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Esa M. Davis, MD, MPH, Jeanne M. Clark, MD, MPH, Joseph A. Carrese, MD, MPH, Tiffany L. Gary, PhD and Lisa A. Cooper, MD, MPH

Esa M. Davis is with the Department of Family Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio. Jeanne M. Clark, Joseph A. Carrese, and Lisa A. Cooper are with the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Md. Jeanne M. Clark, Tiffany L. Gary, and Lisa A. Cooper are with the Welch Center for Prevention, Epidemiology and Clinical Research and the Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. Lisa A. Cooper is also with the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health.

Correspondence: Requests for reprints should be sent to Esa M. Davis, MD, MPH, Department of Family Medicine–Research Division, Case Western Reserve University, 11001 Cedar Ave, Suite 306, Cleveland, OH 44106 (e-mail: edw6{at}case.edu).

Focus groups stratified by race and socioeconomic status were used to examine obese women’s experiences with weight-loss methods. Six themes emerged: failure of weight maintenance, use of psychological and spiritual approaches, role of family influences and societal expectations, role of African American subculture, method affordability, and racial differences in weight-loss methods. Tailored weight-management interventions for women, particularly African Americans and those of low socioeconomic status, should account for features of African American subculture and address affordability concerns, include maintenance strategies that incorporate psychological and spiritual principles, and target family attitudes and behaviors.

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