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Current Obesity Reports

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02-02-2023 | Obesity | REVIEW

A Call to Reconceptualize Obesity Treatment in Service of Health Equity: Review of Evidence and Future Directions

Authors: Sylvia Herbozo, Kristal Lyn Brown, Natasha L. Burke, Jessica Gokee LaRose

Published in: Current Obesity Reports | Issue 1/2023

Abstract

Purpose of Review

Rates of obesity and associated comorbidities are higher among Black and Latino adults compared to white adults. We sought to provide an overview of both structural and individual factors contributing to obesity inequities and synthesize available evidence regarding treatment outcomes in Black and Latino adults, with an eye towards informing future directions.

Recent Findings

Obesity disparities are influenced by myriad systemic issues, yet the vast majority of interventions target individual-level factors only, and most behavioral treatments fail to target drivers beyond eating and physical activity. Extant treatments are not equally accessible, affordable, or effective among Black and Latino adults compared with white counterparts.

Summary

Asset-based, culturally relevant interventions that target the root causes of obesity and address intersectional stress—designed in partnership with intended beneficiaries—are urgently needed. Treatment trials must improve enrollment of Black and Latino adults and report treatment outcomes by race and ethnicity.

Centers for Disease Control. Adult obesity facts. 2022. https://www.cdc.gov/obesity/data/adult.html.

Centers for Disease Control. Obesity, race/ethnicity, and COVID-19. 2022. https://www.cdc.gov/obesity/data/obesity-and-covid-19.html.

Newlin LK, Dorsen C, Melkus GD, Maclean M. Prevalence of obesity, prediabetes, and diabetes in sexual minority women of diverse races/ethnicities: findings from the 2014–2015 BRFSS surveys. Diabetes Educ. 2018;44:348–60. https://doi.org/10.1177/0145721718776599.CrossRef

Crenshaw K. Demarginalizing the intersection of race and sex: a Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. In D. K. Weisbert (Ed.), Feminist legal theory: foundations. 1993:383–395. Temple University Press. (Original work published 1989).

Sarma S, Sockalingam S, Dash S. Obesity as a multisystem disease: trends in obesity rates and obesity-related complications. Diabetes Obes Metab. 2021;23:3–16. https://doi.org/10.1111/dom.14290.CrossRefPubMed

• Puhl RM, Himmelstein MS, Pearl RL. Weight stigma as a psychosocial contributor to obesity. Am Psychol. 2020;75:274–89. https://doi.org/10.1037/amp0000538. Synthesizes literature examining links between weight stigma experiences and weight-related behaviors and health, describes implications for clinical practice, and outlines future directions for research.CrossRefPubMed

Gao F, Zheng KI, Wang XB, Sun QF, Pan KH, Wang TY, et al. Obesity is a risk factor for greater COVID-19 severity. Diabetes Care. 2020;43:e72-74. https://doi.org/10.2337/dc20-0682.CrossRefPubMed

He J, Zhu Z, Bundy JD, Dorans KS, Chen J, Hamm LL. Trends in cardiovascular risk factors in US adults by race and ethnicity and socioeconomic status, 1999–2018. JAMA. 2021;5(326):1286–98. https://doi.org/10.1001/jama.2021.15187.CrossRef

Moore JX, Chaudhary N, Akinyemiju T. Metabolic syndrome prevalence by race/ethnicity and sex in the United States, National Health and Nutrition Examination Survey, 1988–2012. Prev Chronic Dis. 2017;14:160287. https://doi.org/10.5888/pcd14.160287.

10.

Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63:2985–3023. https://doi.org/10.1002/oby.20821.CrossRefPubMed

11.

Goode RW, Styn MA, Mendez DD, Gary-Webb TL. African Americans in standard behavioral treatment for obesity, 2001–2015: what have we learned? West J Nurs Res. 2017;39:1045–69. https://doi.org/10.1177/0193945917692115.CrossRefPubMedPubMedCentral

12.

Seo DC, Sa J. A meta-analysis of psycho-behavioral obesity interventions among US multiethnic and minority adults. Prev Med. 2008;47:573–82. https://doi.org/10.1016/j.ypmed.2007.12.010.CrossRefPubMed

13.

Odoms-Young AM, Zenk SN, Karpyn A, Ayala GX, Gittelsohn J. Obesity and the food environment among minority groups. Curr Obes Rep. 2012;1:141–51. https://doi.org/10.1007/s13679-012-0023-x.CrossRef

14.

Grigsby-Toussaint DS, Zenk SN, Odoms-Young A, Ruggiero L, Moise I. Availability of commonly consumed and culturally specific fruits and vegetables in African-American and Latino neighborhoods. J Am Diet Assoc. 2010;110:746–52. https://doi.org/10.1016/j.jada.2010.02.008.CrossRefPubMedPubMedCentral

15.

Holston D, Stroope J, Greene M, Houghtaling B. Perceptions of the food environment and access among predominantly Black low-income residents of rural Louisiana communities. Int J Environ Res Public Health. 2020;17:5340. https://doi.org/10.3390/ijerph17155340.CrossRefPubMedPubMedCentral

16.

