Resilience to obesity among socioeconomically disadvantaged women: the READI study

• Published in: International Journal of Obesity 2012-06, Vol.36 (6), p.855-865
• Main Authors: Ball, K, Abbott, G, Cleland, V, Timperio, A, Thornton, L, Mishra, G, Jeffery, R W, Brug, J, King, A, Crawford, D
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biological and medical sciences; Body mass; Body Mass Index; Body weight; Cross-Sectional Studies; Diet (weight control); Diet - statistics & numerical data; Diets; Eating disorders; Educational Status; Environmental factors; Epidemiology; Exercise; Fast food; Female; Females; Health; Health aspects; Health Behavior; Health care; Health Knowledge, Attitudes, Practice; Health Promotion and Disease Prevention; Health Status Disparities; Height; Households; Humans; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Neighborhoods; Nutrition research; Obesity; Obesity - epidemiology; original-article; Overweight; Physical activity; Physical fitness; Poverty Areas; Public Health; Residence Characteristics; Resilience (Personality trait); Risk factors; Smoking - adverse effects; Smoking - epidemiology; Sociodemographics; Socioeconomic factors; Socioeconomics; Structural equation modeling; Surveys and Questionnaires; Target groups; Victoria - epidemiology; Vulnerable Populations - statistics & numerical data; Women; Young Adult
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/ijo.2011.183

Objective: This cross-sectional study aimed to identify sociodemographic and behavioural characteristics of ‘overweight-resilient’ women, that is, women who were in a healthy body weight range, despite living in socioeconomically disadvantaged neighbourhoods that place them at increased risk of obesity. The study also aimed to test a comprehensive theoretically derived model of the associations between intrapersonal, social and environmental factors and obesity among this target group. Participants: A total of 3235 women aged 18–45 years from 80 urban and rural neighbourhoods throughout Victoria, Australia, participated in the Resilience for Eating and Activity Despite Inequality study. Measurements: Women reported height, weight, sociodemographic characteristics, leisure-time physical activity, dietary behaviours and a range of theoretically derived cognitive, social and neighbourhood environmental characteristics hypothesized to influence obesity risk. A theoretical model predicting body mass index (BMI) was tested using structural equation models. Results: Women classified as ‘resilient’ to obesity tended to be younger, born overseas, more highly educated, unmarried and to have higher or undisclosed household incomes. They engaged in more leisure-time physical activity and consumed less fast foods and soft drinks than overweight/obese women. Neighbourhood characteristics, social characteristics and cognitive characteristics all contributed to explaining variation in BMI in the hypothesized directions. Conclusions: These results demonstrate several characteristics of women appearing ‘resilient’ to obesity, despite their increased risk conferred by residing in socioeconomically disadvantaged neighbourhoods. Acknowledging the cross-sectional study design, the results advance theoretical frameworks aimed at investigating obesity risk by providing evidence in support of a comprehensive model of direct and indirect effects on obesity of neighbourhood, as well as social, cognitive and behavioural characteristics.