Outpatient weight management in African-Americans: the Healthy Eating and Lifestyle Program (HELP) study

Effective clinical weight management approaches are needed to reach African-Americans.

African-Americans recruited through outpatient practices for a culturally-adapted Healthy Eating and Lifestyle Program were offered 10 weekly weight loss classes (Phase 1) with the option of continuing for another 8-18 months (Phase 2) in a randomized comparison of further group counseling or staff-facilitated self-help vs. follow-up clinic visits only.

Of 237 enrollees (91% women; mean age 43.5 years; mean body mass index 38.0 kg/m(2)), 70 [corrected] attended no classes or only the first Phase 1 class, 134 provided Phase 1 follow-up data, 128 were randomized in Phase 2, and 87 provided final follow-up data ("completers"). Mean weight changes for completers were: -1.5 (P < 0.001), +0.3 (P = 0.47), and -1.2 (P = 0.04) kg, respectively, for Phase 1, Phase 2, and overall (baseline to final visit; average 18 months total duration), with no Phase 2 treatment effect (P = 0.55). Final study weight was > or =5% below baseline for 25% of completers and was strongly predicted by Phase 1 weight loss.

Weight loss achieved in Phase 1 was maintained even with relatively minimal follow-up contact. Increasing the percent who achieve clinically significant weight loss initially would improve long-term results.