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Program may help black women avoid weight gain

By Genevra Pittman

NEW YORK (Reuters Health) - A program including self-monitoring, gym access and occasional counseling calls helped black women maintain their weight in a new study.

Black women who are overweight or slightly obese are known to have a lower risk of weight-related health problems than white women at the same weight.

Research suggests they are typically also more satisfied with their bodies and seem to care less than white women about shedding extra pounds, Gary Bennett, head of the Duke Obesity Prevention Program in Durham, North Carolina, and his colleagues said.

But, "If black women continue to gain weight year and after year, and they almost invariably do … they go from that lower level of obesity, where health risks are relatively low, to that higher level of obesity," Bennett, who led the new study, told Reuters Health.

He said focusing on weight maintenance could be a better strategy for women who are just a bit heavy and aren't interested in losing weight or who have tried without success.

To test that theory, Bennett and his colleagues recruited 194 overweight and obese black women from community health centers for their study, which they specifically avoided calling a weight-loss trial. The women were between 25 and 44 years old with an average weight of 178 pounds, and almost three-quarters of them had an annual income below $30,000.

Half of the women were randomly assigned to go through the year-long program, which included self-monitoring through an automated calling system, monthly counseling calls, feedback on healthy diet goals and a membership to the YMCA. The other half received their usual care.

The idea of the diet goals - which included limiting sugary drinks or avoiding fast food, for example - was to have women consume no more than 200 fewer calories than they burned each day.

Of the original participants, 177 finished the study. At the one-year mark, women in the weight gain prevention program had lost an average of about two pounds; those in the comparison group had gained about one pound. Those differences held for another six months after the program ended.

Additionally, 62 percent of program participants were at or below their original weight at one year, compared to 45 percent of those who were assigned to receive usual care, the researchers reported Monday in JAMA Internal Medicine.

Bennett and his colleagues did not find any differences in waist circumference, blood pressure or cholesterol between women who did and didn't go through the weight gain prevention program, however.

In a commentary published with the study, Dr. Regina Benjamin - until recently the U.S. Surgeon General - and colleagues called the findings "promising."

But, they wrote, "It may be that greater weight losses than those reported … are required to achieve improvements in cardiovascular disease risk factors, and weight maintenance may need to be sustained longer to achieve such health benefits."

Bennett said that because the study program was coordinated through primary care offices and largely computerized, it was less expensive than a weight-loss intervention and should be feasible in a range of communities.

"This is a very easy, simple intervention for us to disseminate very widely," he said.

For heavy people who can't or don't want to lose weight, "maintaining and not gaining weight should be the absolute clinical priority," he said. "There's no reason for a physician not to do this."

SOURCE: http://bit.ly/KEPNSw JAMA Internal Medicine, online August 26, 2013.

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