To improve weight loss and maintenance among two high-risk groups - poor women and African American women - programs should be both affordable and tailored to the individual, new study findings suggest.

People have been looking for “a one-size-fits-all program” for weight loss, but “the reality is there’s going to be different needs based on different people and their different experiences,” said study author Dr. Esa M. Davis, of Case Western Reserve University in Cleveland, Ohio.

Various researchers have studied the weight-loss successes and failures of African American women and poor women. Coupled with their reduced likelihood of participating in weight-loss programs, African-American women are known to be more likely to be less successful with their weight-loss efforts.

Poor women, on the other hand, seem to be less motivated to maintain a reduced weight, according to published reports.

In the current study, Davis and her colleagues investigated the racial and socioeconomic factors that may impact weight management practices among obese women. Their research involved 27 obese African-American and white women, aged 20 to 65 years, who worked for the same Maryland employer. The women were divided into four focus groups based on their race and socioeconomic status.

Based on their comments, the women were generally able to lose weight in the short term, but failed to maintain that weight loss over time. Consequently, many women expressed an interest in weight-loss programs that focused on weight maintenance, Davis and her team report in the September issue of the American Journal of Public Health.

Further, due to the women’s resulting frustration with the cycle of weight loss and weight gain, participants in each focus group said they wanted a weight-management program that also addressed their emotional and psychological concerns.

Some women, particularly African Americans, preferred spiritual programs, while others wanted personal coaching via counselors or therapists, for example.

This suggests that while the public health and medical community has done “a good job” stressing the importance of diet and exercise, they have neglected to “teach (people) how to maintain their weight loss,” Davis said.

They have also neglected to address “the emotional and psychological component of being overweight and trying to lose weight,” she said.

Many of the focus group participants believed that their family, as well as society at large, influenced their thinking about weight management and their feelings about being overweight.

For example, some white women said their families did not accept their being overweight while some African-American women said their families pressured them to accept being overweight. African-American women also identified cultural influences, including the focus on food in various settings, as challenges to their weight maintenance.

Women of the lowest socioeconomic status also believed that their finances hindered their ability to effectively manage their weight. As one 36-year-old white women said, “You know, three boxes of macaroni and cheese for a dollar as opposed to buying chicken breasts that are, you know, 10 bucks, if you get two of them.”

Further, when discussing the ideal weight loss method, white women emphasized physical activity without mentioning any food characteristics, while their African-American counterparts did the opposite, including one 47-year-old who wanted to lose weight while eating “food that tastes good as opposed to bland, flavorless food,” the report indicates.

“This is a study that hears what they’re saying,” Davis said, referring to the women’s various comments about their struggles with weight loss. She added that health care professionals “need to listen” and create tailored programs to address the specific needs expressed by their patients.

Grants from the Robert Wood Johnson Foundation and the National Research Service Award supported the study.

SOURCE: American Journal of Public Health, September 2005.