Sedentary behavior, body mass index, and weight loss maintenance among African American women.

OBJECTIVES: Relationships among sedentary behavior, weight gain, and weight loss and regain are understudied particularly for African Americans, a high risk group for obesity. The hypotheses were: sedentary behavior is positively associated with current body mass and % of weight loss maintained after initial weight loss; these associations differ by physical activity status. DESIGN: Cross-sectional. SETTING: National survey. PATIENTS OR PARTICIPANTS: 1,110 African American women. INTERVENTIONS: Observational study. MAIN OUTCOME MEASURES: A cross-sectional survey was administered to African Americans who had intentionally lost 10% of their body weight. Those who lost weight and maintained at least a 10% weight loss for a year were classified as weight loss maintainers; all others were classified as weight loss re-gainers. Participants were classified into one of four categories based on low and high levels of sedentary behavior and physical activity. The high physical activity, low sedentary behavior category was the reference group. Sociodemographic characteristics and health conditions were covariates. Data were collected in 2009 and analyzed in 2013. RESULTS: Each additional daily hour of sedentary time was associated with an increase in BMI (P<.001) and poorer weight loss maintenance (P<.01). Regardless of sedentary behavior, low physically active participants had BMIs that were greater (P<.001) compared to the reference group. Sedentary behavior had an independent effect on BMI and % of weight loss maintained for high but not low physically active participants. CONCLUSIONS: High levels of sedentary behavior were associated with poorer weight-loss maintenance among African American women even for those with high levels of physical activity. The implications of this study are that physical activity and sedentary behavior, independently and combined, are associated with BMI and weight-loss maintenance.

Descriptive study of educated African American women successful at weight-loss maintenance through lifestyle changes.

BACKGROUND: Interventions to address obesity and weight loss maintenance among African Americans have yielded modest results. There is limited data on African Americans who have achieved successful long-term weight loss maintenance. OBJECTIVE: To identify a large sample of African American adults who intentionally achieved clinically significant weight loss of 10 %; to describe weight-loss and maintenance efforts of African Americans through a cross-sectional survey; to determine the feasibility of establishing a registry of African American adults who have successfully lost weight. DESIGN, SETTING, AND PARTICIPANTS: African American volunteers from the United States ≥ 18 years of age were invited to complete a cross-sectional survey about weight, weight-loss, weight-loss maintenance or regain. Participants were invited to submit contact information to be maintained in a secure registry. MAIN MEASURES: Percentage of participants who achieved long-term weight-loss maintenance reporting various dietary and physical activity strategies, motivations for and social-cognitive influences on weight loss and maintenance, current eating patterns, and self-monitoring practices compared to African Americans who lost weight but regained it. Participants also completed the Short International Physical Activity Questionnaire. KEY RESULTS: Of 3,414 individuals screened, 1,280 were eligible and completed surveys. Ninety-percent were women. This descriptive analysis includes 1,110 women who lost weight through non-surgical means. Over 90 % of respondents had at least some college education. Twenty-eight percent of respondents were weight-loss maintainers. Maintainers lost an average of 24 % of their body weight and had maintained ≥ 10 % weight loss for an average of 5.1 years. Maintainers were more likely to limit their fat intake, eat breakfast most days of the week, avoid fast food restaurants, engage in moderate to high levels of physical activity, and use a scale to monitor their weight. CONCLUSIONS: Influences and practices differ among educated African American women who maintain weight loss compared to those who regain it.

Weight loss maintenance in African-American women: focus group results and questionnaire development.

BACKGROUND: African-American women are disproportionately affected by obesity. Weight loss can occur, but maintenance is rare. Little is known about weight loss maintenance in African-American women. OBJECTIVES: (1) To increase understanding of weight loss maintenance in African-American women; (2) to use the elicitation procedure from the theory of planned behavior (TPB) to define the constructs of attitude, subjective norms, and perceived behavioral control regarding weight loss and maintenance; and (3) to help develop a relevant questionnaire that can be used to explore weight loss and maintenance in a large sample of African Americans. DESIGN: Seven focus groups were conducted with African-American women: four with women successful at weight loss maintenance, three with women who lost weight but regained it. Discussions centered on weight loss and maintenance experiences. PARTICIPANTS: Thirty-seven African-American women. APPROACH: Content analysis of focus group transcripts. RESULTS: Weight loss maintainers lost 22% of body weight. They view positive support from others and active opposition to cultural norms as critical for maintenance. They struggle with weight regain, but have strategies in place to lose weight again. Some maintainers struggle with being perceived as sick or too thin at their new weight. Regainers and maintainers struggle with hairstyle management during exercise. The theoretical constructs from TPB were defined and supported by focus group content. CONCLUSIONS: A weight loss questionnaire for African Americans should include questions regarding social support in weight maintenance, the importance of hair management during exercise, the influence of cultural norms on weight and food consumption, and concerns about being perceived as too thin or sick when weight is lost.