Predictors of trying to lose weight among overweight and obese Mexican-Americans: a signal detection analysis

Abstract

Objective: Signal detection analysis, a form of recursive partitioning, was used to identify combinations of sociodemographic and acculturation factors that predict trying to lose weight in a community-based sample of 957 overweight and obese Mexican-American adults (ages 18-69 years). Design: Data were pooled from the 2004 and 2006 Behavioral Risk Factor Surveillance System conducted in a low-income, semi-rural community in California. Results: Overall, 59 % of the population reported trying to lose weight. The proportion of adults who were trying to lose weight was highly variable across the seven mutually exclusive groups identified by signal detection (range 30-79 %). Significant predictors of trying to lose weight included BMI, gender, age and income. Women who were very overweight (BMI . 28?5 kg/m 2 ) were most likely to be trying to lose weight (79 %), followed by very overweight higher-income men and moderately overweight (BMI 5 25?0-28?5 kg/m 2 ) higher-income women (72 % and 70 %, respectively). Moderately overweight men, aged 28-69 years, were the least likely to be trying to lose weight (30 %), followed by moderately overweight lower-income women (47 %) and very overweight lower-income men (49 %). The latter group is of particular concern since they have characteristics associated with medical complications of obesity (low education and poor access to medical care). Conclusions: Our findings highlight opportunities and challenges for public health professionals working with overweight Mexican-American adults -particularly lower-income adults who were born in Mexico -who are not trying to lose weight and are therefore at high risk for obesity-related co-morbidities. Keywords Signal detection analysisMexican-Americans Weight lossThe high prevalence of obesity among Mexican-Americans is a major public health concern. Recent estimates indicate that more than 75 % of Mexican-American adults in the USA are overweight or obese -less than 25 % are at a healthy, normal weight (1) . These statistics may be a gauge of poor access to and/or lack of effective weightloss strategies and are a stark reminder of how much more progress is needed to reach the Healthy People 2010 target goal of increasing the proportion of adults at a healthy weight to 60 % (2) . Despite the well-recognised benefits of intentional weight loss among overweight and obese individuals (3)(4)(5)(6)(7) , less than 60 % of overweight and obese Latinos are currently trying to lose weight (8) ; this may be an indicator of a low level of readiness for weight loss and therefore has important implications for the success of weight-loss interventions. While previous studies have examined sociodemographic and acculturative correlates of obesity (9,10) and individual responses to weight-loss interventions (11) , few studies (8,12) have examined sociodemographic and acculturative factors in relation to trying to lose weight. To our knowledge none of these studies have examined interactions between these factors or focused on Latino populations,...

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