Valdez Z, Ramírez AS, Estrada E, Grassi K, Nathan S. Community perspectives on access to and availability of healthy food in rural, low-resource. Latino communities Prev Chronic Dis. 2016;13:E170. https://doi.org/10.5888/pcd13.160250.CrossRefPubMed

17.

Leung CW, Williams DR, Villamor E. Very low food security predicts obesity predominantly in California Hispanic men and women. Public Health Nutr. 2012;15:2228–36. https://doi.org/10.1017/S1368980012000857.CrossRefPubMedPubMedCentral

18.

Vedovato GM, Surkan PJ, Jones-Smith J, Steeves EA, Han E, Trude AC, et al. Food insecurity, overweight and obesity among low-income African-American families in Baltimore City: associations with food-related perceptions. Public Health Nutr. 2016;19:1405–16. https://doi.org/10.1017/S1368980015002888.CrossRefPubMed

19.

Moore LV, Roux AV, Evenson KR, McGinn AP, Brines SJ. Availability of recreational resources in minority and low socioeconomic status areas. Am J Prev Med. 2008;1(34):16–22. https://doi.org/10.1016/j.amepre.2007.09.021.CrossRef

20.

Larsen BA, Pekmezi D, Marquez B, Benitez TJ, Marcus BH. Physical activity in Latinas: social and environmental influences. Women’s Health. 2013;9:201–10. https://doi.org/10.2217/whe.13.9.CrossRefPubMed

21.

Harris JL. Targeted food marketing to Black and Hispanic consumers: the tobacco playbook. Am J of Public Health. 2020;110:271–2. https://doi.org/10.2105/AJPH.2019.305518.CrossRef

22.

• Barnhill A, Ramírez AS, Ashe M, Berhaupt-Glickstein A, Freudenberg N, Grier SA, et al. The racialized marketing of unhealthy foods and beverages: perspectives and potential remedies. J Law Med & Ethics. 2022;50:52–9. https://doi.org/10.1017/jme.2022.8. Examines the multitude of factors that companies use to market and advertise unhealthy food and drink options in Black and Latino communities.CrossRef

23.

• Butsch WS, Kushner RF, Alford S, Smolarz BG. Low priority of obesity education leads to lack of medical students’ preparedness to effectively treat patients with obesity: results from the US medical school obesity education curriculum benchmark study. BMC Med Edu. 2020;20:1–6. https://doi.org/10.1186/s12909-020-1925-z. Examines current obesity education in U.S. medical schools as reported by medical school deans and curriculum staff. Describes two recent educational initiatives that included core competencies in obesity in healthcare professional schools.CrossRef

24.

Jay M, Gillespie C, Ark T, Richter R, McMacken M, Zabar S, Paik S, Messito MJ, Lee J, Kalet A. Do internists, pediatricians, and psychiatrists feel competent in obesity care. J Gen Intern Med. 2008;23(1066–70):1066–70. https://doi.org/10.1007/s11606-008-0519-y.CrossRefPubMedPubMedCentral

25.

Bleich SN, Simon AE, Cooper LA. Impact of patient–doctor race concordance on rates of weight-related counseling in visits by Black and White obese individuals. Obesity. 2012;20:562–70. https://doi.org/10.1038/oby.2010.330.CrossRefPubMed

26.

Lewis KH, Gudzune KA, Fischer H, Yamamoto A, Young DR. Racial and ethnic minority patients report different weight-related care experiences than non-Hispanic Whites. Prev Med Rep. 2016;1:296–302. https://doi.org/10.1016/j.pmedr.2016.06.015.CrossRef

27.

Reading JM, Snell LM, LaRose JG. A systematic review of weight-related communication trainings for physicians. Transl Behav Med. 2020;10:1110–9. https://doi.org/10.1093/tbm/ibaa014.CrossRefPubMed

28.

•• Jernigan VB, Hearod JB, Tran K, Norris KC, Buchwald D. An examination of cultural competence training in US medical education guided by the tool for assessing cultural competence training. J Health Dispar Res Pract. 2016;9:150–67. Examines current cultural competency training in medical education in USA.PubMedPubMedCentral

29.

Sabin JA, Marini M, Nosek BA. Implicit and explicit anti-fat bias among a large sample of medical doctors by BMI, race/ethnicity and gender. PLoS One. 2012;7:e48448. https://doi.org/10.1371/journal.pone.0048448.

30.

Gudzune KA, Bennett WL, Cooper LA, Bleich SN. Perceived judgment about weight can negatively influence weight loss: a cross-sectional study of overweight and obese patients. Prev Med. 2014;62:103–7. https://doi.org/10.1016/j.ypmed.2014.02.001.CrossRefPubMedPubMedCentral

31.

Hall WJ, Chapman MV, Lee KM, Merino YM, Thomas TW, Payne BK, et al. Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review. Am J Public Health. 2015;1105:e60-76. https://doi.org/10.2105/AJPH.2015.302903.CrossRef

32.

Van Ryn M, Burke J. The effect of patient race and socio-economic status on physicians’ perceptions of patients. Soc Sci Med. 2000;50:813–28. https://doi.org/10.1016/S0277-9536(99)00338-X.CrossRefPubMed

33.

