsemide))

• any concerning values in baseline labs (participants will be referred to PrimaryCare Physician and will be allowed to return for later enrollment if labs are nolonger concerning)

• Triglycerides 600 Milligrams per deciliter (mg/dL) or higher

• Thyroid stimulating hormone of any abnormal value

• Potassium of any abnormal value