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

Are sugary drink interventions changing people's behaviour?

July 19, 2017
An evaluation of efforts designed to reduce how many sugary drinks we consume shows some success in changing younger people's habits but warns they cannot be the only way to cut consumption.

Young adult obesity: A neglected, yet essential focus to reverse the obesity epidemic

July 18, 2017
The overall burden of the U.S. obesity epidemic continues to require new thinking. Prevention of obesity in young adults, while largely ignored as a target for prevention and study, will be critical to reversing the epidemic, ...

Weight gain from early to middle adulthood may increase risk of major chronic diseases

July 18, 2017
Cumulative weight gain over the course of early and middle adulthood may increase health risks later in life, according to a new study led by researchers from Harvard T.H. Chan School of Public Health. They found that, compared ...

Study finds children carry implicit bias towards peers who are overweight

June 23, 2017
Even children as young as 9 years old can carry a prejudice against their peers who are overweight, according to a new study led by Duke Health researchers. They might not even realize they feel this way.

Mother's obesity boosts risk for major birth defects: study

June 15, 2017
Children of obese women are more likely to be afflicted by major birth defects, including malformations of the heart and genitals, according to a study published on Thursday.

New study finds more than 2 billion people overweight or obese

June 12, 2017
Globally, more than 2 billion children and adults suffer from health problems related to being overweight or obese, and an increasing percentage of people die from these health conditions, according to a new study.

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.