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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

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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

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Funding

This work was supported in part by National Institutes of Diabetes and Digestive and Kidney Diseases (R01DK103668) to Jessica G. LaRose. Additional support received from the American Association of University Women (AAUW). The funders had no role in the design, execution or interpretation of this work.

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Authors and Affiliations

  1. Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA

    Kristal Lyn Brown, Anika L. Hines & Jessica Gokee LaRose

  2. Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Kristal Lyn Brown

  3. Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA

    Nao Hagiwara & Shawn Utsey

  4. Department of African American Studies, Virginia Commonwealth University, Richmond, VA, USA

    Shawn Utsey

  5. Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA

    Robert A. Perera

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  1. Kristal Lyn Brown
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  2. Anika L. Hines
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  3. Nao Hagiwara
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  4. Shawn Utsey
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  6. Jessica Gokee LaRose
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Correspondence to Kristal Lyn Brown.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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Brown, K.L., Hines, A.L., Hagiwara, N. et al. 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 and Ethnic Health Disparities 9, 909–920 (2022). https://doi.org/10.1007/s40615-021-01030-7

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