Mayo RM, Sherrill WW, Sundareswaran P, Crew L. Attitudes and perceptions of Hispanic patients and health care providers in the treatment of Hispanic patients: a review of the literature. Hisp Health Care Int. 2007;5:64–72. https://doi.org/10.1891/154041507780978905.CrossRef

34.

Blair IV, Steiner JF, Fairclough DL, Hanratty R, Price DW, Hirsch H, et al. Clinicians’ implicit ethnic/racial bias and perceptions of care among Black and Latino patients. Ann Fam Med. 2013;11:43–52. https://doi.org/10.1370/afm.1442.CrossRefPubMedPubMedCentral

35.

•• Nong P, Raj M, Creary M, Kardia SLR, Platt JE. Patient-reported experiences of discrimination in the US health care system. JAMA New Open. 2020;3:e2029650. https://doi.org/10.1001/jamanetworkopen.2020.29650. Investigates the prevalence, frequency, and type of patients’ experiences with discrimination as well as differences in prevalence by demographic factors.

36.

Lee JS, Sheer JL, Lopez N, Rosenbaum S. Coverage of obesity treatment: a state-by-state analysis of Medicaid and state insurance laws. Public Health Rep. 2010;125:596–604. https://doi.org/10.1177/003335491012500415.CrossRefPubMedPubMedCentral

37.

Fandek NW. Obesity care & weight loss: what’s covered and what’s not? 2021. https://www.goodrx.com/conditions/weight-loss/weight-loss-treatments-insurance-coverage.

38.

Tomiyama AJ, Hunger JM, Nguyen-Cuu J, Wells C. Misclassification of cardiometabolic health when using body mass index categories in NHANES 2005–2012. Int J Obes. 2016;40:883–6. https://doi.org/10.1038/ijo.2016.17.CrossRef

39.

•• Lewis KH, Edwards-Hampton SA, Ard JD. Disparities in treatment uptake and outcomes of patients with obesity in the USA. Curr Obesity Rep. 2016;5:282–90. https://doi.org/10.1007/s13679-016-0211-1. Synthesizes literature on responses to obesity treatments by race/gender and proposes potential reasons for differential treatment utilization and response.CrossRef

40.

Doty MM, Beutel S, Rasamussen PW, Collins SR. Latinos have made coverage gains but millions are still uninsured. 2015. https://www.commonwealthfund.org/blog/2015/latinos-have-made-coverage-gains-millions-are-still-uninsured.

41.

Lines LM, Urato M, Halpern MT, Subramanian S. Insurance coverage and preventive care among adults. 2014. https://www.ncbi.nlm.nih.gov/books/NBK532434/.

42.

Jannah N, Hild J, Gallagher C, Dietz W. Coverage for obesity prevention and treatment services: analysis of Medicaid and state employee health insurance programs. Obesity. 2018;26:1834–40. https://doi.org/10.1002/oby.22307.CrossRefPubMed

43.

Lee M, Lauren BN, Zhan T, Choi J, Klebanoff M, Abu Dayyeh B, et al. The cost-effectiveness of pharmacotherapy and lifestyle intervention in the treatment of obesity. Obes Sci Pract. 2020;6:162–70. https://doi.org/10.1002/osp4.390.CrossRefPubMed

44.

Conscience Health. Why is semaglutide more experience for obesity? 2022. https://conscienhealth.org/2022/05/why-is-semaglutide-more-expensive-for-obesity/.

45.

Carlson S, Neuberger Z. WIC works: addressing the nutrition and health needs of low-income families for more than four decades. 2021. https://www.cbpp.org/research/food-assistance/wic-works-addressing-the-nutrition-and-health-needs-of-low-income-families#_ftn3.

46.

Fang D, Thomsen MR, Nayga RM Jr, Novotny AM. WIC participation and relative quality of household food purchases: evidence from Food APS. South Econ J. 2019;86:83–105. https://doi.org/10.1002/soej.12363.CrossRef

47.

Powell LM, Chriqui JF, Khan T, Wada R, Chaloupka FJ. Assessing the potential effectiveness of food and beverage taxes and subsidies for improving public health: a systematic review of prices, demand and body weight outcomes. Obes Rev. 2013;14:110–28. https://doi.org/10.1111/obr.12002.CrossRefPubMed

48.

Donnelly GE, Zatz LY, Svirsky D, John LK. The effect of graphic warnings on sugary-drink purchasing. Psychol Sci. 2018;29:1321–33. https://doi.org/10.1177/0956797618766361.CrossRefPubMedPubMedCentral

49.

•• Strings S. Fearing the black body the racial origins of fat phobia. 1st ed. New York: New York University Press; 2019. Explores the history of fat phobia, particularly in regard to Black bodies. Challenges scholars to question the medical motives behind body mass index and obesity among Black women and to acknowledge the racist core of fat phobia.

50.

•• Anekwe CV, Jarrell AR, Townsend MJ, Gaudier GI, Hiserodt JM, Stanford FC. Socioeconomics of obesity. Curr Obes Rep 2020;9:272–9. https://doi.org/10.1007/s13679-020-00398-7. Synthesizes literature on socioeconomic factors contributing to obesity on individual and community levels and emphasizes the need for treatment approaches to be multi-faceted addressing both levels.

