The DPP participants initially randomized to lifestyle were also eligible to receive two additional sessions, referred to as BOOST sessions, per year to reinvigorate
their self-management behaviors for weight loss. Those randomized to metformin and placebo were excluded from BOOST sessions. The sessions were more intensive than HELP sessions and reinforced specific behavioral self-management activities (e.g.,
self-monitoring of fat, calories, and/or physical activity, as well as weight checks) important for weight loss and physical activity adherence and/or maintenance. In addition, the sessions promoted homebased behavioral self-management of weight and physical activity through the use of motivational campaigns. Lifestyle participants received reminders for each BOOST session.