Maintain, don't gain: A new way to fight obesity

August 26, 2013

Programs aimed at helping obese black women lose weight have not had the same success as programs for black men and white men and women.

But new research from Duke University has found that a successful alternative could be a "maintain, don't gain" approach.

The study, which appears in the Aug. 26 issue of JAMA Internal Medicine, compared changes in weight and risk for diabetes, heart disease or stroke among 194 premenopausal black women, aged 25-44. They were recruited from Piedmont Health's six nonprofit community health centers in a multi-county area of central North Carolina, which serves predominantly poor patients.

For the study, half of the participants—97 women—were randomly placed in a primary care-based intervention program called Shape, while the other 97 received usual care from their physicians, generally weight-loss counseling.

The intervention program used software built by Duke researchers that personalized the intervention for each woman. Each woman received an individualized set of behavior-change goals for diet and physical activity. They tracked how well they were doing each week via automated phone calls, and had a coach and a .

After 12 months, the stabilized their weight, while participants in the usual care group continued to gain weight. Sixty-two percent of intervention participants were at or below their weight at the onset of the program, compared to 45 percent of usual-care participants. After 18 months, intervention participants still maintained their weight while the usual care group continued to gain weight.

"Many people go to great lengths to lose weight when their doctor recommends it. They may try a series of diets or join a gym or undergo really complex medical regimens. The complexity of these treatments can make it difficult for many to lose a sufficient amount of weight," said lead author Gary Bennett, an associate professor of psychology and neuroscience and at Duke who studies obesity prevention.

"Our approach was different. We simply asked our patients to maintain their weight," Bennett said. "By maintaining their current weight, these patients can reduce their likelihood of experiencing health problems later on in life."

The study, funded by a grant from the National Institute for Diabetes and Digestive and Kidney Diseases, cited other research showing that overweight and slightly obese premenopausal black women face far lower risks for many chronic diseases than do obese whites and other racial groups.

But by ages 40-59, black women have more than twice the prevalence of class 2 (moderate) obesity and three times the rate of class 3 (extreme) obesity than white women, the study said. This combination of rapid premenopausal weight gain and extreme obesity contributes to disproportionate chronic disease risk among black women, researchers said.

Preventing weight gain could reduce the odds of developing a host of health problems, such as high blood pressure, high cholesterol diabetes, cardiovascular disease, stroke and some cancers, the authors said.

A "maintain, don't gain" approach could be particularly effective for this group for the following reasons:

— Compared to white women, are typically more satisfied with their weight and face fewer social pressures to lose weight, Bennett said. Consequently, they may be particularly receptive to intervention messages about maintaining their weight.

— Preventing weight gain is less intense than trying to lose it, so this approach could be achieved more easily.

"It's true that there are some health risks for these overweight and slightly obese women," Bennett said. "However, these health risks increase dramatically as women continue to gain weight, usually 2 to 4 pounds, year after year."

"We could reduce these health risks if women simply maintained their current weight," Bennett said. "Fortunately, it's much easier to maintain than it is to lose it. We think this 'maintain, don't ' approach can help some women reduce their risk of obesity-related chronic disease."

Explore further: Vigorous physical activity linked to lower incidence of obesity in young African-American women

More information: "Behavioral Treatment for Weight Gain Prevention Among Black Women in Primary Care Practice: A Randomized Controlled Trial," lead author Gary Bennett, Perry Foley, Erica Levine, Sandy Askew, Dori Steinberg, Bryan Batch, Duke University; Jessica Whiteley, University of Massachusetts Boston; Mary Greaney, Dana-Farber Cancer Institute; Heather Miranda, Thomas Wroth, Marni Holder, Piedmont Health Services; Karen Emmons, Dana-Farber Cancer Institute and Harvard School of Public Health; Elaine Puleo, University of Massachusetts Amherst. Trial funded by grant R01DK078798 from the National Institute for Diabetes and Digestive and Kidney Diseases. Dr. Emmons was supported by K05CA124415 and Dr. Bennett was supported by K22CA126992. JAMA Internal Medicine, online Aug. 26, 2013; DOI: 10.1001/jamainternmed.2013.9263

Related Stories

Vigorous physical activity linked to lower incidence of obesity in young African-American women

August 21, 2013
The prevalence of obesity has increased markedly in the U.S. in recent years. According to a new study by researchers from Boston University Slone Epidemiology Center's Black Women's Health Study (BWHS), the risk of becoming ...

Lose weight between babies, study suggests

June 3, 2013
The time between pregnancies is a golden window for obese women to lose weight, a Saint Louis University study finds.

Smoking cessation, weight gain, and subsequent CHD risk

July 2, 2013
The authors used data from the Women's Health Initiative to assess the association between smoking cessation, weight gain, and subsequent coronary heart disease risk among postmenopausal women with and without diabetes.

Obese black Americans half as likely as whites to have bariatric surgery

August 5, 2013
White Americans who are obese are twice as likely as black Americans to have surgery to tackle the problem, a study has found.

'Weightism' increases risk for becoming, staying obese

July 24, 2013
Weight discrimination may increase risk for obesity rather than motivating individuals to lose weight, according to research published July 24 in the open access journal PLoS ONE by Angelina Sutin and Antonio Terracciano ...

Gene variations may explain weight gain among men, women

May 15, 2013
(HealthDay)—Weight gain in men and women is predicted by two different genetic variations—so-called polymorphisms, according to a new study from the Netherlands.

Recommended for you

Shaming overweight kids only makes things worse

November 20, 2017
(HealthDay)—Overweight kids who are shamed or stigmatized are more likely to binge eat or isolate themselves than to make positive changes such as losing weight, a leading pediatricians' group says.

Link between obesity and cancer is not widely recognized

November 17, 2017
A new study published in the Journal of Public Health has shown that the majority of people in the United Kingdom do not understand the connection between weight issues and cancer. Obesity is associated with thirteen types ...

Reversing negative effects of maternal obesity

November 8, 2017
A drug that increases energy metabolism may lead to a new approach to prevent obesity in children born to overweight mothers, UNSW Sydney researchers have found.

Serving water with school lunches could prevent child, adult obesity: study

November 7, 2017
Encouraging children to drink plain water with their school lunches could prevent more than half a million youths in the U.S. from becoming overweight or obese, and trim the medical costs and indirect societal costs associated ...

Why do some obese people have 'healthier' fat tissue than others?

November 1, 2017
One little understood paradox in the study of obesity is that overweight people who break down fat at a high rate are less healthy than peers who store their fat more effectively.

Engineered protein treatment found to reduce obesity in mice, rats and primates

October 19, 2017
(Medical Xpress)—A team of researchers with pharmaceutical company Amgen Inc. report that an engineered version of a protein naturally found in the body caused test mice, rats and cynomolgus monkeys to lose weight. In their ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.