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

Background. Effective clinical weight management approaches are needed to reach African-Americans, Methods. 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. Results. Of 237 enrollees (91% women; mean age 43.5 years; mean body mass index 38.0 kg/m(2)), 167 attended no classes or only die 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"). Meanweight 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 IS months total duration), with no Phase 2 treatment effect (P - 0.55). Final study weight was >= 5% below baseline for 25% of completers and was strongly predicted by Phase 1 weight loss. Conclusions. Weight loss achieved in Phase I was maintained even with relatively minimal follow-up contact, Increasing the percent who achieve clinically significant weight loss initially would improve long-term results. (c) 2005 Elsevier Inc. All rights reserved.