Federal statistics indicate that four of five African-American women are overweight or obese, yet researchers from Baylor College of Medicine and Rice University have identified a large number of African American women who have lost clinically significant amounts of weight and kept it off for longer than a year.
Descriptive results of the large survey study are presented online in the Journal of General Internal Medicine and will be available in print later this year.
"We have very little evidence on successful long-term weight loss in African-Americans," said Dr. Ann Smith Barnes, assistant professor of medicine at BCM and lead author of the report.
"Interventions to address obesity and promote long-term weight maintenance in African-Americans have yielded modest results. Also existing weight control registries of successful weight-loss maintainers have included very few African-American participants."
Dr. Rachel T. Kimbro, associate professor of sociology at Rice University, served as a co-author on the report.
The researchers surveyed 1,110 African American women over the age of 18 on weight, weight loss, weight-loss maintenance and regain. All those in the study had an intended weight loss of 10 percent or more of their body weight and had not had weight-loss surgery.
Weight-loss maintainers, regainers
The women were divided into two main groups weight-loss maintainers and weight-loss regainers. Maintainers lost 10 percent or more of their weight and kept it off for at least a year. Regainers also lost at least a 10 percent of their body weight but gained some of it back.
Approximately 30 percent of the responders were maintainers who had lost an average of 23 percent of their body weight (approximately 50 pounds) and maintained the loss for an average of 5.1 years.
Successful losers achieved their goal by:
- Limiting fat intake
- Eating breakfast
- Avoiding fast food restaurants
- Engaging in moderate to high levels of physical activity
- Using a scale to monitor their weight (at least monthly)
Barnes and Kimbro noted the majority of all survey respondents reported losing weight on their own versus formal weight loss programs. Additionally, maintainers reported health concerns as their trigger to lose weight.
Maintainers were more likely to say that religious faith was important in losing and maintaining weight.
Hairstyle management has been identified in focus groups as having an important influence on physical activity in African-American women. African-American women wear a variety of hairstyles. Some are easy to manage daily and after exercise: Afro, natural, locks, braids, and wig. Relaxed hair is traditionally considered more time-consuming to manage and more negatively affected by sweating.
Although this study did not demonstrate a clear difference in reported physical activity levels among women with natural versus relaxed hair styling, the role of hair management on physical activity needs further exploration.
Additionally, the survey showed that some of the women intentionally gained back some of their weight because they felt they looked too skinny. "A healthy appearance can mean different things for individuals from differing cultural groups," said Barnes.
Barnes acknowledged that although they had hoped to recruit a more diverse sociodemographic group, most women in the study were highly educated. It is difficult to extrapolate these conclusions to lower socioeconomic groups.
The findings of this study give clinicians, researchers, and program planners more information about strategies to assist women similar to those surveyed in achieving meaningful weight loss. In addition, 73 percent of the survey respondents agreed to be a part of an African-American Weight Control Registry.
The ability to continue to gather data on individuals who have successfully lost and maintained weight will add significantly to the understanding of long-term weight loss in this high risk population.
Barnes was awarded a National Institute of Diabetes, Digestive and Kidney Diseases career development award to conduct the study.
Data analysis was supported by the Health Economics Program at the James A. Baker III Institute for Public Policy at Rice University.