51.

Creamer J. Inequalities persist despite decline in poverty for all major race and Hispanic origin groups. 2020. https://www.census.gov/library/stories/2020/09/poverty-rates-forblacks-and-hispanics-reached-historic-lows-in-2019.html#:~:text=Poverty%20rates%20declined%20between%202018,Hispanics%2C%20it%20was%2015.

52.

U.S. Department of Education. Advancing diversity and inclusion in higher education: key data highlights focusing on race and ethnicity and promising practices. 2016. http://www2.ed.gov/rschstat/research/pubs/advancing-diversity-inclusion.pdf.

53.

Sim AY, Lim EX, Leow MK, Cheon BK. Low subjective socioeconomic status stimulates orexigenic hormone ghrelin — a randomised trial. Psychoneuroendocrinology. 2018;89:103–12. https://doi.org/10.1016/j.psyneuen.2018.01.006.CrossRefPubMed

54.

Cheon BK, Hong YY. Mere experience of low subjective socioeconomic status stimulates appetite and food intake. Proc Natl Acad Sci. 2017;114:72–7. https://doi.org/10.1073/pnas.1607330114.CrossRefPubMed

55.

Lee AM, Huo T, Miller D, Gurka MJ, Thompson LA, Modave FP, et al. The effects of experimentally manipulated social status and subjective social status on physical activity among Hispanic adolescents: an RCT. Pediatr Obes. 2022;17:e12877. https://doi.org/10.1111/ijpo.12877.

56.

Cardel MI, Pavela G, Janicke D, Huo T, Miller D, Lee AM, et al. Experimentally manipulated low social status and food insecurity alter eating behavior among adolescents: a randomized controlled trial. Obesity. 2020;28:2010–9. https://doi.org/10.1002/oby.23002.CrossRefPubMed

57.

Tomiyama JA. Stress and obesity. Annu Rev of Psychol. 2019;70:703–18. https://doi.org/10.1146/annurev-psych-010418-102936.CrossRef

58.

•• Williams DR, Lawrence JA, Davis BA. Racism and health: evidence and needed research. Annu Rev Public Health. 2019;40:105–25. https://doi.org/10.1146/annurev-publhealth-040218-043750. Discusses multiple types/levels of racism and its connection to physical and mental health among minorities populations. Outlines recommendations for research on discrimination and health.CrossRefPubMedPubMedCentral

59.

Hunte HE, Williams DR. The association between perceived discrimination and obesity in a population-based multiracial and multiethnic adult sample. Am J Public Health. 2009;99:1285–92. https://doi.org/10.2105/AJPH.2007.128090.CrossRefPubMedPubMedCentral

60.

• Brown KL, Hines AL, Hagiwara N, Utsey S, Perera RA, LaRose JG. The weight of racial discrimination: examining the association between racial discrimination and change in adiposity among emerging adult women enrolled in a behavioral weight loss program. J Racial Ethn Health Disparities. 2022:909–20. https://doi.org/10.1007/s40615-021-01030-7. Investigates the relationship between racial discrimination and treatment response as well as explores possible risk and protective factors in emerging adults enrolled in an adapted behavioral weight loss program.

61.

Hunte HE. Association between perceived interpersonal everyday discrimination and waist circumference over a 9-year period in the midlife development in the United States cohort study. Am J Epidemiol. 2011;173:1232–9. https://doi.org/10.1093/aje/kwq463.CrossRefPubMedPubMedCentral

62.

Smart JF, Smart DW. Acculturative stress: the experience of the Hispanic immigrant. Couns Psychol. 1995;23:25–42. https://doi.org/10.1177/0011000095231003.CrossRef

63.

Cuy CD. Dietary acculturation in Latinos/Hispanics in the United States. Am J Lifestyle Med. 2015;9:31–6. https://doi.org/10.1177/1559827614552960.CrossRef

64.

Delavari M, Sønderlund AL, Swinburn B, Mellor D, Renzaho A. Acculturation and obesity among migrant populations in high income countries—a systematic review. BMC Public Health. 2013;13:458. https://doi.org/10.1186/1471-2458-13-458.CrossRefPubMedPubMedCentral

65.

•• Goode RW, Cowell MM, Mazzeo SE, et al. Binge eating and binge-eating disorder in Black women: a systematic review. Int J Eat Disord. 2020;53:491–507. https://doi.org/10.1002/eat.23217. Synthesizes literature on the prevalence and treatment of binge eating and binge eating disorder in Black women. Highlights the lack of access to and underutilization of binge eating and binge eating disorder treatment.CrossRefPubMedPubMedCentral

66.

Rodgers RF, Berry R, Franko DL. Eating disorders in ethnic minorities: an update. Curr Psychiatry Rep. 2018;20:90. https://doi.org/10.1007/s11920-018-0938-3.CrossRefPubMed

67.

Cachelin FM, Thomas C, Vela A, Gil-Rivas V. Associations between meal patterns, binge eating, and weight for Latinas. Int J Eat Disord. 2017;50:32–9. https://doi.org/10.1002/eat.22580.CrossRefPubMed

68.

