Weight Loss Goals Among African-American Women With Type 2 Diabetes in a Behavioral Weight Control Program

Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA.
Obesity (Impact Factor: 3.73). 01/2011; 19(11):2283-5. DOI: 10.1038/oby.2010.350
Source: PubMed


African-American women with type 2 diabetes experience limited weight loss in behavioral weight control programs. Some research suggests that overly ambitious weight loss expectations may negatively affect weight losses achieved but it is unknown whether they affect weight loss among African-American women. The current study examined personal weight loss goals and expected satisfaction with a reasonable weight loss among African-American women with type 2 diabetes starting a behavioral obesity treatment. We also explored associations among these factors and weight loss treatment outcomes. Self-identified African-American women (N = 84) in a 24-session group program were assessed at baseline and 6-month follow-up. At baseline, women indicated weight loss goals of 14.1 ± 6.6 kg (14% of initial weight). They also reported relatively high expected satisfaction with a reasonable weight loss (7-10%). On average, participants lost 3.0 ± 3.9 kg (3% of initial weight) and attended 73 ± 21% of group sessions. Neither weight loss goals nor expected satisfaction with a reasonable weight loss was correlated with either actual weight loss outcome or attendance. Having higher personal weight loss goals was associated with lower expectations of satisfaction with a reasonable weight loss. This suggests that African-American women with type 2 diabetes enter treatment hoping to lose far more weight than they are likely to achieve. It is important to understand the psychosocial sequelae of failing to reach these goals on subsequent weight maintenance and future weight loss attempts within this population.

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    ABSTRACT: RESUMEN El objetivo del presente estudio fue evaluar los efectos de la entrevista motivacional en conjunto con una intervención cognitivo-conductual grupal. Participaron 25 pacientes con diagnóstico de diabetes mellitus tipo 2 de una institución de salud pública. Los pacientes fueron distribuidos de mane-ra intencional en dos grupos: uno que incluye una sesión de entrevista motivacional individual y el otro una sesión educativa individual. Ambas sesiones se realizaron antes y después de ingresar al tratamiento cognitivo-conductual grupal. Para analizar estadísticamente las mediciones de hemo-globina glucosilada, colesterol y triglicéridos pre, post y seguimiento, se aplicó la prueba t de Student para muestras relacionadas, y asimismo la prueba de rangos de Wilcoxon para identificar dife-rencias significativas entre los puntajes pretest, postest y seguimiento dentro de los grupos educati-vo y motivacional de las variables depresión, ansiedad, autoeficacia, insatisfacción y calidad de vi-da. Se pudo observar que ambas intervenciones generaron cambios importantes en el control del padecimiento, ya que se detectó una disminución en los niveles de hemoglobina glucosilada en casi todos los pacientes. Sin embargo, hubo un incremento de la misma durante el seguimiento en am-bos grupos. En relación a las variables psicológicas, estas mostraron un mayor beneficio, importante clínicamente, en el grupo que tuvo la entrevista motivacional. Los datos permiten concluir que am-bas intervenciones propiciaron cambios conductuales que mejoraron el control glucémico, teniendo la entrevista motivacional un mayor efecto positivo en los aspectos emocionales de los pacientes. ABSTRACT The aim of the present study was to examine the effects of motivational interviewing in conjunction with a cognitive-behavioral group intervention on clinical laboratory measurements and psychological variables of type 2 diabetic patients. Twenty five patients from a public health institution participated. Patients were assigned to one of two groups: one exposed to a single session of motivational interviewing, and the other to a single psycho-education session. The Wil-coxon ranks test was used to identify any initial differences between pretest scores Measures were taken before and after all interventions. Measurements of glycosylated hemoglobin, cholesterol and triglycerides pre-post and follow-up were analyzed through Student's t test for related samples. Within-group comparisons included schooling, motivational variables, depression, anxiety , self-efficacy, dissatisfaction, and quality of life. Both interventions produced improvement as detected by a decrease in glycosylated hemoglobin levels in nearly all patients, but it increased slightly during follow-up in both groups. Psychological variables showed greater clinical improvement in the motivational interviewing group. Results support the conclusion that
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    ABSTRACT: Setting realistic weight loss goals may play a role in weight loss. We abstracted data from randomized controlled trials and observational studies conducted between 1998 and 2012 concerning the association of weight loss goals with weight loss. Studies included those that (i) were conducted in humans; (ii) delivered a weight loss intervention; (iii) lasted ≥6 weeks; (iv) assessed baseline weight loss goals; (vi) assessed pre- and post-weight either in the form of body mass index or some other measure that could be converted to weight loss based on information included in the original study or later provided by the author(s); and (vii) assessed the correlation between weight loss goals and final weight loss or provided data to calculate the correlation. Studies that included interventions to modify weight loss goals were excluded. Eleven studies met inclusion criteria. The overall correlation between goal weight and weight at intervention completion was small and statistically insignificant ( ρ ̂ = 0.0 5 ; P = 0.20). The current evidence does not demonstrate that setting realistic goals leads to more favourable weight loss outcomes. Thus, our field may wish to reconsider the value of setting realistic goals in successful weight loss.
    Obesity Reviews 04/2013; 14(7). DOI:10.1111/obr.12038 · 8.00 Impact Factor
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    ABSTRACT: Several developments regarding obesity management have occurred within the past 2 years that have important implications for family physicians. First, effective November 29, 2011, the Centers for Medicare and Medicaid Services approved Medicare coverage for intensive behavioral therapy for obesity as a stand-alone billable service. Second, the American Medical Association adopted a policy on June 18, 2013, recognizing obesity as a disease requiring a range of medical interventions to advance obesity treatment and prevention.
    The Journal of family practice 02/2014; 63(2 Suppl):S15-20. · 0.89 Impact Factor
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