Effectiveness of Client-Centred Counselling on Weight Management among Black African Women with Overweight and Obesity in High-Income Countries: A Systematic Review

Client-centred counselling, a collaborative approach, aims at reducing ambivalence and enhancing behavioural change for weight loss. This systematic review assessed the effectiveness of client-centred counselling for weight management in Black African women with overweight and obesity in high-income countries, identifying culturally tailored strategies and theoretical underpinnings. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, with nine databases searched from 1970 to June 2022. Twenty-two studies were included, 91% (n=20) of which reported positive effects on weight loss. Face-to-face and a combination of in-person and telephone client-centred counselling were found effective. Although the optimal treatment duration was unclear, interventions lasting six to twelve months were most beneficial. Interventions were delivered by registered dietitians, physicians, nutritionists, and health coaches. Most interventions (n=14) were informed by social cognitive theory, with 19 studies incorporating cultural adaptations such as language considerations, socio-cultural values, constituent involvement, and leveraging target group experiences. Studies using at least two cultural adaptation strategies were more likely to be effective. Client-centred counselling appears promising for weight management in Black African women with overweight or obesity. Long-term follow-up studies are needed to ensure the sustainability and effectiveness of these interventions in this population over time.