Racial differences in perception of healthy body weight in midlife women

Abstract

Perception of healthy body weight may influence health behaviors, including physical activity level, nutritional habits, and health outcomes, and these perceptions may vary importantly by race. Midlife is a critical period for women that typically includes weight gain. We assessed the associations between perception of healthy body weight and body mass index (BMI) and whether they vary by race. In the Do Stage Transitions Result in Detectable Effects study, BMI and perception of body weight (healthy, underweight, or overweight) were measured at baseline examination. Multinomial logistic regression models examined the associations, with race (white vs black) as moderator variable. Of 729 women enrolled, 689 women (95%; black, n = 145; white, n = 544) were included in these analyses. Even though the average BMI was higher for black women than for white women (33.1 vs 29.2 kg/m, respectively; P < 0.0001), black women were less likely to report that they weighed too much (relative risk ratio, 0.4; 95% CI, 0.2-0.9; P = 0.022) and more likely to think that they did not weigh enough (relative risk ratio, 14.2; 95% CI, 1.8-110; P = 0.011). Although black women, in general, face a greater threat of morbidity from weight-related chronic diseases, they are more likely to be accepting of their weight at higher BMIs relative to whites. Weight loss interventions and counseling about healthy body size may influence healthy behavior and reduce the risk of chronic diseases.