Weight Loss Programs May Have Beneficial or Adverse Effects on Fat Mass and Insulin Sensitivity in Overweight and Obese Black Women

Abstract

ObjectiveWeight loss interventions have produced little change in insulin sensitivity in black women, but mean data may obscure metabolic benefit to some and adverse effects for others. Accordingly, we analyzed insulin sensitivity relative to fat mass change following a weight loss program.Design and MethodsFifty-four black women (BMI range 25.9 to 54.7 kg/m2) completed the 6-month program that included nutrition information and worksite exercise facilities. Fat mass was measured by dual-energy X-ray absorptiometry, and insulin sensitivity index (SI) was calculated from an insulin-modified intravenous glucose tolerance test using the minimal model.ResultsBaseline SI (range 0.74 to 7.58 l/mU−1•min−1) was inversely associated with fat mass (r = −0.516, p < 0.001), independent of age. On average, subjects lost fat mass (baseline 40.8 ± 12.4 to 39.4 ± 12.6 kg [mean ± SD], P < 0.01), but 17 women (32 %) actually gained fat mass. SI for the group was unchanged (baseline 3.3 ± 1.7 to 3.2 ± 1.6, P = 0.67). However, the tertile with greatest fat mass loss (−3.6 kg, range −10.7 to −1.7 kg) improved insulin sensitivity (SI +0.3 ± 1.2), whereas the tertile with net fat mass gain (+0.9 kg, range −0.1 to +3.8 kg) had reduced insulin sensitivity (SI −0.7 ± 1.3) from baseline values (P < 0.05 by ANOVA).ConclusionsBlack women in a weight loss program who lose fat mass may have improved insulin sensitivity, but fat mass gain with diminished sensitivity is common. Additional support for participants who fail to achieve fat mass loss early in an intervention may be required for success.

Sustained Obesity and Depressive Symptoms over 6 Years: Race by Gender Differences in the Health and Retirement Study

“…There are public health implications for the results of this study (Leon et al, 2014; Assari et al, 2015a; Krishna et al, 2015). Although, Black men and women with sustained high BMI do not report high depressive symptoms, there should still exist efforts to reduce the sustained high levels of BMI among Black men and women, similar to Whites.…”

“…To maximize benefits, interventions and programs may be tailored to race and gender to match that of the target population. One study that implemented a weight loss intervention among Black women reported that those with the greatest fat mass loss improved insulin sensitivity while those with fat mass gain, which was common, had reduced insulin sensitivity following the 6-month program (Leon et al, 2014). These results demonstrate that additional support may be beneficial for Black women in weight loss programs who fail to achieve optimal weight loss goals.…”

Baseline Body Mass Predicts Average Depressive Symptoms over the Next Two Decades for White but Not Black Older Adults

“…These results may have clinical and public health implications. Social groups have differences in patterns of comorbidity of health problems [149,150,151]. At least for Whites, this study highlights the need for a multidisciplinary and team approach to reduce the burden of obesity and depression.…”