(OR01-02-24) Longitudinal Body Weight Changes in African American Women With Obesity: Differences by Food Security Status

Objectives: Food insecurity can include episodes of food adequacy (i.e., enough food to eat) and food shortage (i.e., not enough food to eat). Importantly, food insecurity is linked to greater body weight, with African American women demonstrating higher rates of both food insecurity and obesity. This study examined longitudinal body weight changes in two cohorts of African American women with obesity, one food secure (FS) and one food insecure (FI).

Methods: African American women (age 18-65 y) with obesity (BMI 30-50 kg/m²) and a reported income ≤ 250% of the federal poverty level were enrolled into the Effects of Episodic Food Insecurity on Psychological and Physiological Responses in African American Women With Obesity (RESPONSES) study. Food security status at baseline was assessed using a modified version of the 6-Item Food Security Scale and 30 FI and 30 FS African American with obesity were enrolled. The primary outcome was body weight (BW) over 22 weeks, which was measured daily via remote assessment using in-home scales. To assess change in BW from baseline across 22 weeks in each of the cohorts, a repeated-measures linear mixed-effects model was estimated. The model included cohort food security status (FI vs. FS), time (week), an interaction term between cohort and time, and baseline age.

Results: Among 60 enrolled participants, mean age was 48.1 y and 45.3 y and mean BMI was 40.0 kg/m² and 39.2 kg/m² for the FS cohort and the FI cohort, respectively, at baseline. Across 22 weeks, the FS cohort demonstrated minimal change in BW from baseline, while the FI cohort showed an increase in BW from baseline. Further, change in BW from baseline in the FI cohort indicated a marked pattern of variability with both decreases and increases at multiple time points across the 22 weeks.

Conclusions: Food-insecure African American women with obesity demonstrated variability in longitudinal body weight changes, compared to food-secure African American women with obesity in the RESPONSES study. These preliminary analyses demonstrate the need to better understand the episodic nature of food insecurity and its influence on body weight.

Funding Sources: National Institutes of Health, including National Institute on Minority Health and Health Disparities, National Institute of General Medical Sciences, and National Institute of Diabetes and Digestive and Kidney Diseases.