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American Journal of Epidemiology Advance Access originally published online on May 22, 2009
American Journal of Epidemiology 2009 170(2):181-192; doi:10.1093/aje/kwp104
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Psychosocial Stress and Change in Weight Among US Adults

Jason P. Block, Yulei He, Alan M. Zaslavsky, Lin Ding and John Z. Ayanian

Correspondence to Dr. John Z. Ayanian, Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115 (e-mail: ayanian{at}hcp.med.harvard.edu).

Received for publication December 23, 2008. Accepted for publication April 2, 2009.

The association of psychosocial stress with weight gain may have important implications for clinical practice and workplace and public health interventions. To determine whether multiple domains of psychosocial stress were associated with weight gain from 1995 to 2004, the authors analyzed a nationally representative longitudinal cohort of 1,355 men and women in the United States. Change in body mass index was assessed for multiple domains of psychosocial stress related to work, personal relationships, life constraints, and finances, controlling for other factors associated with weight gain. All analyses were stratified by sex and weighted to account for the complex survey design. Among men with high baseline body mass index, weight gain was associated with increasing levels of psychosocial stress related to job-related demands (P < 0.001 for interaction with baseline body mass index), lack of skill discretion (P = 0.014), lack of decision authority (P = 0.026), and difficulty paying bills (P = 0.004). Among women with high baseline body mass index, weight gain was associated with job-related demands (P < 0.001 for interaction with baseline body mass index), perceived constraints in life (P < 0.001), strain in relations with family (P = 0.016), and difficulty paying bills (P = 0.010). Interventions to address psychosocial stress may limit weight gain among overweight and obese men and women.

body mass index; longitudinal studies; obesity; overweight; stress, psychological; weight gain

Abbreviations: MIDUS, Midlife in the United States


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