Background: To evaluate whether knowledge of a personalized Diabetes Risk Score (DRS) improved performance in a 12-week lifestyle change program for prediabetes. Methods: Randomized subjects at four clinics provided samples for a DRS at baseline, 12, and 24 weeks. The intervention group received scores at each point, whereas the control group only received this information at 12 and 24 weeks. Outcomes included attendance and changes in weight, abdominal circumference, blood pressure, fasting glucose, hemoglobin A1c, cholesterol, and risk score. Results: Baseline characteristics were similar in the groups (n = 192) and within risk-stratified subgroups. At 12 weeks, there were no differences in outcomes, with mean weight loss of 4.61 kg in the intervention group and 4.43 kg in the control group (p = 0.79). Both groups were given 12-week risk scores, with previously unseen baseline scores for the control group. The control group continued to lose additional weight (1.21 kg) by 24 weeks, whereas the intervention group regained previously lost weight (0.33 kg) (p = 0.04). Conclusions: The knowledge of a single baseline personalized DRS did not affect performance in a lifestyle modification program. However, the knowledge of an improvement in risk score, and the timing of this information, may impact further adherence.