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“Maintain, Don’t Gain”—A Weight Management Approach To Help Those Already Overweight or Obese

Researchers have achieved promising results in an intervention to help overweight and obese African American women prevent further weight gain, using a combination of primary care and community settings, along with technology accessible to those who are socioeconomically disadvantaged. The intervention aimed not for weight loss, but rather to improve the overall well-being of the participants and maintain their current body shape—a message that they hoped would resonate with the participants. By helping overweight and moderately obese individuals avoid further weight gain, the researchers hoped to prevent the additional health risks associated with extreme obesity. The researchers recruited women from primary care centers in a socioeconomically disadvantaged area in the South. Participants were randomly assigned either to the intervention or, for comparison, to their usual care. For 12 months, the women in the intervention group received tailored behavior change goals (for example, no sugar-sweetened beverages), weekly self-monitoring with computer-generated telephone calls, monthly counseling calls from a registered dietician, skills training materials, and a one-year YMCA membership.

Measuring weight at the end of the 12 month intervention, and then again at 18 months, the researchers found that the women in the intervention group better maintained their initial weight: 53 percent had weights at or even below their weight at the start of the study, compared to 39 percent of those in usual care. On average, the women in the intervention group had a slight weight loss of approximately two pounds, while those in the usual care group on average gained that amount of weight. Many of the women had other health risk factors at the outset of the study, but the intervention did not affect blood pressure, blood glucose, or several other cardiovascular risk factors. Importantly, although recruiting from a primary care system, the intervention was largely delivered in the community with dieticians and relatively inexpensive electronic health technologies. This strategy circumvents issues related to insufficient reimbursement, time, and training that may hinder effective weight management solely by primary care physicians. This strategy could also be implemented broadly in communities disproportionately affected by obesity. Longer-term studies may help researchers determine whether—by fending off the usual weight gain over time—this intervention could reduce type 2 diabetes and other obesity-associated diseases.