The relationship between chronic stress and weight management efforts may be a concern for African American (AA) women, who have a high prevalence of obesity, high stress levels, and modest response to obesity treatment. This pilot study randomly assigned 44 overweight/obese AA women with moderate to high stress levels to either a 12-week adaptation of the Diabetes Prevention Program Lifestyle Balance intervention augmented with stress management strategies (Lifestyle + Stress) or Lifestyle Alone. A trend toward greater percentage of baseline weight loss at 3-month data collection was observed in Lifestyle + Stress (−2.7 ± 3.6%) compared with Lifestyle Alone (−1.4 ± 2.3%; p = .17) and a greater reduction in salivary cortisol (Lifestyle + Stress: −0.2461 ± 0.3985 ng/mL; Lifestyle Alone: −0.0002 ± 0.6275 ng/mL; p = .20). These promising results suggest that augmenting a behavioral weight control intervention with stress management components may be beneficial for overweight/obese AA women with moderate to high stress levels and merit further investigation with an adequately powered trial.
ArdJ. D.CoxT. L.ZunkerC.WingoB. C.JeffersonW. K.BrakhageC. (2010). A study of a culturally enhanced EatRight dietary intervention in a predominately African American workplace. Journal of Public Health Management Practice, 16(6), E1-E8.
2.
ArdJ. D.KumanyikaS. K.StevensV. J.VollmerW. M.Samuel-HodgeC. D.KennedyB. M.. . . SvetkeyL. P. (2008). Effect of group racial composition on weight loss in African Americans. Obesity, 16, 306-310.
3.
Banks-WallaceJ. (2007). Outcomes from Walk the Talk: A nursing intervention for Black women. Association of Black Nursing Faculty Journal, 18(1), 19-24.
4.
BjorntorpP. (2001). Do stress reactions cause abdominal obesity and comorbidities?Obesity Reviews, 2(2), 73-86.
5.
BjorntorpP.RosmondR. (2000). Obesity and cortisol. Nutrition, 16, 924-936.
6.
BoltriJ. M.Davis-SmithY. M.SealeJ. P.ShellenbergerS.OkosunI. S.CorneliusM. E. (2008). Diabetes prevention in a faith-based setting: Results of translation research. Journal of Public Health Management Practice, 14(1), 29-32.
7.
CohenS.KamarckT.MermelsteinR. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385-396.
8.
ColeS. R. (1999). Assessment of differential item functioning in the Perceived Stress Scale–10. Journal of Epidemiology and Community Health, 53, 319-320.
9.
CoxT. L.ZunkerC.WingoB. C.JeffersonW. K.ArdJ. D. (2011). Stressful life events and behavior change: A qualitative examination of African American women’s participation in a weight loss program. Qualitative Report, 16, 622-634.
10.
DelahantyL. M.MeigsJ. B.HaydenD.WilliamsonD. A.NathanD. M. (2002). Psychological and behavioral correlates of baseline BMI in the diabetes prevention program (DPP). Diabetes Care, 25, 1992-1998.
11.
Diabetes Prevention Program Research Group. (2002). The Diabetes Prevention Program: Descriptive of lifestyle intervention. Diabetes Care, 25, 2165-2171.
12.
EconomosC. D.HildebrandtM. L.HyattR. R. (2008). College freshman stress and weight change: Differences by gender. American Journal of Behavioral Health, 32(1), 16-25.
13.
FaragN. H.MooreW. E.LovalloW. R.MillsP. J.KhandrikaS.EichnerJ. E. (2008). Hypothalamic-pituitary-adrenal axis function: Relative contributions of perceived stress and obesity in women. Journal of Women’s Health, 17, 1647-1655.
14.
FitzgibbonM. L.StolleyM. R.GanschowP.SchifferL.WellsA.SimonN.DyerA. (2005). Results of a faith-based weight loss intervention for black women. Journal of the National Medical Association, 97, 1393-1402.
15.
FlegalK. M.CarrollM. D.OgdenC. L.CurtinL. R. (2010). Prevalence and trends in obesity among U.S. adults, 1999-2008. Journal of the American Medical Association, 303, 235-241.
16.
Fowler-BrownA. G.BennettG. G.GoodmanM. S.WeeC. C.Corbie-SmithG. M.JamesS. A. (2009). Psychosocial stress and 13-year BMI change among Blacks: The Pitt County Study. Obesity, 17, 2106-2109.