Cachelin FM, Striegel-Moore RH. Help seeking and barriers to treatment in a community sample of Mexican American and European American women with eating disorders. Int J Eat Disord. 2006;39:154–61. https://doi.org/10.1002/eat.20213.CrossRefPubMed

69.

Capodilupo CM, Kim S. Gender and race matter: the importance of considering intersections in Black women’s body image. J Couns Psychol. 2014;61:37–49. https://doi.org/10.1037/a0034597.CrossRefPubMed

70.

Kelch-Oliver K, Ancis JR. Black women’s body image: an analysis of culture-specific influences. Women Ther. 2011;34:345–58. https://doi.org/10.1080/02703149.2011.592065.CrossRef

71.

Mama SK, Quill BE, Fernandez-Esquer ME, Reese-Smith JY, Banda JA, Lee RE. Body image and physical activity among Latina and African American women. Ethn Dis. 2011;21:281–287. https://www.ethndis.org/priorarchives/ethn-21-03-281.pdf.

72.

• Quiñones IC, Herbozo S, Haedt-Matt AA. Body dissatisfaction among ethnic subgroups of Latin women: an examination of acculturative stress and ethnic identity. Body Image. 2022;41:272–83. https://doi.org/10.1016/j.bodyim.2022.03.006. Examines the roles of acculturative stress and ethnic identification in the association between body dissatisfaction and ethnic subgroup as well as the role of ethnic identification in the association between acculturative stress and body dissatisfaction.CrossRefPubMed

73.

• Boutté RL, Burnette CB, Mazzeo SE. BMI and disordered eating in black college women: the potential mediating role of body appreciation and moderating role of ethnic identity. J Black Psychol. 2022. https://doi.org/10.1177/00957984211069064. Evaluate the associations among body appreciation, body dissatisfaction, and disordered eating in Black women as well as the role of body appreciation and ethnic identity in the association between body mass index and disordered eating.

74.

Cho S, Crenshaw KW, McCall L. Toward a field of intersectionality studies: theory, applications, and praxis. Signs J Women Cult Soc. 2013;38:785–810. https://doi.org/10.1086/669608.CrossRef

75.

Crenshaw KW. Demarginalizing the intersection of race and sex: a Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics, University of Chicago Legal Forum. 1989:139–167. https://heinonline.org/HOL/LandingPage?handle=hein.journals/droitsc108&div=17&id=&page=.

76.

Lewis JA, Mendenhall R, Harwood SA, Huntt MB. Coping with gendered racial microaggressions among Black women college students. J Afr Am Stud. 2013;17:51–73. https://doi.org/10.1007/s12111-012-9219-0.CrossRef

77.

Williamson DA. Fifty years of behavioral/lifestyle interventions for overweight and obesity: where have we been and where are we going? Obesity. 2017;25:1867–75. https://doi.org/10.1002/oby.21914.CrossRefPubMed

78.

• Wadden TA, Tronieri JS, Butryn ML. Lifestyle modification approaches for the treatment of obesity in adults. Am Psychol. 2020;75:235–51. https://doi.org/10.1002/oby.21914. Reviews the key components of comprehensive lifestyle modification and summarizes the efficacy of lifestyle interventions and use of new technology and evolving delivery methods.CrossRefPubMedPubMedCentral

79.

Wingo BC, Carson TL, Ard J. Differences in weight loss and health outcomes among African Americans and whites in multicentre trials. Obes Rev. 2014;15:46–61. https://doi.org/10.1111/obr.12212.CrossRefPubMed

80.

West DS, Elaine Prewitt T, Bursac Z, Felix HC. Weight loss of black, white, and Hispanic men and women in the Diabetes Prevention Program. Obesity. 2008;16:1413–20. https://doi.org/10.1038/oby.2008.224.CrossRefPubMed

81.

•• Blackman Carr LT, Samuel-Hodge CD, Ward DS, Evenson KR, Bangdiwala SI, Tate DF. Comparative effectiveness of a standard behavioral and physical activity enhanced behavioral weight loss intervention in Black women. Women Health. 2020;60:676–91. https://doi.org/10.1080/03630242.2019.1700585. Investigates the effectiveness of culturally relevant, physical activity-enhanced behavioral weight loss intervention to a standard behavioral weight loss intervention in Black women during a 6-month period.CrossRefPubMed

82.

Ard JD, Carson TL, Shikany JM, Li Y, Hardy CM, Robinson JC, et al. Weight loss and improved metabolic outcomes amongst rural African American women in the Deep South: six-month outcomes from a community-based randomized trial. J Intern Med. 2017;282:102–13. https://doi.org/10.1111/joim.12622.CrossRefPubMedPubMedCentral

83.

Sbrocco T, Carter MM, Lewis EL, Vaughn NA, Kalupa KL, King S, et al. Church-based obesity treatment for African-American women improves adherence. Ethn Dis. 2005;15:246–55.PubMed

84.

Butryn ML, Forman EM, Lowe MR, Gorin AA, Zhang F, Schaumberg K. Efficacy of environmental and acceptance-based enhancements to behavioral weight loss treatment: the ENACT trial. Obesity. 2017;25:866–72. https://doi.org/10.1002/oby.21813.CrossRefPubMed

85.

