Body Image and Weight Status among African American and Caucasian Overweight Postpartum Women...
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Transcript of Body Image and Weight Status among African American and Caucasian Overweight Postpartum Women...
Body Image and Weight Status among African American and Caucasian Overweight Postpartum Women
Participating in a Weight Loss Intervention
Lori Carter-Edwards, PhD
Department of Community and Family MedicineDuke University Medical Center
Durham, NC
12th Annual CDC Maternal and Child Health Epidemiology ConferenceAtlanta, GA
07 December 2006
Sponsor: National Institute of Diabetes, Digestive, and Kidney Diseases (NIDDK) [R01DK64986]
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Collaborating Team
Duke University Medical Center (Durham, NC)
Truls Ostbye, MD, PhD
Lori Bastian, MD
Jessica Revels, BA
University of North Carolina (Greensboro, NC)
Holiday Durham, MS
Shaw University (Raleigh, NC)
DaJuanicia Holmes, MS
M. Ahinee Amamoo, MS
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Presentation Overview
Purpose
Methods
Results
Conclusions
Strengths and Limitations
Background
Implications
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Background
Racial differences exist in postpartum weight and weight retention.
Postpartum body image may influence adoption and maintenance of healthy lifestyle behaviors.
Body image may differ by race.
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Similar postpartum body area dissatisfaction exists by race.
The magnitude of dissatisfaction is greater among Caucasians than African Americans.
Body image unclear among overweight or obese postpartum women
Body image unclear among those engaged in behavior modification
Background (cont.)
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Purpose
To examine whether body image and weight status differ by race among a sample of African American and Caucasian overweight postpartum women participating in a weight loss intervention.
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Study Sample Derived from the Active Mothers Postpartum
(AMP) Study
Effectiveness of a diet and physical activity intervention on reducing weight among 450 overweight postpartum women (BMI > 25)
Two-arm, unblinded, randomized trial
Methods
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Active Mothers Postpartum (AMP) Study Intervention (n=225) – 8-10 months
Health magazine subscription Education manual Group diet and physical activity sessions Phone counseling sessions Jogging stroller (6 months postpartum)
Control (n=225) Health magazine subscription
Methods (cont.)
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Active Mothers Postpartum (AMP) Study Measurements
Baseline 12 months 18 months 24 months
6 months, intervention group only
Methods (cont.)
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Study Sample Intervention Group - Exclusions
Loss to follow-up (n=31) Strollers only (n=5) Race other than African American or Caucasian (n=9)
Methods (cont.)
Study Sample Size = 180
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Methods (cont.)
Variables Predictor Variables
Race BMI group
Outcome Variable Body Image
Figure Rating Scale (Stunkard et al., 1980) Range: 1-9 8 characteristics about shape
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Methods (cont.)
Figure Rating Scale
Most attractive
Would like to look like
Women find most attractive
Men find most attractive
An ideal mother
Once baby was born
Look like now
Pre-pregnancy
“Desired” Shapes “Actual” Shapes
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ResultsTable 1. Demographics (n=180)
* Statistically significant difference by race (using t-test and chi-square tests).** n=172 respondents
Characteristic African American
Caucasian P-value*
N 75 105 --
Mean Age at Baseline (yrs) 29.8 (+6.2) 32.4 (+4.8) 0.016
% Married 49.3 93.3 <0.001
% College or College Grad 44.0 76.0 <0.001
% Annual Household Income >= $30,000** 57.6 88.9 <0.001
% Primiparous 37.3 44.8 0.320
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ResultsTable 2. Weight Characteristics (n=179)
* Statistically significant difference by race (using t-tests and chi-square tests).** Chi-square test of trend of BMI group by race.
Characteristic African American
Caucasian P-value*
N 75 104 --
Mean BMI at 6 Months Postpartum 35.0 (+8.2) 30.1 (+6.4) 0.021
Mean Weight at 6 Months Postpartum (lbs) 210.4 (+49.9) 181.9 (+36.9) 0.005
% Normal Weight (BMI<25) 0 16.2 <0.001**
% Overweight (25<BMI<30) 33.3 37.1 --
% Obese (BMI>30) 66.7 46.7 --
Mean BMI Overweight 27.7 27.8 0.918
Mean BMI Obese 38.7 35.5 0.038
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Results (cont.)
Mean Distribution of Body Image Factors at 6-Months Postpartum by Race and Weight Status
Shape that is Most Attractive
African American
Caucasian
P=0.0123.3 3.6
By Race - Total (n=153) By Race - BMI>30 (n=89)
P=0.2253.6 3.8
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Results (cont.)
Mean Distribution of Body Image Factors at 6-Months Postpartum by Race and Weight Status
African American
Caucasian
P=0.0113.4 3.8
By Race - Total (n=153) By Race - BMI>30 (n=89)
P=0.0483.8 4.2
Shape You Would Like to Look Like
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Results (cont.)
Mean Distribution of Body Image Factors at 6-Months Postpartum by Race and Weight Status
African American
Caucasian
P=0.0442.8 3.1
By Race - Total (n=153) By Race - BMI>30 (n=89)
P=0.4963.1 3.2
Shape Women Find Most Attractive
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Results (cont.)
Mean Distribution of Body Image Factors at 6-Months Postpartum by Race and Weight Status
African American
Caucasian
P=0.0062.9 3.3
By Race - Total (n=153) By Race - BMI>30 (n=89)
P=0.0392.7 3.1
Shape Men Find Most Attractive
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Results (cont.)
Mean Distribution of Body Image Factors at 6-Months Postpartum by Race and Weight Status
African American
Caucasian
P<0.0013.8 4.5
By Race - Total (n=153) By Race - BMI>30 (n=89)
P=0.0174.1 4.6
Shape of an Ideal Mother
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Results (cont.)
Mean Distribution of Body Image Factors at 6-Months Postpartum by Race and Weight Status
African American
Caucasian
P=0.1896.15.8
By Race - Total (n=153) By Race - BMI>30 (n=89)
P=0.2126.56.2
Your Shape Once Baby Was Born
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Results (cont.)
Mean Distribution of Body Image Factors at 6-Months Postpartum by Race and Weight Status
African American
Caucasian
P=0.8415.55.5
By Race - Total (n=153) By Race - BMI>30 (n=89)
P=0.6996.16.0
Shape You Look Like Now
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Results (cont.)
Mean Distribution of Body Image Factors at 6-Months Postpartum by Race and Weight Status
African American
Caucasian
P=0.9364.74.7
By Race - Total (n=153) By Race - BMI>30 (n=89)
P=0.4595.45.2
Pre-Pregnancy Shape
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Strengths and Limitations
Nested within a weight-loss intervention Examined postpartum body image by race and weight
status
Modest sample size Body image figure rating scale may not be culturally
representative No information on weight change (beyond study scope)
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Conclusions
A greater proportion of African-American compared to Caucasian women:
Were larger at 6 months. Had larger “desired” shapes.
Obese postpartum women differed by race in: Desired shape for themselves. Desired shape perceived by men. Desired shape of an ideal mother.
There were no significant racial differences in perceptions of “actual” shape.
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Implications
There are cultural differences in perceptions of attractiveness based on shape.
Future behavior modification programs may need to account for potential racial differences in body image when designing postpartum weight loss interventions.