Stress Management–Augmented Behavioral Weight Loss Intervention for African American Women

Abstract

The relationship between chronic stress and weight management efforts may be a concern for African American (AA) women, who have a high prevalence of obesity, high stress levels, and modest response to obesity treatment. This pilot study randomly assigned 44 overweight/obese AA women with moderate to high stress levels to either a 12-week adaptation of the Diabetes Prevention Program Lifestyle Balance intervention augmented with stress management strategies (Lifestyle + Stress) or Lifestyle Alone. A trend toward greater percentage of baseline weight loss at 3-month data collection was observed in Lifestyle + Stress (-2.7 ± 3.6%) compared with Lifestyle Alone (-1.4 ± 2.3%; p = .17) and a greater reduction in salivary cortisol (Lifestyle + Stress: -0.2461 ± 0.3985 ng/mL; Lifestyle Alone: -0.0002 ± 0.6275 ng/mL; p = .20). These promising results suggest that augmenting a behavioral weight control intervention with stress management components may be beneficial for overweight/obese AA women with moderate to high stress levels and merit further investigation with an adequately powered trial.

Use of a randomized multiple baseline design: Rationale and design of the Spirited Life holistic health intervention study

“…Relatively few studies have examined interventions with the dual primary aims of weight loss and stress management. In the best example we could find of an intervention focusing on both, Cox and colleagues compared a behavioral weight loss intervention to one with an additional emphasis on stress management [57]. They enrolled only women who had elevated stress levels.…”

Weight Loss Intervention Efficacy Among Black Women

“…Mitchell and Polsky's study 12 had a group meeting intervention with no control (N ¼ 48) and found that 33% of the black women lost at least 5% of their body weight in 12 months. A randomized controlled trial by Cox et al 9 included 44 participants who were exposed to a behavioral weight loss intervention and found that participants lost an average of 3% of their body weight in 3 months. Fitzgibbon et al 10 compared an attention control group that focused on breast health with an intervention group focused on weight loss.…”

“…All results were reported in kilograms except for 2 studies, which reported change in the percent of weight lost. 9,12 All 4 of the systematic reviews examined obese and overweight adults. The level of evidence and quality rating was 2/A for 2 reviews and 2/C for 2 reviews.…”

“…One study had only a physical activity intervention. 8 In 9 studies, interventions were delivered in group settings, 6,[8][9][10][11][12][13] 3 studies used one-on-one counseling, [14][15][16] and 1 used telephone counseling and self-monitoring. 17 Weight changes were the focus of this review; however, other outcomes were measured in the studies including daily steps (1), blood pressure (3), waist circumference (1), glucose (1), cholesterol (2), hemoglobin A1C (3), perceived stress level (1), energy intake (2), self-reported physical activity (2), breast health knowledge (1), selfbreast examination proficiency (1), intervention feasibility (1), and depression (1).…”

Evaluation of physical activity reporting in community Diabetes Prevention Program lifestyle intervention efforts: A systematic review

“…The DPP goal of 150 min of moderate PA was utilized by 54 studies and three studies established alternative goals including one with 180 min of moderate PA per week (Katula et al, 2011), one with 200 min of moderate PA per week (Cox et al, 2012), and one with 4000 steps per day above baseline PA level (Ockene et al, 2012).…”