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Diabetes intervention plus home visits boosts weight loss in mothers with overweight, obesity

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April 11, 2018

Debra Haire-Joshu 2018
Debra Haire-Joshu

Mothers with overweight or obesity assigned to a lifestyle intervention embedded in a home visitation program were more likely to achieve 5% weight loss vs. mothers assigned to standard home visits, according to trial results published in American Journal of Preventive Medicine.

“HEALTH showed that a low intensity intervention embedded within the real-world practice of a parent education home visiting organization and delivered incrementally over time can achieve clinically significant weight outcomes among [women with overweight or obesity] by 24 months,” Debra Haire-Joshu, PhD, Joyce Wood professor of public health and medicine and director of the Center for Diabetes Translation Research and the Center for Obesity Prevention and Policy Research at the Brown School, Washington University in St. Louis, told Endocrine Today. “This is in contrast to time-intensive interventions, which generally report larger magnitudes of weight loss but with diminished effect and weight regain over time. It also showed the added value of this intervention may be in the prevention of excess weight gain and delay of comorbid conditions.”

Researchers analyzed data from 179 women with overweight or obesity aged 18 to 45 years with a minimum of one preschool-aged child participating in Parents as Teachers, a nationwide home visiting organization dedicated to educating families about child development before the child enters school. Researchers randomly assigned the women to either a usual care group (n = 97; mean baseline BMI 34.5 kg/m2) or an intervention group (n = 82; 34.4 kg/m2). The intervention group received the standard Parents as Teachers program with the addition of a lifestyle intervention program, Healthy Eating and Active Living Taught at Home, modeled on the Diabetes Prevention Program. Participants in both groups had similar baseline weight, waist circumference, blood pressure, diet and activity. Researchers measured participants’ weight at 12 and 24 months.

At 12 months, intervention participants lost a mean of 0.7 kg, whereas usual care participants gained a mean of 2.1 kg, for a between-group difference of 2.8 kg (P = .0006). By 24 months, the between-group difference grew to 4.7 kg, according to researchers. Furthermore, at 24 months, mothers assigned to the intervention group were more likely to achieve 5% weight loss vs. mothers assigned to usual care (26% vs. 11%; P = .01). Although usual care participants continued to gain weight, intervention participants maintained their weight loss (3.2 kg vs. –1.5 kg; P = .002).

“Clinically significant weight reduction in women with young children can be achieved through the embedding of evidence-based weight-management interventions within real-world settings,” Haire-Joshu said. “Partnerships with organizations that reach young women and other populations at risk for overweight or obesity as part of their routine practice offer a structure for implementing, sustaining and scaling effective lifestyle change interventions.” by Melissa J. Webb

For more information: Debra Haire-Joshu, PhD, can be reached at djoshu@wustl.edu.

Disclosures: The authors report no relevant financial disclosures.