Corona E, Flores YN, Arab L. Trends in evidence-based lifestyle interventions directed at obese and overweight adult Latinos in the US: a systematic review of the literature. J Community Health. 2016;41:667–73. https://doi.org/10.1007/s10900-015-0119-9.CrossRefPubMed

86.

Koniak-Griffin D, Brecht ML, Takayanagi S, Villegas J, Melendrez M, Balcázar HA. Community health worker-led lifestyle behavior intervention for Latina (Hispanic) women: feasibility and outcomes of a randomized controlled trial. Int J Nurs Stud. 2015;52:75–87. https://doi.org/10.1016/j.ijnurstu.2014.09.005.CrossRefPubMed

87.

Carlos Poston WS, Reeves RS, Haddock CK, Stormer S, Balasubramanyam A, Satterwhite O, et al. Weight loss in obese Mexican Americans treated for 1-year with orlistat and lifestyle modification. Int J Obes. 2003;27:1486–93. https://doi.org/10.1038/sj.ijo.0802439.CrossRef

88.

Marquez B, Anderson A, Wing RR, West DS, Newton RL, Meacham M, et al. The relationship of social support with treatment adherence and weight loss in Latinos with type 2 diabetes. Obesity. 2016;24:568–75. https://doi.org/10.1002/oby.21382.CrossRefPubMed

89.

Walker RE, Gordon M. The use of lifestyle and behavioral modification approaches in obesity interventions for black women: a literature review. Health Educ Behav. 2014;41:242–58. https://doi.org/10.1177/1090198113492768.CrossRefPubMed

90.

Yanovski SZ, Yanovski JA. Progress in pharmacotherapy for obesity. JAMA. 2021;326:129–30. https://doi.org/10.1001/jama.2021.9486.CrossRefPubMedPubMedCentral

91.

Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, et al. Tirzepatide once weekly for the treatment of obesity. New Eng J Med. 2022;387:205–16. https://doi.org/10.1056/NEJMoa2206038.CrossRefPubMed

92.

Khera R, Murad MH, Chandar AK, Dulai PS, Wang Z, Prokop LJ, et al. Association of pharmacological treatments for obesity with weight loss and adverse events: a systematic review and meta-analysis. JAMA. 2016;315:2424–34. https://doi.org/10.1001/jama.2016.7602.CrossRefPubMedPubMedCentral

93.

Shi Q, Wang Y, Hao Q, Vandvik PO, Guyatt G, Li J, et al. Pharmacotherapy for adults with overweight and obesity: a systematic review and network meta-analysis of randomised controlled trials. Lancet. 2022;399:259–69. https://doi.org/10.1016/S0140-6736(21)01640-8. Synthesizes the literature on anti-obesity medication and examines the efficacy of anti-obesity medication for adults. Identifies phentermine–topiramate as highly effective compared to lifestyle modification alone.CrossRefPubMed

94.

Wilding JP, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384:989–1002. https://doi.org/10.1056/NEJMoa2032183.CrossRefPubMed

95.

•• Osei-Assibey G, Adi Y, Kyrou I, Kumar S, Matyka K. Pharmacotherapy for overweight/obesity in ethnic minorities and White Caucasians: a systematic review and meta-analysis. Diabetes Obes Metab. 2011;13:385–93. https://doi.org/10.1111/j.1463-1326.2010.01346.x. Synthesizes the literature on anti-obesity medications and compares the efficacy of anti-obesity medication between ethnic minorities and White Caucasians. Highlights that few studies were identified for comparison which prevented analyses by ethnic groups.CrossRefPubMed

96.

O’Neil PM, Garvey WT, Gonzalez-Campoy JM, Mora P, Ortiz RV, Guerrero G, Claudius B, Pi-Sunyer X. Effects of liraglutide 3.0 mg on weight and risk factors in Hispanic versus non-Hispanic populations: subgroup analysis from scale randomized trials. Endocr Pract. 2016;22:1277–87. https://doi.org/10.4158/EP151181.OR.

97.

Elangovan A, Shah R, Smith ZL. Pharmacotherapy for obesity—trends using a population level national database. Obes Surg. 2021;31:1105–12. https://doi.org/10.1007/s11695-020-04987-2.CrossRefPubMed

98.

Xing S, Sharp LK, Touchette DR. Weight loss drugs and lifestyle modification: perceptions among a diverse adult sample. Patient Educ Couns. 2017;100:592–7. https://doi.org/10.1016/j.pec.20161.004.CrossRefPubMed

99.

Courcoulas AP, King WC, Belle SH, Berk P, Flum DR, Garcia L, et al. Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) study. JAMA Surg. 2018;153:427–34. https://doi.org/10.1001/jamasurg.2017.5025.CrossRefPubMed

100.

Howard R, Chao GF, Yang J, Thumma JR, Arterburn DE, Telem DA, et al. Medication use for obesity-related comorbidities after sleeve gastrectomy or gastric bypass. JAMA Surg. 2022;157:248–56. https://doi.org/10.1001/jamasurg.2021.6898.CrossRefPubMedPubMedCentral

101.

