Community-based Weight Management Research Articles

Risk Factors Associated With General and Abdominal Obesity Among South Asian Minorities in Hong Kong.

South Asians have become a sizable ethnic minority in Hong Kong with unique health and social needs often being overlooked. Elevated obesity risk among South Asians has been highlighted in high-income Western settings; however, relevant local evidence is scarce. This cross-sectional study aims to explore the obesity prevalence and related risk factors among South Asians in Hong Kong. Between June 2022 and February 2023, 535 South Asian adults were recruited via territory-wide health outreach services, and completed a survey and anthropometric measurements on height, weight, and waist circumference. In our female-dominated sample (84.1% female; mean age = 41.0 ± 12.3 years), the observed prevalence of general obesity (body mass index [BMI] ≥ 27.5 kg/m2 for South Asians) and abdominal obesity (waist-to-height ratio [WHtR] > 50%) were 60.2% and 89.4%, respectively. Results from multivariable linear regressions showed that mean BMI and WHtR were significantly higher among women and Pakistani individuals (and Nepalese individuals for BMI only) but lower among better educated and employed respondents. Apart from age, household size, and marital status as common risk factors, having a healthier diet and higher physical activity level were also associated with lower WHtR. Notably, the associations of female gender and Pakistani ethnicity were attenuated after adjustments for socioeconomic and lifestyle factors. In conclusion, there was a high prevalence of obesity in South Asian participants in this study. The identified risk and protective factors could inform targeted services and community-based weight management programs to mitigate obesity and its associated cardiometabolic risks in this fast-growing but vulnerable community.

Impact of a Community-Based Weight Management Program in a North Carolina Health Care System.

Current strategies for obesity management in primary care leave many patients inadequately treated or unable to access treatment entirely. We aimed to evaluate a comprehensive, primary care clinic-based weight management program's clinical effectiveness in a community practice setting. Methods: This was an18-month pre/postintervention study. We collected demographic and anthropometric data on patients enrolled in a primary care-based weight management program.The primary outcomes were percent weight loss postintervention and the proportion of patients who achieved a clinically significant total body weight loss (TBWL) of 5% or greater. Results: Our program served 550 patients over 1,952 visits from March 2019 through October 2020.A total of 209 patients had adequate program exposure, defined as four or more completed visits. Among these, all received targeted lifestyle counseling and 78% received antiobesitymedication.Patients who attended at least four visits had an average TBWL of 5.7% compared to an average gain of 1.5% total body weight for those with only one visit. Fifty-three percent of patients (n=111)achieved greater than 5% TBWL, and 20%(n=43)achieved greater than 10% TBWL. We demonstrated that a community-based weight management program delivered by obesity medicine-trained primary care providers effectively produces clinically significant weight loss. Future work will include wider implementation of this model to increase patient access to evidence-based obesity treatments in their communities.

Early Effects of Improved Mood on Propensity for Emotional Eating During the Physical Activity-only Phase of a Community-Based Behavioral Treatment for Obesity in Women with High Mood Disturbance

Weight loss beyond the short term is problematic for individuals with obesity. Especially for women, emotional eating is one of the greatest barriers and might require attention early in a behavioral weight-loss program. Physical activity-associated mood improvement may be associated with reduced emotional eating. Women with obesity volunteered for a community-based weight-management treatment. Effects associated with the initial 10 weeks, which focused on behavioral support of physical activity (prior to addressing eating behavior change), were assessed. Groups were designated based on whether participants’ high total mood disturbance (TMD) scores reduced to a normal level (n = 45) or remained high (n = 27). Although significant overall improvements in emotional eating were found, F(1, 70) = 22.80, p < .001, its change scores did not significantly differ by group, F(1, 70) = 0.82, p = .370. Using aggregated data, the prediction of reduction in emotional eating by lowered TMD scores was not statistically significant. Adding change in self-efficacy for controlled eating into Step 2 of the regression model significantly increased the explained variance to R2 = .10, p = .014, with group not being a significant contributor when added in Step 3. TMD reduction was significantly predicted by increase in physical activity, β = -.23, p = .028, and completion of at least 3 bouts/week, rpb = -.22, p= .015. Because physical activity-related reductions in negative mood and increases in self-efficacy were associated with reduced emotional eating, viability for those behavioral factors as early treatment targets were signaled.

