Obesity Management Solutions in Rural Communities

Abstract

Purpose of Review: Obesity is more common in rural than in urban areas. The disparities in body mass index (BMI) may be due to growing socioeconomic disparities in rural communities, including limited healthcare infrastructure, lack of access to healthy and affordable food, transportation barriers, financial insecurity, lower educational attainment, and barriers to physical activity. To address these issues, obesity management models are needed in rural areas to promote and sustain weight loss. Obesity interventions for rural populations published in the last 5 years are included in this review. Recent Findings: Recent clinical trials report improvements in nutrition knowledge, physical activity, reduced energy consumption, and weight loss in rural populations. Three elementary school-based interventions implemented nutrition, physical activity, or a nutrition plus physical activity interventions ranging in duration from 2 months to 3 years. These interventions observed improvements in nutrition knowledge, daily energy intake, and body mass index (BMI), such that the trial resulted in weight loss or prevented weight gain. Two school-based lunch interventions observed increases in fruit and vegetable intake, reductions in energy consumption, and decreases sugar and sodium intake. Two large cluster randomized controlled trials in the USA showed clinically significant weight loss could be achieved via different lifestyle intervention approaches. Similarly, a 1-year intensive lifestyle intervention in Germany documented reductions in body weight and BMI. Additionally, recent telehealth interventions compared the use of teleconferencing, telephone counseling, and short message service (SMS) interventions to promote weight loss. Overall, findings showed that telehealth interventions can recruit and retain rural adults, and improvements in weight loss were greater than or equal to in-person interventions. Summary: Obesity is a serious public health problem associated with cardiovascular disease, type 2 diabetes, osteoarthritis, and certain cancers. Well-designed, geographically tailored interventions with proper control conditions are needed for rural populations. Including data from neighborhood built environment with comprehensive interventions that address barriers to healthy eating, physical activity, and behavior change hold the most promise for the future.