Weight Loss Success of Participants Residing in Rural and Urban Areas

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Rural residents are significantly more likely to be overweight and obese than are urban residents. However, few data have compared weight control program responses in these population groups. Therefore, the primary aim of this study was to evaluate the weight loss outcomes of participants in a multisite, online behavioral intervention by residential location (rural vs urban) and, second, assess any possible differences in adherence to treatment goals.


A total of 492 adult participants (mean BMI = 35.7 kg/m2; 90% female; 24% minority) were categorized based on their home ZIP code and the 2010 US Census Urban and Rural Classification criteria (58.3% rural; 41.7% urban). Weight (kg) was measured in-person at baseline and 6 months after participating in a behavioral weight control intervention. Adherence to physical activity and calorie and fat intake goals was assessed based on weekly self-monitoring journals. Weekly online chat attendance and completion of weekly online self-monitoring journals were recorded. Presence of obesogenic foods in the home was self-reported at baseline and 6 months.


There were no statistically significant differences in weight loss between rural and urban participants (-6.1 kg vs -5.3 kg, P = .16), nor were there differences in chat attendance, self-monitoring journals, self-reported physical activity, calorie intake, or obesogenic foods reported in the household.


Overall, there was no difference in weight loss and adherence to treatment goals for rural and urban participants. Further research on rural and urban residents is necessary to explore the factors responsible for the disparity in obesity prevalence.

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