OBJECTIVE: To evaluate the impact of a 4-month dietary and lifestyle program co-designed and led by Aboriginal and Torres Strait Islander people on weight and metabolic markers, diet, and physical activity in overweight and obese adults in a remote Indigenous community. STUDY DESIGN: Single arm, pre-post intervention study. SETTING, PARTICIPANTS: Adult residents (18-65 years) of a remote Northern Territory community with body mass index (BMI) values of at least 25 kg/m INTERVENTION: Hope for Health, a culturally sensitive 4-month program supporting self-managed health improvement based on dietary and lifestyle change, 1 August to 30 November 2022. MAIN OUTCOME MEASURES: Weight loss of at least 5%
changes in BMI, waist circumference, other metabolic markers (blood pressure, biomarkers of metabolic health and inflammation), diet, and physical activity
participant perceptions of the program. RESULTS: We assessed outcomes for 55 participants who completed weight assessments at both baseline and program end (mean age, 42.5 years [standard deviation, 10.1 years]
36 women [65%]). Forty participants lost and 15 gained weight
overall mean weight loss was 1.5 kg (95% confidence interval [CI], 0.5-2.4 kg), and ten participants (18%
95% CI, 9-31%) achieved at least 5% weight reduction. The mean change in BMI (53 participants) was -0.60 kg/m CONCLUSIONS: Community appreciation of the program and the improvements in cardiometabolic risk factors are encouraging, providing an example of a culturally sensitive, co-designed initiative led by Indigenous people for reducing the prevalence of chronic disease in remote areas. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN12622000274785
prospective: 2 February 2022).