Changes In Self-Determination Constructs Among Breast Cancer Survivors Participating In A Community-Based Lifestyle Weight Management Program

Changes In Self-Determination Constructs Among Breast Cancer Survivors Participating In A Community-Based Lifestyle Weight Management Program

Sequential Mediation of the Relation of Increased Physical Activity and Weight Loss by Mood and Emotional Eating Changes: Community-Based Obesity Treatment Development Guided by Behavioral Theory.

Psychological/behavioral correlates of weight loss, including emotional eating, require improved understandings. These might be especially useful in the context of community-based interventions. Women with obesity, enrolled in 6-month community-based weight loss treatments emphasizing either self-regulation (n = 54) or typical educational methods (n = 52), were evaluated on changes in physical activity/exercise, mood, emotional eating, and weight. Significant improvements on each measure were found in both groups, with significantly greater advances made in the self-regulation emphasis group. Using a lagged variable analytic framework, change in emotional eating significantly mediated physical activity → weight change (over both 6 and 12 months) relationships. Group membership moderated only the mood → emotional eating change relationship. Paths from changes in physical activity → mood → emotional eating → weight were significant, with no alternate path reaching significance. Group was not a significant moderator. Identified paths from physical activity to weight loss, through sequential changes in mood and then emotional eating, should be leveraged to guide community-based weight management curricular development and application. Through such large-scale possibilities for dissemination, means for the reversal of the obesity epidemic could be made possible.

Links between obesity, weight stigma and learning in adolescence: a qualitative study

BackgroundEducational attainment is a key social determinant of health. Health and education are linked by multiple pathways, many of which are not well understood. One such pathway is the association between being above a healthy weight and lower academic achievement. While various explanations have been put forward to explain this relationship, evidence for causal pathways is sparse and unclear. This study addresses that evidence gap.MethodsWe interviewed 19 adults (late 20s; 14 female, 5 male) and one young person (14 years, male) from the UK in 2019/2020. Participants were recruited from the ALSPAC 1990s birth cohort, sampled to ensure diversity in socio-economic status and educational attainment, and a community-based weight management group for young people. Interviews focused on experiences of being above a healthy weight during secondary school and how this may have affected their learning and achievement. Interviews were face-to-face, digitally recorded, and transcribed verbatim. We analysed the data thematically.ResultsWe identified key pathways through which higher body weight may negatively impact educational performance and showed how these are linked within a novel theoretical model. Because larger body size is highly stigmatised, participants engaged in different strategies to minimise their exposure to negative attention. Participants sought to increase their social acceptance or become less socially visible (or a combination of both). A minority navigated this successfully; they often had many friends (or the ‘right’ friends), experienced little or no bullying at school and weight appeared to have little effect on their achievement at school. For most however, the behaviours resulting from these strategies (e.g. disruptive behaviour, truanting, not working hard) or the physical, social or mental impacts of their school experiences (e.g. hungry, tired, self-conscious, depressed) made it difficult to concentrate and/or participate in class, which in turn affected how teachers viewed them.ConclusionsAction to combat weight stigma, both within schools and in wider society, is urgently required to help address these educational disparities that in turn can impact health in later life.

