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Abstract
Obesity remains one of the greatest public health threats in the 21st century, increasing the risk for many chronic illnesses, including Type 2 diabetes and CVD, with economic costs associated with treatments for obesity reaching $147 billion/year in 2008 for inpatient and outpatient treatments and prescription drugs. Despite an increase in prevention and intervention efforts to reduce the health and economic burden associated with obesity and binge eating in the past decade, treatments are still disproportionate among women and/or racial/ethnic minority groups. In particular, overweight and obese Latina women with binge eating disorder are less likely to seek and receive treatment for problematic eating behaviors and have a higher risk of chronic illnesses. Therefore, there is still a need to identify psycho- and sociocultural determinants that will influence treatment engagement and success among overweight and obese Latina women with binge eating disorder. This study identified culturally appropriate modifications of an evidenced-based behavioral weight loss program, The LEARN Program for Weight Management,10th Edition (LEARN; Brownell, 2004). Through constant comparative analysis, participants (n = 20, MAGE = 30, SD = 9.87, MBMI = 34.40, SD = 6.64, Mbinge eating episodes= 4, SD = 4.92) identified surface and deep level changes needed for the LEARN manual. Surface level changes included: redundancy of lesson content, positive remarks and critiques of content, need for culturally relevant examples, and structure of self-monitoring forms. Deep level changes included a consideration of diversity factors, Latino health beliefs and expectations, environmental facilitators and barriers, cultural significance of food and physical activity, and unique individual factors (e.g., family dynamics, past experiences with health monitoring and chronic illness management, and responsibilities as a caregiver). With cultural modifications, participants reported that the LEARN manual could be an effective and feasible method to address psychological and sociological factors associated with obesity and binge eating disorder. Suggestions to improve adherence to a healthy lifestyle manual are offered. In order to address health disparities and reduce the prevalence rates of obesity and binge eating disorder among Latina women, it is crucial that treatments emphasize a healthy lifestyle change approach while considering key cultural factors to more effectively recruit and retain this understudied and undertreated population.