Vivamos Activos Fair Oaks Program for Weight Loss in Low Income Latinos

Inclusion Criteria:

   1. Age 18 years or older;

   2. Body mass between 30 and 55 kg/m2

   3. One or more CHD risk factors: Systolic blood pressure between 130 and 200 mmHg;
   Diastolic blood pressure between 80 and 105 mmHg; Total cholesterol > 180 mg/dL; LDL
   cholesterol > 120 mg/dL; HDL Cholesterol < 40 mg/dL; Triglycerides > 150 mg/dL; HbA1c
   between 6.0 and 11.5%; Fasting plasma glucose between 95 and 400 mg/dL; Diagnosis of
   Type 2 diabetes

   4. Residing in catchment area of the Fair Oaks Adult Clinic and receiving primary care at
   Fair Oaks Adult Clinic.

Exclusion Criteria:

   1. Inability to speak Spanish;

   2. Unwilling to attempt weight loss;

   3. Significant medical co-morbidities, including uncontrolled metabolic disorders (e.g.,
   thyroid, diabetes, renal, liver), unstable heart disease, advanced heart failure, and
   ongoing substance abuse;

   4. On greater than 10 prescription medications;

   5. Psychiatric disorders requiring antipsychotics or multiple medications;

   6. Body weight change > 25 lbs. in the preceding 3 months;

   7. Pregnant, planning to become pregnant, or lactating less than six months;

   8. Family household member already enrolled in the study;

   9. Intends to or is enrolled in a study that would limit full participation in VAFO;

10. Participants who are unwilling to have home visits by study staff;

11. Resident of a long term care facility;

12. Plans to move during the study period (24 months post-randomization);

13. Investigator discretion for clinical safety or adherence reasons (e.g., unstable
   housing, chronic pain).