Can A Community-Based Weight Management Programme, that is Scalable, Provide Effective Diabetes Management Support for Adults with T1D or T2D: A Mixed Methods Evaluation

Can A Community-Based Weight Management Programme, that is Scalable, Provide Effective Diabetes Management Support for Adults with T1D or T2D: A Mixed Methods Evaluation

How weight and body size affect learning: a qualitative exploration of experiences in secondary school

BackgroundBeing above a healthy weight is associated with lower academic achievement. Various explanations have been put forward to explain this association, but evidence for causal pathways is sparse and unclear. This study sought to qualitatively explore the association between bodyweight, body size, and learning. MethodsWe interviewed 19 adults (late 20s; 14 women, five men) and one young person (14 years, male) from the UK in 2019–20. Ethnicity was not formally recorded. Adult participants were recruited from the ALSPAC 1990s birth cohort, sampled to ensure diversity in socioeconomic status and educational attainment; the teenage participant was recruited from a youth community-based weight management group. Interviews focused on experiences of being above a healthy weight (self-identified) during secondary school and on how this bodyweight might have affected their learning and achievement. Interviews were face-to-face, digitally recorded, and transcribed verbatim. We analysed the data thematically to create three key themes linked within a theoretical model. Ethics approval for this study was obtained from the ALSPAC Ethics and Law Committee (86964) and the Faculty of Health Sciences Research Ethics Committee (85702) at the University of Bristol FindingsBecause a larger body size is highly stigmatised, all participants engaged in different strategies to minimise their exposure to negative attention. Participants sought to either increase their social acceptance or become less socially visible (or a combination of both). Three participants appeared to navigate this experience successfully: they had many friends (or the right friends), experienced little or no bullying at school, and weight appeared to have little effect on their achievement at school. For most, however, school was a negative social environment, and the behaviours resulting from these strategies (eg, disruptive behaviour, truanting, not working hard) or the physical, social, or mental impacts of their school experiences (eg, hungry, tired, self-conscious, depressed) made it difficult to concentrate or participate in class, which in turn affected how they felt teachers viewed them. InterpretationEngaging in negative behaviours to increase social acceptance or trying to be “invisible” in school might be key pathways through which higher bodyweight might negatively impact educational performance. Action to combat weight stigma, both within schools and in wider society, is urgently required and might help address these educational disparities. FundingThe Health Foundation.

Effective Treatment of Nonalcoholic Fatty Liver Disease Using a Community-Based Weight Management Program.

IntroductionObesity-related gastrointestinal disorders including nonalcoholic fatty liver disease (NAFLD) and gastroesophageal reflux disease (GERD) are more frequent and usually present earlier than type 2 diabetes mellitus (T2DM) and cardiovascular disorders. This provides an opportunity for the gastroenterologist to intervene early with an effective weight-loss therapy. We evaluated the outcomes of a multifaceted, community-based gastroenterologist-supervised weight management program compared with patient-directed weight-loss efforts after physician advice. The program is aimed at achieving a 10% total body weight (TBW) loss at three months, a known determinant for NAFLD regression.MethodsThis is a retrospective pre- and post-intervention study of NAFLD patients, who participated in a medically supervised weight management program in the period between May 2017 and May 2019. The program is comprised of a very-low-calorie (800 kcal/day) meal replacement diet, a recommended medical fitness program, and weekly behavioral support groups. Patients are followed on monthly basis and slowly transitioned to a whole food plant-based or Mediterranean diet after three months of participation. Patients’ weight trends driven by self-directed efforts to lose weight after physician advice were collected based on historical data up to two years prior to program participation. The primary outcome was defined as percentage TBW loss at three months under medical supervision (post-intervention) compared with patient-directed weight-loss efforts (pre-intervention). The secondary outcomes included percentage TBW loss in relation to behavioral support group attendance and improvement in GERD and T2DM disease status after program participation. Linear mixed and linear regression models were used to assess for a statistically significant difference in percentage TBW loss. Statistical significance was defined as p < 0.05.ResultsA total of 114 NAFLD patients (mean age 55 years, mean BMI 39 kg/m2, 77 females, and 37 males) completed at least three months of follow-up and were included in the study. Of those, 89 patients had a documented three-month office visit. At three months, 65% of patients had lost at least 10% of their TBW. Percentage TBW loss under medical supervision was noted to be significantly higher and occurred at a faster rate over three months when compared with patient-directed efforts after physician advice (p < 0.001). Patients who attended the behavioral support groups ≥ 50% of the time had a 3% higher TBW loss at three months compared with patients who attended <50% of the time (p = 0.006). Approximately, 52% of patients with GERD and 38% of patients with T2DM had symptoms improvement and/or medication reduction at their three-month follow-up visit.ConclusionA multifaceted, community-based, gastroenterologist supervised weight management program is effective in achieving a clinically significant TBW loss of at least 10% within three months of participation. This weight loss was greater and occurred at a faster rate when compared with patient-directed efforts. Additionally, improvement in GERD and T2DM disease status was noted in 52% and 38% of patients with these conditions, respectively. Further community-based studies of a larger scale are needed to determine the sustainability of this weight loss over one year.

