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!
Laser activated gold pyramids could deliver drugs, DNA into cells without harm
24.03.2017 | Harvard John A. Paulson School of Engineering and Applied Sciences
What does congenital Zika syndrome look like?
24.03.2017 | University of California - San Diego
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
20.03.2017 | Event News
14.03.2017 | Event News
07.03.2017 | Event News
24.03.2017 | Materials Sciences
24.03.2017 | Physics and Astronomy
24.03.2017 | Physics and Astronomy