Findings demonstrate that severely obese African American women face more significant physical, dietary, and psychosocial challenges than their overweight or moderately obese peers, underscoring the need for tailored weight loss interventions for this high-risk group. Compared to women with lower BMI, those who were severely obese were less physically active, reported poorer dietary habits, and had lower self-assessed physical and mental well-being. These disparities highlight how physical limitations and psychosocial burdens, rather than just individual motivation or knowledge, may impede healthy behavior change in this population.

The study’s results have important implications for public health and clinical practice. They indicate that traditional behavioral weight loss programs—often designed for general or moderately obese populations—may not sufficiently address the specific barriers faced by severely obese African American women, particularly those related to mobility challenges, mental health, stress, and social support. The findings provide empirical justification for developing more tailored, equitable interventions that incorporate strategies to reduce physical barriers, manage stress, and improve psychosocial functioning.

Finally, the results offer practical guidance for future intervention research by identifying the types of lifestyle, psychosocial, and environmental factors that should be considered when designing targeted programs. They also highlight the need for continued research to understand the weight loss needs of this population and evaluate the effectiveness of tailored approaches, given the high prevalence of severe obesity and disproportionate impact on African American women.