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Young women often fail to spot their weight gain

Race/ethnicity, contraceptive use linked to accurate self-perception, with black women and DMPA users more likely to correctly perceive gain

Despite popular belief about women's weight concerns, young women commonly fail to recognize recent gain of as many as 11 pounds – putting them at risk for cardiovascular disease and other obesity-related conditions. Self-perception of weight gain also appears to be significantly influenced by race, ethnicity and contraceptive methods.

In a study published online and in the March issue of the Journal of Women's Health, University of Texas Medical Branch (UTMB) researchers found that a significant number of women evaluated at six-month intervals did not recognize recent gains in weight.

Overall, nearly one-third and one-quarter of women did not recognize gains of approximately 4.5 and 8.8 pounds during a six month interval, respectively. However, black women and DMPA users (depot medroxyprogesterone acetate, commonly known as the birth control shot) were more likely to recognize weight gain than their counterparts.

This is believed to be the first study to explore the accuracy of self-perception of recent weight gain. The findings build on a growing body of UTMB research on actual weight gain and awareness of weight among reproductive-aged women, with particular focus on the links between contraception use and weight gain.

Researchers surveyed a sample of 466 women with an average age of 25. Approximately 37 percent of the subjects were Hispanic, 35 percent non-Hispanic white and 29 percent non-Hispanic black women. Roughly 39 percent of the women used DMPA, 36 percent used an oral contraceptive and 25 percent were non-hormonal contraceptive users. Every six months over 36 months the women completed a symptom checklist that included questions on whether they felt they had gained weight. The researchers also evaluated data on height, BMI, physical activity and whether or not the women had borne children, among other potential correlates.

"We were surprised to find that race and ethnicity are determinants of accurate recognition of weight gain, predictors that have never before been reported," said lead author Dr. Mahbubur Rahman, M.B.B.S., Ph.D., M.P.H., Assistant Professor in the Department of Obstetrics and Gynecology. He notes that further studies using detailed measures that include cultural, psychological and perceptual aspects of weight change in women are needed to explore this relationship.

Regarding the finding that DMPA users are likelier to recognize weight gain, Rahman believes the finding may be attributed to the fact that DMPA has been widely reported to be associated with weight gain and that users may be engaging in more mindful and continuous weight monitoring.

"In prior studies, we've reported that one-quarter of reproductive-age women who are overweight or obese consider themselves to be normal weight. Misperception of actual weight coupled with inaccuracies in self-perception of weight gain is a threat to the success of obesity prevention programs," said Rahman. "Changing a health behavior depends on patients understanding susceptibility to a health problem."

Rahman suggests women weigh themselves regularly so that they realize significant changes. He adds that this research, though not based on a random sample and therefore not necessarily representative of all women, gives clinicians a point of discussion when counseling reproductive-age women about obesity and weight loss.

This study was co-authored by Abbey B. Berenson, director of the Center for Interdisciplinary Research in Women's Health at UTMB. It was supported by two grants awarded by the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD).

ABOUT UTMB Health: Established in 1891, Texas' first academic health center comprises four health sciences schools, three institutes for advanced study, a research enterprise that includes one of only two national laboratories dedicated to the safe study of infectious threats to human health, and a health system offering a full range of primary and specialized medical services throughout Galveston County and the Texas Gulf Coast region. UTMB Health is a component of the University of Texas System and a member of the Texas Medical Center.

Olivia H. Goodman | EurekAlert!
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