A high-risk, socioeconomically disadvantaged group of obese patients seem to have achieved modest weight loss and improved blood pressure control by attending a behavioral intervention program. The study is published Online First in the JAMA journal Archives of Internal Medicine.
The study’s background information states that the U.S. primary care system fails to sufficiently approach obesity. Socioeconomically disadvantaged patients who turn to community health centers for help are especially affected by the limited availability of treatments to tackle obesity.
Gary G. Bennett, Ph.D., of Duke University, Durham, N.C., and his team decided to perform a two-group, 24-month randomized effectiveness trial in three Boston community health centers from February 2008 to May 2011, involving 365 obese participants who received treatment for hypertension. The participants consisted of 71.2% black patients and 13.1% Hispanic patients, of which 68.5% were female and 32.9% had a lower education than high school.
The participants were randomly assigned into either a common care group or to a behavioral intervention group, which involved setting goals for changing behavior, twelve optional group support sessions, self-monitoring of progress via a website or interactive voice response system and 18 telephone counseling calls, as well as community resource links.
The researchers state:
“The Be Fit, Be Well lifestyle intervention slowed weight and blood pressure increases in this high-risk patient population. Although six-month weight losses were modest, they were sustained for 24 months and were associated with clinically significant alterations in blood pressure trajectories.”
The findings revealed that participants in the behavioral intervention group managed to achieve a weight loss of -1.03 kg or 2.2 pounds and a reduction of -0.38 in patients BMI at 24 months, as compared to the common care group.
The researchers also noted that the intervention group had a lower average systolic blood pressure (SBP) during the 24 months, compared with the common care group, although they noted no substantial difference. However, the incline of higher SBP per year was substantially higher in the common care group. It was also noted that those in the intervention group had a significantly greater level of blood pressure control at 24 months, as compared with the common care group.
The researchers say in a concluding statement:
“As a pragmatic effectiveness trial, our findings are arguably more generalizable to real-world health center settings than are those of highly controlled efficacy trials with larger treatment effects. More work is necessary to best address the needs of socioeconomically disadvantaged patients who bear the greatest risk and disease burden of obesity.”
Written by Petra Rattue