Factors Associated with Weight Loss Maintenance and Weight Regain Among African American and White Adults Initially Successful at Weight Loss

Background: Providing ongoing treatment through extended care programs can improve weight loss maintenance (WLM), but the effectiveness of these programs for African Americans (AA) are mixed and may be due to unique cultural factors. Purpose: To identify, prioritize, and organize factors associated with WLM as experienced by AA and White adults initially successful with weight loss. Methods: Adults identified their greatest amount of lifetime weight loss, and those achieving ≥5% weight loss were classified as maintainers (continued >5% weight reduction for ≥1 year) or regainers (≤5% weight reduction) based on current weight. The nominal group technique was conducted to identify and rank WLM facilitators and barriers. Online card sorting tasks and hierarchical clustering were performed to illustrate conceptual relationships between facilitators (maintainers only) and barriers (regainers only). Results: Participants (maintainers, n = 46; regainers, n = 58; 81.7% women, 48.1% AA) identified known factors associated with successful weight management (daily weighing, self-monitoring, regular physical activity, mindful eating). However, the perceived importance of these factors differed between groups (maintainer vs. regainers; AA vs. Whites). Unique factors affecting WLM were also identified (refresher groups recommended by White maintainers and regainers; self-accountability identified by AA maintainers). Salient facilitators and barriers were best represented in 2–3 clusters; each group had ≥1 unique cluster(s) revealing group-specific higher-order domains associated with successful WLM. Conclusions: As lifestyle interventions for WLM (particularly for AA) are developed, attention to the preferences, and lived experiences of these groups is recommended. Strategies targeting physical activity maintenance and autonomy-supportive approaches may improve WLM among AA.