Weight-management intervention effective for weight gain prevention among black women

An intervention not focused on weight loss was effective for weight gain prevention among socioeconomically disadvantaged black women, according to a report published by JAMA Internal Medicine, a JAMA Network publication.

Promoting clinically meaningful weight loss among black women has been a challenge. Compared to white women, "black women have higher rates of body weight satisfaction, fewer social pressures to lose weight, and sociocultural norms that tolerate heavier body weights," according to the study background.

"New weight management strategies are necessary for this population," according to the study by Gary G. Bennett, Ph.D., of Duke University, Durham, N.C., and colleagues.

Researchers compared changes in weight and cardiometabolic risk among black women assigned to either a behavioral weight gain prevention intervention or usual care in a clinical trial (the Shape Program). The intervention included weekly self-monitoring via interactive voice response telephone calls, monthly counseling calls, tailored skills training materials and a one-year gym membership.

Participants in the clinical trial were 194 overweight and class 1 obese (body mass index [BMI] of 25-34.9) premenopausal black women ages 25 to 44 years. Assessments were done at 12 and 18 months. At baseline, the women had an average age of 35.4 years, an average weight of almost 179 pounds (81.1 kg), and an average BMI of 30.2.

"We explicitly informed participants that Shape was not a weight loss trial. We did not expect participants to be motivated to lose weight. Instead, we informed participants that Shape was an approach designed to improve their overall well-being and to maintain their current body shape," the study notes.

The 12-month weight change was larger among the intervention participants (average, -2.2 pounds [1 kg]) relative to usual care (average, 1.1 pounds [0.5 kg]). At 12 months, 62 percent of intervention participants were at or below their baseline weight compared with 45 percent of usual-care participants. By 18 months, intervention participants maintained significantly larger changes in weight (average difference, -3.7 pounds [-1.7 kg]), according to the study results.

No difference was seen between treatment groups in change in waist circumference, blood pressure, blood pressure control, glucose or lipid levels at any time point, the results also indicate.

'It is clear that new treatment approaches, such as weight gain prevention, are necessary to contend with the considerable challenge of obesity in this population," the study concludes.

In a related commentary, Regina M. Benjamin, M.D., M.B.A., former U.S. Surgeon General, Washington, D.C., and colleagues write: "Sadly, some communities face a disproportionate burden of obesity."

"Because of its outreach beyond the clinical setting, the Shape intervention is an example of linking the clinical approach for high-risk patients with the public-health community approach," the authors note.

"The promising results from this study and others testing approaches based in health care settings (e.g., the POWER [Practice Based Opportunities for Weight Reduction] trials) suggest that these approaches may be effective for preventing weight gain or promoting weight loss, but additional research is needed to determine the extent to which they reduce obesity-related health risks," the authors conclude.