Faculty mentor/PI email address
powellle@rowan.edu
Keywords
Anti-obesity medication, Food insecurity, Health disparities, NHANES, Weight-loss strategies, Race/ethnicity
IRB or IACUC Protocol Number
Non-human research. NHANES dataset publicly available, with de-identification.
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Background: Nearly half of US adults meet FDA criteria for anti-obesity pharmacotherapy (AOM), yet utilization remains low. Recent GLP-1RAs prescribing has intensified focus on access disparities, but how weight loss strategy selection varies by social determinants among AOM-eligible adults is poorly understood.
Hypothesis: Weight loss strategy selection among AOM-eligible adults varies by race/ethnicity and food security status, with food insecure populations likely to use maladaptive strategies.
Methods: Survey-weighted cross-sectional analysis of NHANES 2017–March 2020. AOM eligibility: BMI ≥30 or BMI ≥27 with cardiometabolic comorbidity. Among adults reporting past-year weight loss attempts (n=2,100; weighted N=59.5 million), 19 self-reported strategies were compared across race/ethnicity and food security using survey-weighted chi-square testing and logistic regression adjusting for age, sex, BMI. Analyses were performed with R and the survey package to capture NHANES complexity.
Results: Exercise use varied by race (p< 0.001): NH Black (OR 2.06) and NH Asian (OR 1.65) adults exercised more than NH White adults. Food insecurity predicted lower exercise (very low: OR 0.58), reduced fruit/vegetable intake (OR 0.55), and increased meal skipping (OR 2.04). NH Black adults had elevated purging odds (p=0.002); estimates should be interpreted cautiously with low event rates (n=42). Prescription AOM use was < 13% across all subgroups. Insurance status was not associated with any strategy.
Conclusions: Weight loss strategies among AOM-eligible adults vary significantly by race/ethnicity and food security. Food insecure populations disproportionately use maladaptive rather than evidence-based methods. These disparities are not solely explained by insurance, suggesting structural/cultural barriers. Findings may guide culturally targeted obesity interventions.
Disciplines
Dietetics and Clinical Nutrition | Medicine and Health Sciences
Included in
Weight Loss Strategy Disparities Among Anti-Obesity Medication-Eligible US Adults: A Cross-Sectional NHANES Analysis
Background: Nearly half of US adults meet FDA criteria for anti-obesity pharmacotherapy (AOM), yet utilization remains low. Recent GLP-1RAs prescribing has intensified focus on access disparities, but how weight loss strategy selection varies by social determinants among AOM-eligible adults is poorly understood.
Hypothesis: Weight loss strategy selection among AOM-eligible adults varies by race/ethnicity and food security status, with food insecure populations likely to use maladaptive strategies.
Methods: Survey-weighted cross-sectional analysis of NHANES 2017–March 2020. AOM eligibility: BMI ≥30 or BMI ≥27 with cardiometabolic comorbidity. Among adults reporting past-year weight loss attempts (n=2,100; weighted N=59.5 million), 19 self-reported strategies were compared across race/ethnicity and food security using survey-weighted chi-square testing and logistic regression adjusting for age, sex, BMI. Analyses were performed with R and the survey package to capture NHANES complexity.
Results: Exercise use varied by race (p< 0.001): NH Black (OR 2.06) and NH Asian (OR 1.65) adults exercised more than NH White adults. Food insecurity predicted lower exercise (very low: OR 0.58), reduced fruit/vegetable intake (OR 0.55), and increased meal skipping (OR 2.04). NH Black adults had elevated purging odds (p=0.002); estimates should be interpreted cautiously with low event rates (n=42). Prescription AOM use was < 13% across all subgroups. Insurance status was not associated with any strategy.
Conclusions: Weight loss strategies among AOM-eligible adults vary significantly by race/ethnicity and food security. Food insecure populations disproportionately use maladaptive rather than evidence-based methods. These disparities are not solely explained by insurance, suggesting structural/cultural barriers. Findings may guide culturally targeted obesity interventions.