Background

There is a longstanding belief that body image concerns are less common among racial minorities than white individuals. Yet this is understudied among individuals in weight management, where negative body image is common and factors such as high weight and shape concern (WSC) have been linked to poor weight loss. Using three different weight control samples, we investigate race-related differences in the prevalence of high WSC and body ideals that promote WSC.

Methods

The first sample was adults with overweight/obesity in the Look AHEAD public use dataset (n=4896, 59.6±6.75yrs, BMI: 35.95±5.87; 66% white; 59% female), and the second was young adults with BMI 20-30.9 enrolled in the SNAP weight gain prevention trial (n=599, 27.7+4.4 yrs, BMI: 25.4+2.6, 73% white, 78.3% female). WSC was assessed with one item: During the past 6 mos, has your weight/shape mattered to how you feel about yourself? A third was the LEAN into Health trial of women with BMI >25 who wanted to lose weight (n=61, 41.8±10.7yrs; BMI: 30.7±3.0; 77% white). WSC was assessed with the Body Shape Questionnaire along with internalized weight bias, thin and athletic body ideals.

Results

In Look AHEAD, WSC varied by race (χ2=141.6, p<.001) with 17% of white and 31% of minority participants reporting high WSC. The difference by race was seen in both men and women. WSC did not differ by race in SNAP (p=.98), as over 20% of both white and minority participants reported high WSC. In LEAN into Health, white and minority participants did not differ in WSC (p=.92), or in body ideals that promote WSC: internalized weight bias (White: 4.24±1.3; Minority: 4.24±1.2, p=.86), thin body ideals (White: 2.85±1.0; Minority: 3.22±1.0, p=.22) or athletic body ideals (White: 2.42±1.0; Minority: 2.81±1.2, p=.22).

Conclusions

In three different weight control samples high WSC was at least equally common in racial minority as white participants. Interventions for high WSC to improve weight loss should target both white and minority participants.