Research literature has identified that obesity is a serious health problem in the United States. It is estimated that approximately 97 million adults in the United States are overweight or obese. Compared to men, women have higher rates of obesity. Minority women in general experience high rates of obesity, while African-American women experience the highest rates of obesity. Studies have shown that African-American females have poorer weight loss treatment outcomes, are less likely to utilize professional help when attempting to lose weight, and diet for shorter periods of time than women from other ethnic groups.
The problems associated with being overweight are not only a concern for the general public but also for the Armed Forces. In order to maintain combat readiness and to reduce overweight health-related expenses, service members are required to adhere to strict weight, body fat, and physical fitness standards. Despite the mandatory physical fitness training, many active-duty service members have difficulty maintaining weight standards. In 1996,40% of all administrative discharges were the result of being overweight. The Department of Psychology at TAMC thus developed the LEAN program in response to the military readiness problems associated with obesity.
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A number of studies have shown the effectiveness of the TAMC LEAN program. This retrospective study focuses on the efficacy of the LEAN Program for active-duty females of European-American and African-American ethnic origin. Based on the abundance of literature suggesting that European-American females have significantly better results in traditional weight loss programs than African-American females, it is hypothesized that European-American females will lose significantly more weight than African-American females.
THE LEAN PROGRAM
The acronym LEAN stands for healthy lifestyle; low-intensity exercise; reasonable expectations; emotions that are balanced; healthy attitudes; and healthy, well-balanced nutrition. The primary goal of the LEAN Program is to teach service members to live a healthy lifestyle by consistently making healthier eating and activity choices, resulting in weight reduction and long-term weight maintenance. Active-duty service members are referred to LEAN by their primary care provider when they fail to meet military body fat percentages and weight standards. Once the referral is received, participants are assessed for program eligibility and appropriateness. Body mass index (BMI), weight gain history, problems associated with being overweight, sources of support, and a history of previous weight loss attempts are identified.
Admission is limited to those who meet the following criteria: 1) medically cleared to participate, 2) on active-duty status, 3) capable of performing low-intensity exercises, 4) emotionally stable, and 5) stationed on the island of Oahu for 12 months. After the interested participants are found eligible and are determined to be appropriate for participation, they are informed that they may begin participation in LEAN during the next available group cycle, which begins every month. Their names are recorded in the order that they were interviewed, and they are telephoned by a member of the LEAN program staff when the next LEAN group becomes available.
Those who are not eligible or determined to be inappropriate for program participation are provided treatment alternatives by TAMC staff to assist them with their individual weight loss or healthy lifestyle goals. These options include receiving individual weight management counseling from a psychology provider, registered dietitian, and/or a physical therapist.
The LEAN Program consists of two phases. Phase I is a one-week intensive outpatient treatment that begins at 6:45 am and ends at 4:30 pm. Participation is limited to 8-10 service members. The LEAN Program utilizes a multidisciplinary team approach that includes a health psychologist, family practice physician, registered dietitian, physical therapist, occupational therapist, and paraprofessionals. A psychoeducation group format is used to teach participants to make healthy lifestyle choices, including: creating a healthy environment for themselves, learning the benefits of low-intensity exercise and weight loss, reading food labels, strategic meal preparation, reducing “emotional eating”, and learning relapse-prevention strategies. In addition to the daily lectures, the participants will participate in two 45-minute scheduled aerobic exercise classes and are provided with three meals a day. All of the scheduled LEAN Program activities are performed as a group. kamagra tablets
Phase II consists of weekly follow-up visits for a year that assists the participants in making and sustaining lifestyle changes that lead to improved health status and weight maintenance. The follow-up visits last approximately 60 minutes. Participants are weighed, and the results are carefully monitored and documented in their weight loss logs. Participants are encouraged to discuss specific challenges that they encountered throughout the past week with the LEAN Program staff. Adjustments to their individual food intake and exercise regimen are made at that time.