154640 Weight-Wise: A weight loss program for low-income women in the North Carolina WISEWOMAN program

Tuesday, November 6, 2007: 8:45 PM

Carmen D. Samuel-Hodge, PhD, MPH, RD , Center for Health Promotion and Disease Prevention and School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
Beverly A. Garcia, MPH , Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
Thomas C. Keyserling, MD, MPH , Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
Sara C. Lindsley, MS, BSN, RN , Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Wilmington, NC
Kathryn P. Bramble, MA , Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Wilmington, NC
Larry F. Johnston, MA , Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
Trisha E. Hardy, MPH, RD , University of North Carolina at Chapel Hill, McKing Consulting Corporation, Centers for Disease Control and Prevention, Atlanta, GA
Ziya Gizlice, PhD , Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
Alice Ammerman, DrPH, RD , Nutrition Department and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC
Taryn Edwards, RN, BSN , Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, NC
Alison Gustafson, PhD, MPH, RD , Nutrition, University of Kentucky, Lexington, KY
Patricia A. Poindexter, MPH, CHES , Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA
     

Low-income US women have the highest rates of overweight/obesity. Adapting effective behavioral weight loss programs for this high risk group is an important step in translational research to impact cardiovascular disease risk.

This randomized trial, conducted at one WISEWOMAN site, evaluated the effectiveness of a 16-week behavioral weight loss program adapted from the Diabetes Prevention Program for low-income, midlife women. Participants with a BMI of 25-45 were randomized to intervention or wait-list control. The primary outcome was weight loss assessed at 5 months. A one-year maintenance intervention was evaluated for feasibility among intervention participants losing ≥ 8 lbs at 5 months. The study included 143 women (71 intervention; 72 controls) age 53 on average, with a mean BMI of 35. Half had diagnosed hypertension, 13% diabetes, and 36% hyperlipidemia. Follow-up measures were obtained from 88% of participants at 5 months. The between group difference in weight loss was 9.5 lb (p<.0001), with 54% of intervention participants losing ≥ 8 lbs. Compared to controls, systolic (SBP) and diastolic blood pressure (DBP) were significantly reduced (mean difference between groups: 6.8 mmHg SBP, p<.01; 3.4 mmHg DBP, p<.05) and HDL-cholesterol significantly improved (mean differences of 2.5 mg/dL, p<.05). Among intervention participants who returned for follow-up after an additional 12 months of maintenance intervention, (n=36/39, 92%), 50% maintained a mean weight loss of > 9.7 lbs (≥ 5% initial body weight).

Behavioral weight loss programs originally evaluated in efficacy trials can be effectively adapted to produce clinically meaningful short-term weight reductions among low-income women.

 

 

Learning Objectives:
Describe the core components of a behavioral intervention designed to promote weight loss among low-income, midlife women. Identify the clinical outcomes that should be measured to assess the effectiveness of a weight loss intervention.

Keywords: Women's Health, Weight Management

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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