Factors associated with weight loss pilot program among middle-aged and older minority adults with obesity or diabetes

Background. The prevalence of obesity and diabetes is rapidly increasing. Although a variety of efforts exist to ameliorate these dual epidemics, few studies specifically target low-income minority patients.

Methods. This study examines the ability of a tailored health promotion program at a faith-based wellness center to improve body mass index (BMI) and HbA1c among low-income, uninsured, primarily minority patients with obesity and diabetes. Only middle-aged and older patients referred from local hospitals were included in these analyses (n=109, mean age=53.7 years [±6.5]). Interventions included health coach visit, dietician consult, and exercise consult. Biometric and health status measurements were collected at baseline, 6 months, 12 months, and 18 months. Paired t-tests were performed to identify changes in key biometric and health measures from baseline to last observation. Ordinary least squares regression was used to identify covariates of improved BMI and HbA1c.

Results. Approximately 82% of participants were African American, and the sample's mean annual income was $14,792. On average, patients received 35 intervention elements (i.e., health coach visit=16; dietitian consult=11; exercise consult=8) and showed significant reduction in BMI (from 37.1kg/m2 to 36.5 kg/m2) and HbA1c (from 8.8% to 7.9%) from baseline to last observation. Significant improvements were observed for diabetes knowledge, perceived health, and anxiety. Regression analysis suggests that each additional dietitian consult decreased BMI and HbA1c by 0.17% and 0.41%, respectively.

Conclusion. Findings indicate the need for multi-factorial tailored dietary programs, including dietician consult, to combat the dual epidemic of obesity and diabetes among low-income middle-aged and older minority patients.