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To address the burden of type 2 diabetes, the Centers for Disease Control and Prevention (CDC) launched the National Diabetes Prevention Program (National DPP) in 2010 (1). The program promotes weight loss through lifestyle change, based on remarkable findings of 58% reduced cumulative incidence over 3 years in an efficacy trial (2). Major successes include reaching hundreds of thousands of at-risk individuals nationwide, robust outcomes, and widespread insurance coverage (1, 3), but more work is needed to ensure lasting impact, and retention plays a critical part. This Commentary briefly reviews the new retention study by Cannon et al.(4), linkage to other critical pieces, and future directions. In considering solutions to a complex national problem, I seek to contribute my uniquely broad experience with the National DPP working as a lifestyle coach, securing funding, overseeing delivery, reaching …