Aminian A, Tu C, Milinovich A, Wolski KE, Kattan MW, Nissen SE. Association of weight loss achieved through metabolic surgery with risk and severity of COVID-19 infection. JAMA Surg. 2022;157:221–30. https://doi.org/10.1001/jamasurg.2021.6496.CrossRefPubMed

102.

Byrd AS, Toth AT, Stanford FC. Racial disparities in obesity treatment. Curr Obes Rep. 2018;7:130–8. https://doi.org/10.1007/s13679-018-0301-3.CrossRefPubMedPubMedCentral

103.

Altieri MS, Yang J, Yin D, Talamini MA, Spaniolas K, Pryor AD. Patients insured by Medicare and Medicaid undergo lower rates of bariatric surgery. Surg Obes Relat Dis. 2019;15:2109–14. https://doi.org/10.1016/j.soard.2019.05.001.CrossRefPubMed

104.

•• Johnson-Mann C, Martin AN, Williams MD, Hallowell PT, Schirmer B. Investigating racial disparities in bariatric surgery referrals. Surg Obes Relat Dis. 2019;15:615–20. https://doi.org/10.1016/j.soard.2019.02.002. Evaluates referral patterns for bariatric surgery from a primary care clinic among Black, Latino, and white adults.CrossRefPubMed

105.

•• Kröner Florit PT, Corral Hurtado JE, Wijarnpreecha K, Elli EF, Lukens FJ. Bariatric surgery, clinical outcomes, and healthcare burden in Hispanics in the USA. Obes Surg. 2019;29:3646–52. https://doi.org/10.1007/s11695-019-04047-4. Investigates the utilization of bariatric surgery and associated healthcare outcomes in Latino adults compared to non-Latino adult using national database.

106.

Sundaresan N, Roberts A, Thompson KJ, McKillop IH, Barbat S, Nimeri A. Examining the Hispanic paradox in bariatric surgery. Surg Obes Relat Dis. 2020;16:1392–400. https://doi.org/10.1016/j.soard.2020.06.009.CrossRefPubMed

107.

Hoffman AB, Myneni AA, Orom H, Schwaitzberg SD, Noyes K. Disparity in access to bariatric surgery among African-American men. Surg Endosc. 2020;34:2630–7. https://doi.org/10.1007/s00464-019-07034-z.CrossRefPubMed

108.

•• Turner M, Vigneswaran Y, Dewey E, Wolfe BM, Stroud AM, Spight D, et al. Weight loss and co-morbidity resolution between different races and ethnicities after gastric bypass. Surg Obes Relat Dis. 2019;15:1943–8. https://doi.org/10.1016/j.soard.2019.09.061. Examines weight-loss and remission of obesity-related co-morbidities by race and ethnicity in multicenter, observational study over a 5-year follow-up.CrossRefPubMed

109.

Istfan N, Anderson WA, Apovian C, Ruth M, Carmine B, Hess D. Racial differences in weight loss, hemoglobin A1C, and blood lipid profiles after Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis. 2016;12:1329–36. https://doi.org/10.1016/j.soard.2015.12.028.CrossRefPubMed

110.

•• Thomas DD, Anderson WA, Apovian CM, Hess DT, Yu L, Velazques A, et al. Weight recidivism after Roux-en-Y gastric bypass surgery: an 11-year experience in a multiethnic medical center. Obesity. 2019;27:217–25. https://doi.org/10.1002/oby.22360. Examines influence of race and type 2 diabetes on weight recidivism after Roux-en-Y gastric bypass surgery at a single center.CrossRefPubMed

111.

Coleman KJ, Brookey J. Gender and racial/ethnic background predict weight loss after Roux-en-Y gastric bypass independent of health and lifestyle behaviors. Obes Surg. 2014;24:1729–36. https://doi.org/10.1007/s11695-014-1268-0.CrossRefPubMed

112.

Khorgami Z, Arheart KL, Zhang C, Messiah SE, de la Cruz-Muñoz N. Effect of ethnicity on weight loss after bariatric surgery. Obes Surg. 2015;25:769–76. https://doi.org/10.1007/s11695-014-1474-9.CrossRefPubMed

113.

King RA, Patel KC, Mark VM, Shah A, Laferrère B. Role of ethnicity on weight loss and attrition after bariatric surgery. Obes Surg. 2019;29:3577–80. https://doi.org/10.1007/s11695-019-04029-6.CrossRefPubMed

114.

•• Mocanu V, Dang JT, Switzer N, Madsen K, Birch DW, Karmali S. Sex and race predict adverse outcomes following bariatric surgery: an MBSAQIP analysis. Obes Surg. 2020;30:1093–101. https://doi.org/10.1007/s11695-020-04395-6. Investigates predictive factors for mortality and major complications following bariatric surgery using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data registry.CrossRefPubMed

115.

Nafiu OO, Mpody C, Michalsky MP, Tobias JD. Unequal rates of postoperative complications in relatively healthy bariatric surgical patients of white and black race. Surg Obes Relat Dis. 2021;17:1249–55. https://doi.org/10.1016/j.soard.2021.04.011.CrossRefPubMed

116.

