![]() ![]() We did not expect participants to be motivated to lose weight. Although a small amount of weight loss is advantageous to prevent future gains, we explicitly informed participants that Shape was not a weight loss trial. 29 Briefly, it was a theory-based 30 and evidence-based 31– 33 treatment designed to create a slight (<200 kcal) daily energy deficit to offset 12-month weight gains. The Shape intervention is described more fully elsewhere. We hypothesized that, relative to usual care, the intervention would promote weight stability for 12 months that would be maintained 18 months after randomization. We conducted a randomized clinical trial to evaluate the efficacy of a weight gain prevention intervention for overweight and class 1 obese (25–34.9) black female primary care patients in a community health center setting. 28 These features make weight gain prevention ideal for primary care settings, particularly those that serve populations with a disproportionate obesity burden. 27 Such strategies are particularly well suited for delivery using electronic health (eHealth) technologies, which have the potential to reach large, high-risk populations at low cost. 24– 26 Thus, prevention of weight gain might also be more acceptable than weight loss for black women in the overweight and class 1 obese weight range.įinally, weight gain prevention can be achieved at lower treatment intensity than is required for weight loss. Relative to white women, black women have higher rates of body weight satisfaction, fewer social pressures to lose weight, and sociocultural norms that tolerate heavier body weights. Second, black women may be particularly receptive to intervention messages about maintaining weight status. It is possible that preventing premenopausal weight gains and stabilizing weight in the overweight and class 1 obese range would minimize the accumulation of visceral abdominal fat 23 and reduce the odds of a host of adverse cardiometabolic outcomes. 22 The combination of rapid premenopausal weight gain 22, 23 and extreme obesity 22 contributes to disproportionate chronic disease risk among black women. 21, 22 By age 40 to 59 years, black women have more than twice the prevalence of class 2 obesity than white women and 3 times the prevalence of class 3 (extreme) obesity. However, at approximately 1 kg/y, the mean rate of premenopausal weight gain among black women outpaces the rates among women in other racial or ethnic groups. Halting weight gains at the overweight or class 1 obese level might therefore maintain the relative health advantage of black women. Stevens et al 21 showed that no black women, regardless of BMI, had an incidence of hypertriglyceridemia as high as that of white women with a BMI of 30. 16– 21 For example, Taylor et al 16 reported that type 2 diabetes mellitus, hypertension, and low high-density lipoprotein cholesterol were more strongly associated with BMI among whites than among blacks. Cardiometabolic risk factors similarly exhibit weaker associations with overweight and class 1 obesity in black women than in white women. 11– 15 For example, Calle et al 15 found that black women with a BMI between 30 and 35 had an increased mortality risk that ranged up to 17% comparedwith a 30% to 53% increase for white women. First, several studies have shown that for black women, overweight and class 1 obesity are less strongly associated with all-cause and cardiovascular disease mortality than in white women. There are several reasons that weight gain prevention might be an advantageous treatment option for black women in this BMI range. 8 For black women who are overweight and class 1 obese (body mass index, 25–34.9), weight gain prevention might be one such strategy. 7 The limited success in promoting clinically meaningful weight loss among this group suggests the need for new weight management approaches. 1– 3 Across numerous studies, including vanguard clinical weight loss trials, 4– 6 black women typically demonstrate smaller and less clinically relevant weight losses than white women and men and black men. É um banco de dados de logs rastreados de programas instalados armazenados em nosso site, preparados e mantidos pela equipe do Revo Uninstaller Pro Você pode facilmente (com um clique no botão "Desinstalar" no Revo Uninstaller Pro) usar esses logs para desinstalar programas do seu computador.Promoting clinically meaningful weight loss among black women is a particularly vexing clinical challenge. ![]()
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