Department of Psychological Sciences, University of California Irvine, Irvine, CA, USA.
School of Medicine, Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
J Behav Med. 2021 Dec;44(6):822-832. doi: 10.1007/s10865-021-00231-z. Epub 2021 May 18.
Black women have a higher prevalence of obesity and tend to have suboptimal outcomes in behavioral weight loss programs for reasons that are not fully understood. Studies have shown a potential relationship between perceived psychological stress and weight loss in behavioral interventions. This study sought to assess whether baseline stress was directly or indirectly associated with 6-month weight change among Black women participating in a behavioral weight loss study. Indirect pathways of interest included depressive symptoms and dietary intake. A secondary analysis of data (n = 409) collected from a cluster, randomized behavioral weight loss trial was conducted. Demographics, anthropometry, surveys, and dietary data were collected at baseline and 6 months. Path analysis was used to test for direct and indirect effects of baseline stress on 6-month weight change while controlling for sociodemographic factors and intervention group. Baseline stress was not directly associated with 6-month weight change nor was it indirectly associated via depressive symptoms in the adjusted model. However, each of the direct paths linking baseline stress to weight loss were statistically significant. Stress was not associated with 6-month weight change via dietary intake. Baseline stress was positively associated with 6-month depressive symptoms which in turn was associated with less weight change. Depressive symptoms may offer an additional psychosocial target to consider when designing behavioral weight loss interventions for Black women.
黑人女性肥胖的患病率较高，并且在行为减肥计划中的效果往往不理想，其原因尚未完全阐明。研究表明，在行为干预中，感知到的心理压力与减肥之间存在潜在关系。本研究旨在评估基线压力是否与参加行为减肥研究的黑人女性的 6 个月体重变化直接或间接相关。感兴趣的间接途径包括抑郁症状和饮食摄入。对一项集群随机行为减肥试验（n = 409）收集的数据进行了二次分析。在基线和 6 个月时收集了人口统计学、人体测量学、调查和饮食数据。路径分析用于测试基线压力对 6 个月体重变化的直接和间接影响，同时控制社会人口因素和干预组。基线压力与 6 个月体重变化无直接关联，在调整后的模型中也与抑郁症状无间接关联。然而，将基线压力与体重减轻联系起来的每一条直接路径都具有统计学意义。压力与 6 个月的体重变化无关，也与饮食摄入无关。基线压力与 6 个月时的抑郁症状呈正相关，而抑郁症状又与体重减轻幅度较小有关。在为黑人女性设计行为减肥干预措施时，抑郁症状可能提供了另一个需要考虑的心理社会目标。