•• Welsh LK, Luhrs AR, Davalos G, Diaz R, Narvaez A, Perez JE, et al. Racial disparities in bariatric surgery complications and mortality using the MBSAQIP data registry. Obes Surg. 2020;30:3099–110. https://doi.org/10.1007/s11695-020-04657-3. Evaluates the associations between race and 30-day complications using Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data registry.CrossRefPubMedPubMedCentral

117.

Coffman MJ, de Hernandez BU, Smith HA, McWilliams A, Taylor YJ, Tapp H, et al. Using CBPR to decrease health disparities in a suburban Latino neighborhood. Hisp Health Care Int. 2017;15:121–9. https://doi.org/10.1177/1540415317727569.CrossRefPubMedPubMedCentral

118.

•• Carr LT, Bell C, Alick C, Bentley-Edwards KL. Responding to health disparities in behavioral weight loss interventions and COVID-19 in black adults: recommendations for health equity. J Racial Ethn Health Disparities. 2022;22:1–9. https://doi.org/10.1007/s40615-022-01269-8. Discusses how systematic racism may perpetuate obesity and COVID-19 severity in Black adults. Outlines recommendations to improve obesity treatment for Blacks and directions for policy change.CrossRef

119.

•• U.S. Department of Health and Human Services. Social determinants of health. 2020. https://health.gov/healthypeople/priority-areas/social-determinants-health. Describes social determinants of change and how Healthy People 2030 addresses these factors.

120.

Derose KP, Williams MV, Branch CA, Flórez KR, Hawes-Dawson J, Mata MA, et al. A community-partnered approach to developing church-based interventions to reduce health disparities among African-Americans and Latinos. J Racial Ethn Health Disparities. 2019;6:254–64. https://doi.org/10.1007/s40615-018-0520-z.CrossRefPubMed

121.

Kim KH, Linnan L, Campbell MK, Brooks C, Koenig HG, Wiesen C. The WORD (wholeness, oneness, righteousness, deliverance): a faith-based weight-loss program utilizing a community-based participatory research approach. Health Educ Behav. 2008;35:634–50. https://doi.org/10.1177/1090198106291985.CrossRefPubMed

122.

LaRose JG, Lanoye A, Ferrell D, Lu J, Mosavel M. Translating evidence-based behavioral weight loss into a multi-level, community intervention within a community-based participatory research framework: the Wellness Engagement (WE) Project. Transl Behav Med. 2021;11:1235–43. https://doi.org/10.1093/tbm/ibaa140.CrossRefPubMedPubMedCentral

123.

Brooks F, Kendall S. Making sense of assets: what can an assets based approach offer public health? Crit Public Health. 2013;23:127–30. https://doi.org/10.1080/09581596.2013.783687.CrossRef

124.

Puhl RM, Andreyeva T, Brownell KD. Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. Int J Obes. 2008;32:992–1000. https://doi.org/10.1038/ijo.2008.22.CrossRef

125.

•• Pickett S, Burchenal CA, Haber L, Batten K, Phillips E. Understanding and effectively addressing disparities in obesity: a systematic review of the psychological determinants of emotional eating behaviours among Black women. Obes Rev. 2020;21:e13010. https://doi.org/10.1111/obr.13010. Synthesizes the literature examining the influence of psychological factors on emotional eating and weight in Black women.

126.

Neumark-Sztainer D. Higher weight status and restrictive eating disorders: an overlooked concern. J Adolesc Health. 2015;56:1–2. https://doi.org/10.1016/j.jadohealth.2014.10.261.CrossRefPubMed

127.

Heymsfield SB, Peterson CM, Thomas DM, Heo M, Schuna JM Jr. Why are there race/ethnic differences in adult body mass index-adiposity relationships? A quantitative critical review. Obes Rev. 2016;17:262–75. https://doi.org/10.1111/obr.12358.CrossRefPubMed

128.

Roberto CA, Galbraith K, Lydecker JA, Ivezaj V, Barnes RD, White MA, et al. Preferred descriptions for loss of control while eating and weight among patients with binge eating disorder. Psychiatry Res. 2016;246:548–53. https://doi.org/10.1016/j.psychres.2016.09.045.CrossRefPubMedPubMedCentral

129.

Lydecker JA, Galbraith K, Ivezaj V, White MA, Barnes RD, Roberto CA, Grilo CM. Words will never hurt me? Preferred terms for describing obesity and binge eating. Int J Clin Pract. 2016;70:682–90. https://doi.org/10.1111/ijcp.12835.CrossRefPubMed

Title: A Call to Reconceptualize Obesity Treatment in Service of Health Equity: Review of Evidence and Future Directions
Authors: Sylvia Herbozo
Kristal Lyn Brown
Natasha L. Burke
Jessica Gokee LaRose
Publication date: 02-02-2023
Publisher: Springer US
Keywords: Obesity
Obesity
Published in: Current Obesity Reports / Issue 1/2023
Electronic ISSN: 2162-4968
DOI: https://doi.org/10.1007/s13679-023-00493-5

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Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

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Keynote webinar | Spotlight on medication adherence

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Keynote webinar | Spotlight on medication adherence

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At a glance: The STEP trials