Effects of Behaviorally Supported Exercise and Exercise-Induced Mood Changes on Elevated Blood Pressure and Hypertension in African American Adults with Severe Obesity

African Americans with obesity have high rates of hypertension. Exercise has been shown to significantly reduce high blood pressure; however, effects through associated reductions in anxiety and depression are unclear. African American adults with either class 2 or 3 obesity (n = 86; Mage = 43.4 years) and either elevated blood pressure (n = 16) or stage 1 (n = 33) or stage 2 (n = 37) hypertension participated in a theoretically driven community-based weight-management program. There were significant increases in exercise outputs; while systolic and diastolic blood pressure, anxiety, and depression significantly decreased from baseline–month 6. Increased exercise significantly predicted reduced anxiety, depression, and diastolic blood pressure. Change in anxiety significantly mediated the relationship between exercise and both systolic and diastolic blood pressure changes. Increasing exercise from the equivalent of 1.5 to 4.5 moderate bouts/week reduced elevated blood pressure/hypertension in African American adults with severe obesity largely through their exercise-associated improvement in anxiety.

Development and Feasibility of a Family-Based Health Behavior Intervention Using Intelligent Personal Assistants: Randomized Controlled Trial.

BackgroundIntelligent personal assistants such as Amazon Echo and Google Home have become increasingly integrated into the home setting and, therefore, may facilitate behavior change via novel interactions or as an adjunct to conventional interventions. However, little is currently known about their potential role in this context.ObjectiveThis feasibility study aims to develop the Intelligent Personal Assistant Project (IPAP) and assess the acceptability and feasibility of this technology for promoting and maintaining physical activity and other health-related behaviors in both parents and children.MethodsThis pilot feasibility study was conducted in 2 phases. For phase 1, families who were attending a community-based weight management project were invited to participate, whereas phase 2 recruited families not currently receiving any additional intervention. Families were randomly allocated to either the intervention group (received a smart speaker for use in the family home) or the control group. The IPAP intervention aimed to promote positive health behaviors in the family setting through utilization of the functions of a smart speaker and its linked intelligent personal assistant. Data were collected on recruitment, retention, outcome measures, intervention acceptability, device interactions, and usage.ResultsIn total, 26 families with at least one child aged 5 to 12 years were recruited, with 23 families retained at follow-up. Across phase 1 of the intervention, families interacted with the intelligent personal assistant a total of 65 times. Although device interactions across phase 2 of the intervention were much higher (312 times), only 10.9% (34/312) of interactions were coded as relevant (related to diet, physical activity or well-being). Focus groups highlighted that the families found the devices acceptable and easy to use and felt that the prompts or reminders were useful in prompting healthier behaviors. Some further intervention refinements in relation to the timing of prompts and integrating feedback alongside the devices were suggested by families.ConclusionsUsing intelligent personal assistants to deliver health-related messages and information within the home is feasible, with high levels of engagement reported by participating families. This novel feasibility study highlights important methodological considerations that should inform future trials testing the effectiveness of intelligent personal assistants in promoting positive health-related behaviors.Trial RegistrationISRCTN Registry ISRCTN16792534; http://www.isrctn.com/ISRCTN16792534

What Motivates Engagement in a Community-Based Behavior Change Strategy for Overweight Children?

