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        Adding Social Support to Weight Loss Programmes Enhances Success for African Americans Struggling With Obesity

        CHICAGO -- October 26, 2009 -- Standard behavioural treatments for obesity appear to be less successful in African Americans than in whites. Cultural modifications to these standard programmes -- such as enrolling in a weight loss programme with a family member or friend -- may enhance their effectiveness, but only if the involved partner attends sessions frequently or also loses weight. Data from this study are reported in the October 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

        Shiriki K. Kumanyika, PhD, MPH, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, and colleagues conducted a 2-year trial of a culturally specific weight loss programme among 344 African American men and women. The goal was to achieve and maintain a 5% to 10% weight loss. Components of the programme included counselling that encouraged self-monitoring of food intake and physical activity, distribution of pedometers, group sessions involving weight and activity checks and skill building, and community-based field workshops such as cooking demonstrations and gym visits.

        A total of 63 individuals enrolled in the programme alone and 281 enrolled with a friend or family member (130 of whom were designated as the main, or index, participants and 151 as partners). Of the participants with partners, 65 (and 78 partners) were randomly assigned to a high-support group in which both individuals were expected to attend and participate fully in all treatment sessions. The remaining 65 (and 73 partners) were assigned to a low-support group, in which some portions of the programme were restricted to the main participants. All participants' progress was measured at 6, 12, 18, and 24 months.

        After 24 months, main participants had lost an average of 2.4 kg (about 5.3 lbs). Participants in the 2 family groups initially had better attendance and greater weight loss than those in the individual group, but these changes were not statistically significant and decreased over time.

        However, participants whose partners attended more personally tailored counselling sessions had lost more weight at 6 months in the high-support group and at 6, 12, and 24 months in the low-support group. In addition, those in both family groups whose partner lost at least 5% of their body weight had greater weight loss at 6 months than those whose partner lost less than 5% (6.1% vs 2.9% of body weight lost in the high-support group and 6.1% vs 3.1% in the low-support group).

        "We evaluated family and friend social support as a specific cultural adaptation strategy, which was added to an ethnic-specific programme that was also adapted in other respects," the authors concluded. "Beneficial effects on weight loss were linked to actual rather than assigned partner participation and to partner success in losing weight. Further studies may elucidate ways to facilitate effective family or friend participation and to improve absolute weight losses."

        Funding for this study was provided by a grant from the National Heart, Lung, and Blood Institute.

        SOURCE: Archives of Internal Medicine



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