Factors Associated with Weight Loss Maintenance and Weight Regain Among African American and White Adults Initially Successful at Weight Loss

• Published in: Journal of racial and ethnic health disparities Vol. 9; no. 2; pp. 546 - 565
• Main Authors: Kinsey, Amber W., Phillips, Janice, Desmond, Renee, Gowey, Marissa, Jones, Catherine, Ard, Jamy, Clark, Jeanne M., Lewis, Cora E., Dutton, Gareth R.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.04.2022; Springer Nature B.V
• Subjects: Accountability; Adult; Adults; African Americans; Autonomy; Barriers; Behavior; Black or African American; Chronic illnesses; Cluster analysis; Clustering; Cultural factors; Epidemiology; Exercise; Female; Gastrointestinal surgery; Humans; Life Style; Lifestyles; Maintenance; Male; Medicine; Medicine & Public Health; Minority & ethnic groups; Nominal group technique; Obesity; Obesity - therapy; Overweight; Physical activity; Quality of Life Research; Self report; Selfmonitoring; Social Inequality; Social Structure; Task performance; Weighing; Weight; Weight control; Weight Gain; Weight Loss; Weight reduction; Women; Extended care; Obesity; Card sorting; Physical activity; Weight loss maintenance; Cognitive mapping
• ISSN: 2197-3792; 2196-8837; 2196-8837
• DOI: 10.1007/s40615-021-00985-x

Background Providing ongoing treatment through extended care programs can improve weight loss maintenance (WLM), but the effectiveness of these programs for African Americans (AA) are mixed and may be due to unique cultural factors. Purpose To identify, prioritize, and organize factors associated with WLM as experienced by AA and White adults initially successful with weight loss. Methods Adults identified their greatest amount of lifetime weight loss, and those achieving ≥5% weight loss were classified as maintainers (continued >5% weight reduction for ≥1 year) or regainers (≤5% weight reduction) based on current weight. The nominal group technique was conducted to identify and rank WLM facilitators and barriers. Online card sorting tasks and hierarchical clustering were performed to illustrate conceptual relationships between facilitators (maintainers only) and barriers (regainers only). Results Participants (maintainers, n = 46; regainers, n = 58; 81.7% women, 48.1% AA) identified known factors associated with successful weight management (daily weighing, self-monitoring, regular physical activity, mindful eating). However, the perceived importance of these factors differed between groups (maintainer vs. regainers; AA vs. Whites). Unique factors affecting WLM were also identified (refresher groups recommended by White maintainers and regainers; self-accountability identified by AA maintainers). Salient facilitators and barriers were best represented in 2–3 clusters; each group had ≥1 unique cluster(s) revealing group-specific higher-order domains associated with successful WLM. Conclusions As lifestyle interventions for WLM (particularly for AA) are developed, attention to the preferences, and lived experiences of these groups is recommended. Strategies targeting physical activity maintenance and autonomy-supportive approaches may improve WLM among AA.