Introduction. The success of family-based community programs for childhood obesity may be increased by promoting social-cognitive factors that influence motivation and participant engagement. Incentivizing behavior can potentially enhance engagement and encourage behavior change. This research investigated motivators to engagement with a multicomponent incentive-based strategy to improve attendance and health-related behavior change in a family community-based weight management program for overweight and obese children. Method. Qualitative analysis combining; demographic data (n = 512), survey of parents (n = 273), and stakeholder (n = 10) and family interviews (n = 24). Participants were selected from program providers and families participating in an Australian community weight management program during a randomized controlled trial (n = 512 children). Maximum variation sampling (demographics and group characteristics) and inductive thematic analysis were used. Results/Conclusion. Four factors influencing engagement were (1) personal value, (2) achievement, (3) support, and (4) overwhelm. These themes corroborated with social-cognitive factors, fostered by a combination of behavior change components in the program that increased participant accountability and intrinsic motivation. Focusing on autonomous goal planning with parental involvement, tracking of goals, and reviewing of goals may complement existing strategies in child-focused treatment programs. Low-value noncash incentives linked to goal setting for encouraging healthy eating and physical activity were well accepted and may enhance family engagement and attendance.

Effect of mHealth With Offline Antiobesity Treatment in a Community-Based Weight Management Program: Cross-Sectional Study.

BackgroundWeight loss interventions using mobile phone apps have recently shown promising results.ObjectiveThis study aimed to analyze the short-term weight loss effect of a mobile coaching intervention when it is integrated with a local public health care center and a regional hospital’s antiobesity clinic as a multidisciplinary model.MethodsA total of 150 overweight or obese adults signed up to complete an 8-week antiobesity intervention program with human coaching through a mobile platform. Paired t tests and multiple linear regression analysis were used to identify the intervention factors related to weight change.ResultsAmong the 150 participants enrolled in this study, 112 completed the 8-week weight loss intervention. Weight (baseline: mean 77.5 kg, SD 12.9; after intervention: mean 74.8 kg, SD 12.6; mean difference −2.73 kg), body mass index, waist circumference, fat mass (baseline: mean 28.3 kg, SD 6.6; after intervention: mean 25.7 kg, SD 6.3; mean difference −2.65 kg), and fat percentage all showed a statistically significant decrease, and metabolic equivalent of task (MET) showed a statistically significant increase after intervention. In multiple linear regression analysis, age (beta=.07; P=.06), △MET (beta=−.0009; P=.10), number of articles read (beta=−.01; P=.04), and frequency of weight records (beta=−.05; P=.10; R2=0.4843) were identified as significant factors of weight change. Moreover, age (beta=.06; P=.03), sex (female; beta=1.16; P=.08), △MET (beta=−.0009; P<.001), and number of articles read (beta=−.02; P<.001; R2=0.3728) were identified as significant variables of fat mass change.ConclusionsThe multidisciplinary approach, combining a mobile health (mHealth) care app by health care providers, was effective for short-term weight loss. Additional studies are needed to evaluate the efficacy of mHealth care apps in obesity treatment.

Prototyping for public health in a local context: a streamlined evaluation of a community-based weight management programme (Momenta), Northumberland, UK

ObjectivesStakeholder co-production in design of public health programmes may reduce the ‘implementation gap’ but can be time-consuming and costly. Prototyping, iterative refining relevant to delivery context, offers a potential solution....

