Effective Weight Management Strategies May be a Click Away - Ethnic Differences in Response to Fast Food Marketing

Two new studies suggest that the Internet is an effective aid in helping people lose weight and keep it off. The research was presented today at the 2005 Annual Scientific Meeting of NAASO, The Obesity Society. Other new research presented today reveals how social-psychological differences between various ethnic groups influence their response to fast food promotion.

Randomized Trial of an Interactive Internet Weight Loss Program: Six-Month Results (8-OR; 11:30 a.m. PT) Although there is a general perception that military personnel are fit and at a healthy weight, the prevalence of overweight and obesity in that population is similar to the general public, with 57 percent of the U.S. Air Force overweight or obese. This prevalence has increased by three to four percent each year for the last five years.

In one study of 452 overweight U.S. Air Force personnel, significantly more participants who supplemented usual care weight loss efforts with a Minimal Contact Behavioral Internet Therapy (MCBIT) met the five percent or more weight loss goal than those who relied on usual care alone. All of the participants were five pounds below the Air Force's Maximum Allowable Weight (MAW) or heavier.

"Despite how commonplace it is, there is a stigma in the military about being overweight and joining a weight loss program," said Christine Hunter, Ph.D., chief, Air Force Substance Abuse Program Development for the U.S. Air Force, who led the study. "Finding programs that offer a private atmosphere to promote healthy weight management and overcome the barriers to attending a group program are essential to ensure the health and readiness of military personnel."

The MCBIT group received a comprehensive weight loss program consisting of a self-help book, two motivational phone calls and an interactive Internet weight loss program where they received weekly feedback of food and exercise diaries. The usual care group selected their own weight loss program, such as Weight Watchers or a military-sponsored program.

Over 24 weeks, the MCBIT group lost weight compared to a weight gain seen in the usual care group. MCBIT participants who were above MAW lost an average of 1.2 kilograms, compared to a half kilogram gain in the usual care group. MCBIT participants who began the study under MAW lost an average of 2.7 kilograms, compared to a one kilogram gain in the usual care group. The Internet group also experienced significantly more favorable changes in waist circumference and body fat. Specifically, 23.2 percent of those participants who were above MAW lost at least five percent of initial body weight compared to only 7.4 percent of the usual care group.

"An Internet-based program may be of particular importance for military personnel who relocate frequently or who are deployed out of the country," noted Dr. Hunter.

Can We STOP Regain After Successful Weight Loss: 18-month Results of a Randomized Trial (7-OR; 11:15 a.m. PT)

A second study found that an Internet-based counseling program helped participants who recently lost a significant amount of weight prevent regain. According to Rena Wing, Ph.D., the lead investigator of the study, about 80 percent of people who lose a large amount of weight regain it over time.

Dr. Wing and colleagues compared face-to-face, Internet and newsletter interventions to prevent regain over 18 months in 314 individuals who had recently lost an average of 44 pounds.

The study was unique in that it is the first weight maintenance trial to draw its participants from a variety of other weight loss trials. Typically, participants continue in the same trial for weight loss and maintenance. The face-to-face and Internet programs had identical comprehensive content that included the same frequency of face-to-face or online group meetings/counseling, respectively. Median weight regain was 2.5 pounds in the face-to-face group, 6.0 pounds in the Internet group and 10.4 pounds in the newsletter group.

"While the participants receiving face-to-face counseling fared the best, our study suggests that Internet-based weight maintenance programs can provide a level of personal counseling, skill-building and motivation important in helping people sustain weight loss," said Dr. Wing, professor of psychiatry and human behavior at Brown Medical School in Providence, RI.

Many of the strategies employed in the face-to-face and Internet interventions were gleaned from the National Weight Control Registry, a registry of more than 4,000 individuals who have successfully lost and kept off weight. Among these strategies was daily weighing, which helped alert participants if they were headed into the "red zone" of gaining more than five pounds. According to Dr. Wing, daily weighing is an important component of curbing weight regain. More participants in the face-to-face and Internet groups weighed themselves daily (71 percent and 65.2 percent, respectively) compared to just 28.9 percent of the newsletter group. Daily weighing was associated with prevention of weight regain - but only in the Internet and face-to-face conditions. This suggests that participants in those two groups were able to use the information from the scale to make constructive changes in their eating and exercise behaviors.

Ethnic Differences in Reported Parent/Caregiver Exposure and Responses to Fast Food Marketing (27-OR; 11:45 a.m. PT)

Another study presented today concludes that individual attitudes as well as broader acceptance by those within the same ethnic community influence how parents of different ethnic backgrounds respond and ultimately behave toward fast food marketing. There has been increased discussion about the impact of fast food marketing on rising childhood obesity rates, and this study is believed to be the first to link attitudes and norms to fast food consumption by children. The findings suggest that targeted fast food promotion may encourage unhealthy attitudes and norms toward fast food, which in turn, contribute to increased fast food consumption.

"Our study uncovered that attitudes and norms as well as perceptions of fast food convenience vary by ethnic group, and these differences influence consumption behavior, rather than the amount of exposure to fast food promotion being the sole driver of consumption behavior," noted Sonya Grier, Ph.D., Robert Wood Johnson Health and Society Scholar at the University of Pennsylvania, the lead investigator and former food industry market researcher.

The research was conducted by The Children's Hospital of Philadelphia in eight medically underserved communities in New York, New Jersey, Virginia, West Virginia, Maryland and Puerto Rico. The study of 300 African American, Asian, Hispanic (black and white) and Non-Hispanic white caregivers of children two to 12 years old points to three factors that contribute to fast food consumption, which vary by ethnicity.

-Caregivers who reported more exposure to fast food promotions tend to feel that eating fast food is acceptable and normative (i.e., more desirable to others around them) -Caregivers who perceived that fast food restaurants are conveniently located for them tend to hold more positive attitudes about fast food -Caregiver reports of more favorable social norms and more positive attitudes toward fast food is related to greater consumption of fast food by their children.

Analyses also demonstrated ethnic group differences in perceptions about fast food marketing: Asians reported that they see less fast food promotion than all other groups, and they also reported less favorable social norms than all other groups; whites reported fast food restaurants being less conveniently located to them than all other groups; Asians and whites reported less favorable attitudes toward fast food than blacks and Hispanics; and finally, whites reported that their children eat significantly less fast food than children of Hispanic parents.

Rates of childhood obesity have been steadily increasing, with approximately 16 percent of children classified as overweight. Prevalence of overweight is especially high among certain populations such as Mexican Americans, African Americans and Native Americans, with rates of overweight above 20 percent. NAASO, The Obesity Society, is a leading scientific society dedicated to the study of obesity. NAASO is committed to encouraging research on the causes, treatment and prevention of obesity as well as to keeping the scientific community and public informed of new advances in the field. For more information about NAASO and obesity, visit www.naaso.org or call (301) 563-6526.