Weight loss and improved metabolic outcomes amongst rural African American women in the Deep South: six-month outcomes from a community-based randomized trial

J Intern Med. 2017 Jul;282(1):102-113. doi: 10.1111/joim.12622. Epub 2017 May 17.


Background: Obesity is highly prevalent in African American women, especially those in the rural southern USA, resulting in persistent health disparities.

Objective: To test the effectiveness of an evidence-based behavioural weight loss intervention delivered by community health advisors to African American women in the rural south.

Design and methods: Overweight or obese African American women (30-70 years) from eight counties in Mississippi and Alabama participated in a 24-month randomized controlled trial of an evidence-based behavioural weight loss programme augmented with community strategies to support healthy lifestyles (Weight Loss Plus, N = 154) compared to the weight loss programme alone (Weight Loss Only, N = 255). This study reports on 6-month outcomes on primary (weight change) and secondary (waist circumference, blood pressure, lipids, fasting blood glucose) outcomes, coinciding with the completion of the intensive weight loss phase.

Results: Weight Loss Only participants lost an average of 2.2 kg (P < 0.001). Weight Loss Plus participants lost an average of 3.2 kg (P < 0.001). The proportion of the total sample that lost at least 5% of their body weight was 27.1% with no difference between treatment groups. Similarly, we observed statistically significant reductions in blood pressure, waist circumference and triglycerides in each treatment group, with no statistical differences between groups.

Conclusion: Trained lay health staff and volunteers from the rural southern USA were able to deliver a translation of a high-intensity behavioural intervention targeted to African American women, resulting in clinically meaningful weight loss and improvement in other metabolic outcomes in a significant proportion of participants.

Keywords: African American; community-based; metabolic outcomes; randomized trial; rural communities; weight loss.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Behavior Therapy
  • Black or African American*
  • Blood Glucose / metabolism
  • Blood Pressure
  • Caloric Restriction
  • Diet, Reducing
  • Exercise Therapy
  • Female
  • Humans
  • Lipids / blood
  • Middle Aged
  • Obesity / blood
  • Obesity / ethnology*
  • Obesity / therapy*
  • Overweight / blood
  • Overweight / ethnology*
  • Overweight / therapy*
  • Risk Factors
  • Treatment Outcome
  • Triglycerides / blood
  • Waist Circumference
  • Weight Loss*


  • Blood Glucose
  • Lipids
  • Triglycerides