The present review examines efficacious psycho-behavioral interventions in preventing weight gains or reducing weight among US multiethnic and minority adults as few studies were conducted to review such interventions to date.
Data were examined from 24 controlled intervention studies, representing 23 programs and involving 13,326 adults. Studies were identified through manual and online search of databases that include MEDLINE, Academic Search Premier, ERIC, PsycARTICLES, SPORTDiscus, and CINAHL Plus.
Whereas one-component (n=5, d=0.08, 90% CI=-0.04, 0.35) and two-component interventions (n=13, d=0.22, 90% CI=0.05, 0.40) showed a low mean effect size, three-component interventions (n=6, d=0.52, 90% CI=0.39, 0.65) showed a moderate effect size. Interventions conducted in individual sessions (n=15, d=0.40, 90% CI=0.24, 0.56) showed a higher mean effect size than group interventions (n=9, d=0.08, 90% CI=-0.04, 0.30) although the confidence intervals overlapped.
The study results indicate that future obesity prevention interventions targeting multiethnic and minority adults might benefit from incorporating individual sessions, family involvement, and problem solving strategies into multi-component programs that focus on lifestyle changes.
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"The overall aging of the U.S. population and the general rise in obesity prevalence across the population, including among older age groups, provides a strong rationale for a more comprehensive evaluation of factors of potential importance in contributing to obesity heading into late life. Traditionally, obesity research in older age groups has focused on individual-level variables, such as age and psychosocial factors associated with eating behav- iors. Yet, among the putative factors prominently contributing to obesity rates across the life course are " obesogenic environments " that set the stage for higher average caloric intakes and fewer daily opportunities for walking, bicycling, and other forms of regular physical activity. "
[Show abstract][Hide abstract] ABSTRACT: Background:
Obesity is an increasingly prevalent condition among older adults, yet relatively little is known about how built environment variables may be associated with obesity in older age groups. This is particularly the case for more vulnerable older adults already showing functional limitations associated with subsequent disability.
The Lifestyle Interventions and Independence for Elders (LIFE) trial dataset (n = 1600) was used to explore the associations between perceived built environment variables and baseline obesity levels. Age-stratified recursive partitioning methods were applied to identify distinct subgroups with varying obesity prevalence.
Among participants aged 70-78 years, four distinct subgroups, defined by combinations of perceived environment and race-ethnicity variables, were identified. The subgroups with the lowest obesity prevalence (45.5-59.4 %) consisted of participants who reported living in neighborhoods with higher residential density. Among participants aged 79-89 years, the subgroup (of three distinct subgroups identified) with the lowest obesity prevalence (19.4 %) consisted of non-African American/Black participants who reported living in neighborhoods with friends or acquaintances similar in demographic characteristics to themselves. Overall support for the partitioned subgroupings was obtained using mixed model regression analysis.
The results suggest that, in combination with race/ethnicity, features of the perceived neighborhood built and social environments differentiated distinct groups of vulnerable older adults from different age strata that differed in obesity prevalence. Pending further verification, the results may help to inform subsequent targeting of such subgroups for further investigation.
Clinicaltrials.gov Identifier = NCT01072500.
Full-text · Article · Dec 2015 · International Journal of Behavioral Nutrition and Physical Activity
"Although these data are encouraging, the Registry is comprised predominately of Caucasian women, making it a less representative sample. Minorities, including AA women, are largely underrepresented in the behavioral lifestyle intervention literature , however, two systematic reviews addressing obesity treatment in minority populations were recently published  . Reviews concluded that cultural adaptations , church-based studies , a low carbohydrate diet plan , individual sessions , family-centered programs  , and problem-solving skills   promoted both weight loss and maintenance in minority adults. "
[Show abstract][Hide abstract] ABSTRACT: We performed a systematic review of the behavioral lifestyle intervention trials conducted in the United States published between 1990 and 2011 that included a maintenance phase of at least six months, to identify intervention features that promote weight loss maintenance in African American women. Seventeen studies met the inclusion criteria. Generally, African American women lost less weight during the intensive weight loss phase and maintained a lower % of their weight loss compared to Caucasian women. The majority of studies failed to describe the specific strategies used in the delivery of the maintenance intervention, adherence to those strategies, and did not incorporate a maintenance phase process evaluation making it difficult to identify intervention characteristics associated with better weight loss maintenance. However, the inclusion of cultural adaptations, particularly in studies with a mixed ethnicity/race sample, resulted in less % weight regain for African American women. Studies with a formal maintenance intervention and weight management as the primary intervention focus reported more positive weight maintenance outcomes for African American women. Nonetheless, our results present both the difficulty in weight loss and maintenance experienced by African American women in behavioral lifestyle interventions.
Full-text · Article · Apr 2013 · Journal of obesity
"Incorporating a problem-solving component gave additional efficacy for long-term weight loss maintenance (Seo & Sa, 2008). Of the 24 studies examined in this review, four yielded significant long-term results; three of those studies incorporated a problem-solving component into the paradigm (Seo & Sa, 2008). An additional meta-analysis found that lifestyle interventions led to significantly reduced body weight, BMI, waist circumference and other health markers as compared to standard care (Galani & Schneider, 2007). "
[Show abstract][Hide abstract] ABSTRACT: Obesity and binge eating disorder are detrimental health conditions that are associated with lower qualities of life. Individuals with obesity often face societal discrimination and frequently experience related medical disorders such as diabetes, hypertension, and hyperlipidemia. Current research suggests neurobiological similarities between obesity, binge eating disorder, and substance dependence. In addition, behavioral similarities link the two conditions; obese and substance dependent individuals often report similar features such as loss of control towards food or substances, respectively, and cravings. Treatment options for obesity have begun to use this information to formulate pharmacological and therapeutic interventions that may provide greater results for weight loss and decreased binge frequency. Similarly, treatment approaches to substance addictions should consider aspects of weight management. Findings from research and treatment studies are presented with the aim of reviewing the current literature of obesity within the context of an addiction framework and providing information on empirically supported approaches to the treatment of co-occurring obesity and substance addiction.
Preview · Article · Mar 2010 · Journal of Addiction Medicine