Differential response of African American and Caucasian women to extended-care programs for obesity management

Objective: The current study examined ethnic differences in patterns of weight loss and regain in response to an initial behavioral weight loss intervention followed by an extended- care maintenance program. Methods: We analyzed data from 224 women (African American n=43, Caucasian n=181) from rural communities who participated in an initial 6-month lifestyle intervention for obesity and were then randomized to a face-to-face, telephone, or educational/control extendedcare condition. Results: African American participants lost less weight during the initial phase of treatment than Caucasian participants (mean ± SE=-6.8 ± .80 vs -10.7 ± .38 kg, respectively, P=.003). Investigating weight change during month 6 to month 18, we found a significant interaction between ethnicity and the provision of an extended-care program. Caucasian participants randomized to either of two extended-care programs regained less weight than those assigned to the control condition (1.2 ± .58 and 4.2 ± .79 kg, respectively, P=.003), but the provision of extended care did not influence weight regain among African American participants (1.9 ± 1.12 and 1.34 ± 2.04 kg, respectively, P=.815). Conclusion: Collectively, these findings suggest that although African American participants lost less weight during the initial phase of treatment, they exhibited better long-term weight-loss maintenance than Caucasian participants. Further, while the provision of extended care successfully enhanced weight maintenance among Caucasian participants, African American participants maintained their initial weight losses regardless of extended care.