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The Role of Weight Perception in Race Differences in BMI Among College Graduate and Non–College Graduate Women
Author(s) -
Bell Caryn N.,
Blackman Carr Loneke T.
Publication year - 2020
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.22765
Subject(s) - underweight , overweight , medicine , obesity , gerontology , body mass index , demography , race (biology) , sociology , botany , biology
Objective Racial differences in BMI increase with education. Weight perception may be an important factor in overweight and obesity in black women. The aim of this study was to determine the mediating role of weight underassessment on race differences in BMI in college graduates compared with non–college graduates. Methods Weight perception was assessed among respondents to the 2007‐2014 National Health and Nutrition Examination Survey ( n = 4,871). Those who had BMI‐assessed overweight or obesity and self‐assessed underweight or about‐right weight underassessed their weight. The associations between race and BMI through weight underassessment by college graduate status were determined using a moderated mediation analysis. Results Black women had higher BMI than white women (β = 2.72, SE = 0.28), and disparities were larger in college graduates (β = 3.50, SE = 0.25) compared with non–college graduates (β = 0.78, SE = 0.15). Non–college graduate black women were more likely to underassess their weight ( z score = 0.43, SE = 0.05). Indirect associations between race and BMI through weight underassessment were found only among non–college graduates ( z score = −0.02, SE = 0.01), but race differences in BMI remained after accounting for weight perception among college graduates and non–college graduates. Conclusions This study demonstrates that a nuanced, intersectional understanding of weight perception and BMI among women is required to address racial disparities in obesity.