17.
GeronimusA. T.HickenM.KeeneD.BoundJ. (2006). “Weathering” and age patterns of allostatic load scores among Blacks and Whites in the United States. American Journal of Public Health, 96, 826-833.
18.
Hermann-EngelsJ.GretebeckR. J.GretebeckK.JimenezL. (2005). Promoting healthful diets and exercise: Efficacy of a 12-week after-school program in urban African Americans. Journal of the American Dietetics Association, 105, 455-459.
19.
HollisJ. F.GuillionC. M.StevensV. J.BrantleyP. J.AppelL. J.ArdJ. D. . . . Weight Loss Maintenance Trial Research Group. (2008). Weight loss during the intensive intervention phase of the Weight-Loss Maintenance Trial. American Journal of Preventive Medicine, 35, 118-126.
20.
KaiserK. A.AffusoO.BeasleyT. M.AllisonD. B. (2011). Getting carried away: A note showing baseline observation carried forward (BOCF) results can be calculated from published complete-cases results. International Journal of Obesity. Advance online publication. doi:10.1038/ijo.2011.25
21.
KandersB. S.Ullman-JoyP.ForeytJ. P.HeymsfieldS. B.HeberD.ElashoffR. M.. . . BlackburnG. L. (1994). The Black American Lifestyle Intervention (BALI): The design of a weight loss program for working-class African-American women. Journal of the American Dietetic Association, 94, 310-313.
22.
KaranjaN.StevensV. J.HollisJ. F.KumanyikaS. K. (2002). Steps to soulful living (steps): A weight loss program for African-American women. Ethnicity and Disease, 12, 316-319.
23.
KatzerL.BradshawA. J.HorwathC. C.GrayA. R.O’BrienS.JoyceJ. (2008). Evaluation of a “nondieting” stress reduction program for overweight women: A randomized trial. Journal of Health Promotion, 22, 264-274.
24.
KennedyB. M.ChampagneC.RyanD. H.NewtonR.ConishB. K.HarshaD. W. . . . Lower Mississippi Delta Nutrition Intervention Research Initiative. (2009). The “Rolling Store”: An economical and environmental approach to the prevention of weight gain in African American women. Ethnicity and Disease, 19, 7-12.
25.
KimK. H.BursacZ.DiLilloV. G.WhiteD. B.WestD. S. (2009). Stress, race, and body weight. Health Psychology, 28, 131-135.
26.
KumanyikaS. K. (1994). Obesity in minority populations: An epidemiologic assessment. Obesity Research, 2, 166-182.
27.
KumanyikaS. K.EspelandM. A.BahnsonJ. L.BottomJ. B.CharlestonJ. B.FolmarS. . . . TONE Cooperative Research Group. (2002). Ethnic comparison of weight loss in the Trial of Nonpharmacologic Interventions in the Elderly. Obesity Research, 10, 96-106.
28.
KumanyikaS. K.GaryT. L.LancassterK. J.Samuel-HodgeD.Banks-WallaceJ.BeechB. M.. . . Whitt-GloverM. C. (2005). Achieving healthy weight in African-American communities: Research perspectives and priorities. Obesity Research, 13, 2037-2047.
29.
KumanyikaS. K.WaddenT. A.ShultsJ.FassbenderJ. E.BrownS. D.BowmanM. A.. . . WuX. (2009). Trial of family and friend support for weight loss in African American adults. Archives of Internal Medicine, 169, 1795-1804.
30.
Look AHEAD Research Group. (2006). The Look AHEAD Study: A description of the lifestyle intervention and the evidence supporting it. Obesity, 14, 737-752.
31.
LueckenL. J.GalloL. C. (2007). Handbook of physiological research methods in health psychology. Thousand Oaks, CA: Sage.
32.
ManzoniG. M.PagniniF.GoriniA.PreziosaA.CastelnuovoG.MolinariE.RivaG. (2009). Can relaxation training reduce emotional eating in women with obesity? An exploratory study with 3 months of follow-up. Journal of the American Dietetic Association, 109, 1427-1432.
33.
