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Racial differences in perception of healthy body weight in midlife women: results from the Do Stage Transitions Result in Detectable Effects study

Thomas, Semara MD1; Ness, Roberta B. MD, MPH2; Thurston, Rebecca C. PhD3; Matthews, Karen PhD3; Chang, Chung-Chou PhD4; Hess, Rachel MD, MS4

Menopause: The Journal of The North American Menopause Society: March 2013 - Volume 20 - Issue 3 - p 269–273
doi: 10.1097/gme.0b013e31826e7574
Original Articles

Objective 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.

Methods 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.

Results 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/m2, 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).

Conclusions 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.

From the 1Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA; 2University of Texas School of Public Health, Houston, TX; and Departments of 3Psychiatry and 4Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.

Received May 26, 2012; revised and accepted July 26, 2012.

Clinical Trials Registration with (NCT00097994).

Funding/support: R.H. and the Do Stage Transitions Result in Detectable Effects study were supported by a grant from the National Institutes of Health’s National Institute on Aging (K23AG024254).

Financial disclosure/conflicts of interest: None reported.

Address correspondence to: Semara Thomas, MD, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA. E-mail:

© 2013 by The North American Menopause Society.