Dose response relationship between program attendance and children\u2019s outcomes in a community based weight management program for children and their families

IntroductionThe Go4Fun program in New South Wales, Australia is a community based weight management program for overweight and obese children aged 7–13 years and their families. This study assessed the impact of the number and type of sessions attended on body mass index (BMI) z-score, fruit and vegetable intake and physical activity and sedentary behaviours to determine the number of sessions required to achieve optimal program outcomes.MethodsSecondary analysis was conducted on pre and post participant program data collected over 3.5 years. Relationships between session attendance and program outcomes were assessed using Spearman’s correlation and multivariate analyses of variance and multivariate regression. Number of sessions required to achieve optimal program outcomes was determined using piecewise linear regression.ResultsFor 3090 participants (48.5% of registrants) who attended at least five sessions, outcome measures improved significantly at post program compared with pre (p < 0.01). No relationships were seen between number and type of sessions attended and outcome measures.Children of mothers without a post-school qualification (university degree or vocational qualification) were more likely to achieve lower levels of improvements in BMI z-score (p = 0.02) and vegetable intake (P < 0.01) than those children with post-school qualified mothers (F = 3.68, p = 0.03). Children of mothers without post-school education that attended seven sessions or more achieved significantly better BMI z-score outcomes (p < 0.01) than those who attended fewer sessions.ConclusionsMaternal educational attainment influences program attendance and health and behavioural outcomes in a family based obesity treatment program.

‘There were other guys in the same boat as myself’: the role of homosocial environments in sustaining men’s engagement in health interventions

ABSTRACTCurrent approaches to obesity recommend weight control strategies that focus on energy-restricted diets and increased physical activity. However, these approaches meet with (at best) limited success despite being central to evidence, policy and practice. There is apparently more to weight loss, including potentially important psychosocial processes that affect behaviour change. Using an ethnographic and narrative approach, this study explored the psychosocial processes experienced by those attending a men-only, community-based weight management intervention. Methods of data collection included semi-structured interviews and participant observation, and thematic analysis was used to analyse and interpret the data collected. Analysis and interpretation suggests that personally meaningful psychosocial processes in participants’ accounts comprised three themes, including (1) ‘Everybody is in the same boat’: A shared safe place; (2) ‘It’s a nudge in the right direction’: Broadening horizons and a push forward; and (3) ‘You need to want to change’: Taking control. This paper concludes with some implications for future practice and research in the area of weight loss and health promotion.

Benefits for African American and white low-income 7\u201310-year-old children and their parents taught together in a community-based weight management program in the rural southeastern United States

BackgroundLow-income children and parents are at increased risk for developing overweight and obesity. Therefore, the purpose of this exploratory study was to compare whether African American and white children and parents benefitted equally from a community-based weight management intervention delivered in two rural counties in southeastern North Carolina (N.C.).MethodsWe compared the efficacy of the Family Partners for Health intervention for African American and white children and their parents by testing the three-way interaction of the intervention group according to visit and race.ResultsAfrican American children in the intervention group weighed significantly (P = 0.027) less than those in the control group, while white children in the intervention group weighed less than those in the control group, but the difference did not reach statistical significance. African American and white parents in the intervention group weighed less than their respective control groups across all three data collections, but the difference was only significant in the group of white parents (P = 0.010) at the completion of the study. At the completion of the study, African American children in the intervention group received significantly (P = 0.003) more support for physical activity than African American children in the control group. At both time points, white children in the intervention group were not significantly different from those in the control group. African American parents in the intervention group scored slightly worse in the stress management assessment compared to those in the control group, while white parents in the intervention group showed a significantly (P = 0.041) better level of stress management than those in the control group. At the completion of the study, African American parents in the intervention group scored somewhat worse in emotional eating self-efficacy compared to the scores of the African American parents in the control group, while white parents in the intervention group scored significantly (P < 0.001) better than those in the control group.ConclusionsWe were successful in affecting some outcomes in both African American and white children and parents using the same intervention.Trial registrationNCT01378806 Registered June 22, 2011.

