The research is published March 12 in Archives of Internal Medicine.
Obesity treatments are not widely available in the U.S. primary care setting, particularly for low-income patients who seek care at community health centers, according to the study's authors.
"We undertook this study in federally qualified health centers, requiring minimal primary care time, so that we might develop a strategy that could be easily implemented through the broad range of health centers that receive support from the federal government," says epidemiologist Graham A. Colditz, MD, DrPH, the Niess-Gain Professor of Surgery at Washington University School of Medicine in St. Louis and associate director of prevention and control at the Siteman Cancer Center. "The great recession added to the strains under which our inner city, low-income participants were living. Despite this, we managed to retain 86 percent of the patients through the entire study."
The two-year study included 365 obese patients receiving treatment for high blood pressure. More than 70 percent were African-American, 68 percent were female, and 33 percent had less than a high school education. The average participant was 54 years old.
The patients were randomly assigned to receive either usual care or to participate in a program that promoted weight loss by setting goals to change behavior, self-monitoring online or with an automated phone system, counseling sessions by telephone and optional group support sessions. The patients were all seen at three community health centers in Boston.
Compared to those receiving usual care, the lifestyle intervention slowed increases in weight and blood pressure in this population of high-risk patients. Although six-month weight losses were modest — a little more than two pounds — the patients did not gain back any weight over the two-year study. The lifestyle intervention was associated with improvements in blood pressure that were clinically significant.
During the study, the average systolic blood pressure (the top number in a blood pressure reading) was lower in the intervention group compared with the usual care group but not significantly different. However, increases in systolic blood pressure were significantly lower in the intervention group. And at two years, patients in the intervention group were more likely to have controlled blood pressure than patients in the usual care group.
The researchers note this study's modest results may apply better to real-world health center settings than results from highly controlled trials that show larger effects from treatment.
Because low-income patients are underrepresented in clinical trials but bear the greatest risk and disease burden of obesity, Colditz and his colleagues call for more work to find the best ways to address their needs.
Bennett GG, Warner ET, Glasgow RE, Askew S, Goldman J, Ritzwoller DP, Emmons KM, Rosner BA, Colditz GA. Obesity treatment for socioeconomically disadvantaged patients in primary care practice. Archives of Internal Medicine. Online March 12, 2012.
This study was supported in part by grants from the National Heart, Lung, and Blood Institute and the National Cancer Institute.
Washington University School of Medicine's 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children's hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children's hospitals, the School of Medicine is linked to BJC HealthCare.
Alvin J. Siteman Cancer Center is the only NCI-designated Comprehensive Cancer Center within a 240-mile radius of St. Louis. Siteman Cancer Center is composed of the combined cancer research and treatment programs of Barnes-Jewish Hospital and Washington University School of Medicine.
Julia Strait | EurekAlert!
Speed data for the brain’s navigation system
06.12.2016 | Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE)
Study suggests possible new target for treating and preventing Alzheimer's
02.12.2016 | Oregon Health & Science University
In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.
Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...
Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...
A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.
Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...
In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.
“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...
The Max Planck Institute for Physics (MPP) is opening up a new research field. A workshop from November 21 - 22, 2016 will mark the start of activities for an innovative axion experiment. Axions are still only purely hypothetical particles. Their detection could solve two fundamental problems in particle physics: What dark matter consists of and why it has not yet been possible to directly observe a CP violation for the strong interaction.
The “MADMAX” project is the MPP’s commitment to axion research. Axions are so far only a theoretical prediction and are difficult to detect: on the one hand,...
16.11.2016 | Event News
01.11.2016 | Event News
14.10.2016 | Event News
06.12.2016 | Materials Sciences
06.12.2016 | Medical Engineering
06.12.2016 | Power and Electrical Engineering