Poorer People Less Likely to Lose Weight in Healthy Ways

Lower income populations less likely to follow healthy recommendations for losing weight

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) It's notoriously difficult to lose weight. Researchers may have uncovered at least some answers as to why efforts to lose weight are often less successful for those with lower incomes.

In a recent study, people from lower income groups were less likely to try to lose weight in healthy ways.

The researchers found that poorer young people trying to shed pounds were more likely to skip meals or not eat at all for extended periods of time — methods that are not recommended and often unsuccessful and unhealthy.

"Ask your doctor for healthy ways to lose weight."

This study was led by Lisa Kakinami, PhD, of McGill University in Montreal, Quebec.

Dr. Kakinami and her team looked at data on more than 9,000 people from the National Health and Nutrition Examination Survey (NHANES). NHANES, which is part of an initiative from the Centers for Disease Control and Prevention (CDC), has a participant population that is believed to be a representative sample of the general United States population.

From 1999 to 2008, the researchers collected data on participants aged 16 or older. Then between 2005 and 2010, they collected data on those who were 8 to 15 years old. The final sample consisted of 6,035 adults and 3,250 youths from four income categories (under $20,000; $20,000 to $44,999; $45,000 to $74,999; and at or above $75,000). All participants wanted to lose weight.

Participants self-reported their household incomes and were asked questions about their attempts to lose weight. Adults (those 16 years old and older) were asked 13 questions, and youths were asked six.

Body mass index (BMI) — a measure of body fat based on weight and height — was measured by trained health technicians. Overweight or obese people were considered to have a BMI of 25 or higher.

Despite efforts to lose weight in the previous year, adults gained an average of 1.4 kilograms (just over three pounds), and youth gained an average of 5.4 kilograms (almost 12 pounds). People making the least money gained the most weight.

Recommendations for the healthiest way to lose weight include eating less fat and sweets, increasing exercise and drinking lots of water. Most quick ways to lose weight touted on television or in magazines, such as over-the-counter diet pills, are not recommended.

Compared to adults whose household income was $75,000 or more, adults making the least (less than $20,000) were 50 percent less likely to exercise, 42 percent less likely to drink a lot of water, and 25 percent less likely to reduce their intake of fats or sweets when trying to lose weight.

Youths from the lowest income group were 33 percent less likely to exercise to lose weight than youths from the most affluent group. The youths from the lowest income group were also 1.7 times more likely to skip meals, and 2.3 times more likely to fast (voluntarily not eating for varying lengths of time).

Youths from families with the lower incomes were more likely to use multiple weight-loss strategies inconsistent with recommendations, the study authors found.

It was unclear why there were differences in weight loss strategies between the different income groups. While it could be that people from lower income groups may not be able to afford to join a weight-loss group, they can still drink more water when dieting, which they did not do, the study authors noted. They surmised that people with less income may have stresses that pose barriers to weight loss.

The authors concluded that there is a need for a stronger effort to tailor messages emphasizing weight-loss strategies consistent with recommendations, especially among the lower socioeconomic groups.

Eve Pearson, MBA, RD, CSSD, LD, a nutritionist and owner of Nutriworks, which offers comprehensive nutrition consulting in Dallas, Texas, told dailyRx News that this study "demonstrates that we need to figure out more about why people, in general, choose strategies inconsistent with recommendations for weight loss. They're clearly not successful based on the increase in body weight over the year in both adults and youth. As health care professionals, we must learn where they receive their information regarding how to lose weight and try to target education to those outlets."

Scott Kahan, MD, MPH, director of the National Center for Weight and Wellness in Washington DC, commented in a press release for the Center for Advancing Health that this is the first study he’s seen to “explicitly assess the link between poverty and actual weight loss behaviors."

Dr. Kahan said, "The new data suggest that the poorest among us, who are already disproportionately hurt by overweight and obesity, may also be wasting money on unproven and perhaps dangerous weight loss products."

This study appeared May 22 in the American Journal of Preventive Medicine.

The authors did not disclose any conflicts of interest.

Review Date: 
May 28, 2014
Last Updated:
May 29, 2014