Benefits for African American and white low-income 7–10-year-old children and their parents taught together in a community-based weight management program in the rural southeastern United States

Benefits for African American and white low-income 7–10-year-old children and their parents taught together in a community-based weight management program in the rural southeastern United States

The Weight-Focused Forms of Self-Criticising/Attacking and Self-Reassuring Scale: Confirmatory Factor Analysis and associations with control, loss of control of eating and weight in overweight and obese women.

The Weight-Focused Forms of Self-Criticising/Attacking and Self-Reassuring Scale (WFSCRS) is based on the original Forms of Self-Criticising/Attacking and Self-Reassuring Scale (FSCSRS; Gilbert etal., 2004, British Journal of Clinical Psychology, 43, 31) and assesses the inadequate and hated forms of self-criticism and the ability to self-reassure when coping with attempts to control body weight, shape, and eating. The aim of this study was to examine the factor structure, consistency, and reliability of the WFSCRS in overweight and obese women. The factorial structure of the WFSCRS was examined through a confirmatory factor analysis in 724 overweight and obese women participating in a commercial weight management programme. The scale's construct and convergent validity were also examined. The WFSCRS had a three-factor structure, similar to the FSCSRS, which fitted the data well. The WFSCRS had high internal reliability, construct, and discriminant validity. The scale was positively associated with measures of shame, body image, eating-related difficulties, symptoms of anxiety, depression, and stress, and body mass index (BMI). The two forms of self-criticism were significantly associated with higher BMI, and this effect was mediated by increased loss of control over eating (for both forms) and decreased flexible control over eating (for the hated self form). The WFSCRS is a valid measure for assessing self-reassurance and two denigratory forms (inadequate self and hated self) of self-criticism in people who are overweight and obese. The WFSCRS was developed to measure weight/shape and eating-related self-criticism and self-reassurance. The WFSCRS was examined in a large sample of overweight and obese women attending a community-based weight management programme. The WFSCRS presented a three-factor structure measuring two forms of self-criticism (inadequate self and hated self) and the ability to be self-reassuring. The two forms of self-criticism and self-reassurance are differentially associated with BMI, through the mediating effect of loss of control over eating and flexible control over eating.

The Healthy Weights Initiative: results from the first 2,000 participants.

BackgroundA free, comprehensive, adult obesity reduction program was initiated in the cities of Moose Jaw and Regina, Saskatchewan, Canada.ObjectiveThis study aimed to determine the short-term and long-term adherence outcomes, identify factors that impact long-term adherence, and measure health outcomes.MethodsThe Healthy Weights Initiative (HWI) attendance was determined by using an electronic swipe card. An on-site exercise therapist also documented physical activity, duration, and intensity, as well as attendance of dietary and cognitive behavioral therapy education classes. Logistic regression determined which factors were associated with long-term adherence (exercising three times per week at 1 year) and various health outcomes.ResultsIn this study, 2,167 participants started and 2,000 completed the 24-week program (92.3%). Upon 24-week completion, the majority of the participants in Moose Jaw (59.0%) and Regina (63.1%) purchased 1-year fitness memberships at the YMCA. At 1 year, 79.8% of the participants were exercising three times a week or more at the Moose Jaw YMCA. Logistic regression revealed that participants who did not exercise three times a week at 1 year at the YMCA were more likely to have a spouse/partner who did not support the program (OR=2.01; 95% CI=1.81–2.22) and more likely to have a medical comorbidity (OR=1.22; 95% CI=1.03–1.49). At 24 weeks, average weight loss was modest (12.7 pounds) and regressed slightly at 1 year (10.4 pounds). However, at 24 weeks, many health gains were statistically significant and were maintained for 1 year. For example, the prevalence of depressed mood reduced from 49.0% at baseline to 13.0% at 24 weeks and increased to 19.0% at 1 year (P=0.000). Conclusion: We found that the availability of a community-based weight management program (Healthy Weights Initiative) demonstrated good adherence, modest weight loss, and positive health outcomes.