The Weight of Racial Discrimination: Examining the Association Between Racial Discrimination and Change in Adiposity Among Emerging Adult Women Enrolled in a Behavioral Weight Loss Program

Kristal Lyn Brown; Anika L Hines; Nao Hagiwara; Shawn Utsey; Robert A Perera; Jessica Gokee LaRose

doi:10.1007/s40615-021-01030-7

The Weight of Racial Discrimination: Examining the Association Between Racial Discrimination and Change in Adiposity Among Emerging Adult Women Enrolled in a Behavioral Weight Loss Program

J Racial Ethn Health Disparities. 2022 Jun;9(3):909-920. doi: 10.1007/s40615-021-01030-7. Epub 2021 Mar 29.

Authors

Kristal Lyn Brown^{1

2}, Anika L Hines³, Nao Hagiwara⁴, Shawn Utsey^{4

5}, Robert A Perera⁶, Jessica Gokee LaRose³

Affiliations

¹ Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA. Kbrow222@jhmi.edu.
² Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Kbrow222@jhmi.edu.
³ Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
⁴ Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
⁵ Department of African American Studies, Virginia Commonwealth University, Richmond, VA, USA.
⁶ Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.

Abstract

Background: Non-Hispanic Black (NHB) emerging adult (EA) women are at disproportionate risk for obesity but experience limited benefit from behavioral weight loss (BWL) programs. Race-related stress could play a role; the goal of this study was to examine the association between racial discrimination (RD) and early (3 months) changes in adiposity, and to explore potential protective factors, among EA in an adapted BWL program.

Methods: This is an ancillary study of non-Hispanic White (NHW) and NHB EA women enrolled in an adapted BWL trial (N = 49; 55.1% NHB; Age 21.2 (2.1); BMI = 33.0 + 4.3 kg/m²). At baseline, group- and personal-level RD (RD-group and RD-personal), racial identity (NHB women only), vigilant coping, and social support were assessed via validated questionnaires. Weight and waist circumference were measured objectively at 0 and 3 months.

Results: NHW women manifested greater reductions in waist circumference relative to NHB women (p = .004). RD-personal did not predict change in waist circumference at 3 months (p = .402); however, the association between RD-group and change in waist circumference was statistically significant (p = .015), such that reporting greater group-level discrimination predicted a smaller decrease in waist circumference; the model explained 22% of the variance. Social support and vigilant coping were not statistically significant in the model. Among NHB women only, higher racial identity-centrality predicted greater reduction in waist circumference (p = .019).

Conclusion: Findings suggest racial discrimination could contribute to greater cardiometabolic risk during this developmental period. Future research should examine how experiences of racial discrimination unfold in the daily lives of NHB women to inform mechanistic interventions to enhance health and well-being.

Trial registration: NCT02736981. Low Intensity Weight Loss for Young Adults.

Keywords: Emerging adults; Health disparities; Obesity; Racial discrimination; Racism; Women.

Publication types

Clinical Trial
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Adiposity
Adult
Female
Humans
Obesity / therapy
Racism*
Weight Loss
Weight Reduction Programs*
Young Adult

Associated data

ClinicalTrials.gov/NCT02736981

Abstract

Publication types

MeSH terms

Associated data

Grants and funding