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. 2022 Jul;63(1 Suppl 1):S67-S74.
doi: 10.1016/j.amepre.2022.01.031.

Pretreatment and During-Treatment Weight Trajectories in Black and White Women

Camille R Schneider-Worthington  1 , Amber W Kinsey  2 , Fei Tan  3 , Sheng Zhang  3 , Alena C Borgatti  4 , Andrea L Davis  4 , Gareth R Dutton  2
Affiliations

Pretreatment and During-Treatment Weight Trajectories in Black and White Women

Camille R Schneider-Worthington et al. Am J Prev Med. 2022 Jul.

Abstract

Introduction: Black participants often lose less weight than White participants in response to behavioral weight-loss interventions. Many participants experience significant pretreatment weight fluctuations (between baseline measurement and treatment initiation), which have been associated with treatment outcomes. Pretreatment weight gain has been shown to be more prevalent among Black participants and may contribute to racial differences in treatment responses. The purpose of this study was to (1) examine the associations between pretreatment weight change and treatment outcomes and (2) examine racial differences in pretreatment weight change and weight loss among Black and White participants.

Methods: Participants were Black and White women (n=153, 60% Black) enrolled in a 4-month weight loss program. Weight changes occurring during the pretreatment period (41 ± 14 days) were categorized as weight stable (±1.15% of baseline weight), weight gain (≥+1.15%), or weight loss (≤-1.15%). Recruitment and data collection occurred from 2011 to 2015; statistical analyses were performed in 2021.

Results: During the pretreatment period, most participants (56%) remained weight stable. Pretreatment weight trajectories did not differ by race (p=0.481). At 4-months, those who lost weight before treatment experienced 2.63% greater weight loss than those who were weight stable (p<0.005), whereas those who gained weight before treatment experienced 1.91% less weight loss (p<0.01).

Conclusions: Pretreatment weight changes can impact weight outcomes after initial treatment, although no differences between Black and White participants were observed. Future studies should consider the influence of pretreatment weight change on long-term outcomes (e.g., weight loss maintenance) along with potential racial differences in these associations. This study is registered (retrospectively registered) at ClinicalTrials.gov (NCT02487121) on June 26, 2015.

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Figures

Figure 1.
Figure 1.
CONSORT flow diagram. Notes: The upper portion (gray boxes) of the diagram was adapted from the published primary ImWeL results. The lower portion (black outlined boxes) reflects the sample for the present study.
Figure 2.
Figure 2.
Comparison of mean ± SD percent pre-treatment, total, and during-treatment weight loss by race. *p<0.05.
See this image and copyright information in PMC

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