Weight loss and improved metabolic outcomes amongst rural African American women in the Deep South: six-month outcomes from a community-based randomized trial

Abstract

Background: Obesity is highly prevalent in African American women, especially those in the rural southern USA, resulting in persistent health disparities.

Objective: To test the effectiveness of an evidence-based behavioural weight loss intervention delivered by community health advisors to African American women in the rural south.

Design and methods: Overweight or obese African American women (30-70 years) from eight counties in Mississippi and Alabama participated in a 24-month randomized controlled trial of an evidence-based behavioural weight loss programme augmented with community strategies to support healthy lifestyles (Weight Loss Plus, N = 154) compared to the weight loss programme alone (Weight Loss Only, N = 255). This study reports on 6-month outcomes on primary (weight change) and secondary (waist circumference, blood pressure, lipids, fasting blood glucose) outcomes, coinciding with the completion of the intensive weight loss phase.

Results: Weight Loss Only participants lost an average of 2.2 kg (P < 0.001). Weight Loss Plus participants lost an average of 3.2 kg (P < 0.001). The proportion of the total sample that lost at least 5% of their body weight was 27.1% with no difference between treatment groups. Similarly, we observed statistically significant reductions in blood pressure, waist circumference and triglycerides in each treatment group, with no statistical differences between groups.

Conclusion: Trained lay health staff and volunteers from the rural southern USA were able to deliver a translation of a high-intensity behavioural intervention targeted to African American women, resulting in clinically meaningful weight loss and improvement in other metabolic outcomes in a significant proportion of participants.

Keywords: African American; community-based; metabolic outcomes; randomized trial; rural communities; weight loss.

Conflict of interest statement

Conflict of Interest Statement

There are no conflicts of interest among any of the authors.

© 2017 The Association for the Publication of the Journal of Internal Medicine.

Figures

Figure 1.

CONSORT diagram

Figure 2.

Percent of participants reporting any, 3% or 5% weight loss by treatment group

Figure 3:

Waterfall plot of individual participant change in weight (kg) by treatment group