Weight loss maintenance in African-American women: a systematic review of the behavioral lifestyle intervention literature

Authors: Tussing Humphreys, Lisa; FITZGIBBON, MARIAN - University Of Illinois; KONG, ANGELA - University Of Illinois; ODOMS-YOUNG, ANGELA - University Of Illinois

Submitted to: Journal of Obesity
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/28/2013
Publication Date: 4/1/2013
Citation: Tussing Humphreys, L.M., Fitzgibbon, M., Kong, A., Odoms-Young, A. 2013. Weight loss maintenance in African-American women: a systematic review of the behavioral lifestyle intervention literature. Journal of Obesity. 2013;2013:31.

Interpretive Summary: Obesity is highest among US black women. The weight loss intervention literature reports that black women lose less weight than any other adults enrolled in similar weight management programs. However, black women do lose a modest amount of weight in these programs which results in improved health status and reduced disease risk. Unfortunately the health benefits achieved through weight loss are not sustained if weight loss is not maintained. Therefore, understanding weight loss program components that promote successful weight maintenance in black women is of great research interest. Our purpose was to review the existing behavioral weight management research published between 1990 and 2011 and identify intervention components associated with better weight maintenance. Studies included in this review were conducted in the US, included black women, had a weight management portion of their program, and weight results could be obtained separately for black women. Sixteen studies were included in the review. Findings suggest that black women maintain a lower percentage of their initial weight loss compared to white women. Continuation of contact through in-person sessions, personalized treatment, and inclusion of cultural adaptations are intervention components that likely facilitated less weight regain for black women in several of the larger studies. Nonetheless, black women appear to have limited success in behavioral interventions that target individual-level weight management approaches. Future research must address the complex relationship between biological and environmental factors that make weight management such a challenge for black women.

Technical Abstract: African-American women are disproportionally burdened by obesity. Results from behavioral weight loss interventions report that African-American women lose less weight compared to other subgroups but, show improvement in their cardiometabolic risk profile. Unfortunately, the health benefits are not sustained unless weight loss is maintained and emphasizes the importance of understanding factors associated with successful weight management in African-American women. The purpose of this article is to conduct a systematic review of all behavioral weight loss intervention trials conducted in the United States that included a maintenance phase published between 1990 and 2011 and results could be obtained separately for African-American women. Sixteen studies met the inclusion criteria. Findings suggest that African-American women maintain a lower percentage of their initial weight loss compared to white women. Continuation of contact through in-person sessions, personalized treatment, and inclusion of cultural adaptations are intervention components that likely facilitated less weight regain for African-American women in several of the multi-site trials. Nonetheless, African-American women appear to have limited success in behavioral interventions that target individual-level weight management approaches. Future research must address the constraining and complex connectedness of biological and environmental factors that make weight management such a formidable challenge for African-American women.