Approximately 55% of the American Population is either overweight or obese. African American women in particular are at significant risk for becoming obese with as many as 49% currently qualifying for obesity (BMI greater than or equal to 30). Low-income, African American women appear less likely to engage in dietary and activity habits associated with weight maintenance and cultural factors may influence their acceptance of excessive body weight. Furthermore, traditional weight loss approaches have been minimally effective with low-income, African American women. Focus group research suggest that African-American women may be responsive to prevention programs which focus on the health b3enefits of weight management and which employ culturally sensitive educational materials. Preliminary research also suggests that a patient centered motivational intervention which uses messages targeted at patient's motivational level, knowledge and perceived barriers may enhance preention efforts. Primary care physicians who provide routine medical care to low-income, African American women are in a unique position to offer preventive services to deter weight gain and promote maintenance of weight loss. This randomized, two arm treatment study will use culturally sensitive educational materials by trained primary care physicians. It will compare physicians directed education (standard care group) to another group who receive customized education plus patient centered messages by primary care physicians. It will attempt to determine a physician delivered patient centered intervention is more effective than standard cre in regard to prevention of weight gain and achievement of weight loss at 6 months. It will also examine whether the groups differ in regard to weight maintenance at 12 and 18 months follow up. It is hypothesized that patients in the patient centered group will demonstrate less weight gain, more weight loss at 6 months, greater maintenance of weight loss at 12 and 18 months as well as dietary and physical activity improvement throughout the observation period than patients receiving standard care.
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