McTigueK.LarsonJ. C.ValoskiA.BurkeG.KotchenJ.LewisC. E.. . . KullerL. (2006). Mortality and cardiac and vascular outcomes in extremely obese women. Journal of the American Medical Association, 296, 79-86.
34.
MustA.SpadanoJ.CoakleyE. H.FieldA. E.ColditzG.DietzW. H. (1999). The disease burden associated with overweight and obesity. Journal of the American Medical Association, 282, 1523-1529.
35.
OgdenC. L.CarrollM. D.CurtinL. R.McDowellM. A.TabakC. J.FlegalK. M. (2006). Prevalence of overweight and obesity in the United States, 1999-2004. Journal of the American Medical Association, 295, 1549-1555.
36.
Samuel-HodgeC. D.JohnstonL. F.GizliceZ.GarciaB. A.LindsleyS. C.BrambleK. P.. . . KeyserlingT. C. (2009). Randomized trial of a behavioral weight loss intervention for low-income women: The Weight Wise Program. Obesity, 17, 1891-1899.
37.
SchiffmanS. S.GrahamB. G.Sattely-MillerE. A.Peterson-DancyM. (2000). Elevated and sustained desire for sweet taste in African-Americans: A potential factor in the development of obesity. Nutrition, 16, 886-893.
38.
SchulzA.IsraelB.WilliamsD.ParkerE.BeckerA.JamesS. (2000). Social inequalities, stressors and self reported health status among African American and White women in the Detroit metropolitan area. Social Science & Medicine, 51, 1639-1653.
39.
ShaoJ.JordanD. C.PritchettY. L. (2009). Baseline observation carry forward: Reasoning, properties, and practical issues. Journal of Biopharmaceutical Statistics, 19, 672-684.
40.
SharpL. K.KimmelL. G.KeeR.SaltounC.Chih-HungC. (2007). Assessing the Perceived Stress Scale for African American adults with asthma and low literacy. Journal of Asthma, 44, 311-316.
41.
SmithD. W.McFallS. L. (2005). The relationship of diet and exercise for weight control and the quality of life gap associated with diabetes. Journal of Psychosomatic Research, 59, 385-392.
42.
StevensJ. (2000). Obesity and mortality in African-Americans. Nutrition Reviews, 58, 346-358.
StricklandO. L.GigerJ. N.NelsonM. A.DavisC. M. (2007). The relationships among stress, coping, social support, and weight class in premenopausal African American women at risk for coronary heart disease. Journal of Cardiovascular Nursing, 22, 272-278.
45.
TorresS. J.NowsonC. A. (2007). Relationship between stress, eating behavior, and obesity. Nutrition, 23, 887-894.
46.
TurnerR. J.AvisonW. R. (2003). Status variations in stress exposure: Implications for the interpretation of research on race, socioeconomic status, and gender. Journal of Health and Social Behavior, 44, 488-505.
47.
VicennatiV.PasquiF.CavazzaC.PagottoU.PasqualiR. (2009). Stress-related development of obesity and cortisol in women. Obesity, 17, 1678-1683.
48.
WaddenT. A.ButrynM. L.SarwerD. B.FabricatoreA. N.CrerandC. E.LipschutzP. E.. . . WilliamsN. N. (2006). Comparison of psychosocial status in treatment-seeking women with class III vs. class I-II obesity. Surgery for Obesity and Related Disease, 2, 138-145.
49.
Walcott-McQuiggJ. A. (1995). The relationship between stress and weight-control behavior in African-American women. Journal of the National Medical Association, 87, 427-432.
50.
WangY.BeydounM. A. (2007). The obesity epidemic in the United States-gender, age, socioeconomic, racial/ethnic, and geographic characteristics: A systematic review and meta-regression analysis. Epidemiologic Reviews, 29, 6-28.
51.
WareJ. H. (2003). Interpreting incomplete data in studies of diet and weight loss. New England Journal of Medicine, 348, 2136-2137.
52.
WestD. S.DiLilloV. G.BursacZ.GoreS. A.GreeneP. B. (2007). Motivation interviewing improves weight loss in women with type 2 diabetes. Diabetes Care, 30, 1081-1087.
53.
WestD. S.PrewittT. E.BursacZ.FelixH. C. (2008). Weight loss of Black, White, and Hispanic men and women in the Diabetes Prevention Program. Obesity, 16, 1413-1420.
