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My obesity management and disease prevention experiences encompass several clinical (university-based and private psychology practice), research (NIH clinical trials and translational studies) and training (developing/mentoring diverse practitioners and programs in the community) roles. Most of my work involves the design and pragmatic application of evidence-based lifestyle behavior change interventions as a roadmap for more widespread dissemination of disease prevention programs to benefit public health. I serve as Principal Investigator (PI) in the multi-site longitudinal follow-up of the Diabetes Prevention Program Outcomes Study (DPPOS) cohort to examine: 1) the effectiveness of early metformin treatment (initiated during pre-diabetes) on the development of cardiovascular disease and cancer; 2) the longer term impact of the intensive lifestyle treatment, continued (in less intensive form) during DPPOS; and 3) the clinical course of dysglycemia, associated metabolic abnormalities, and the development of long term disease outcomes among all randomized treatment groups.