Associations Between Body Weight Status and Substance Use Among African American Women in Baltimore, Maryland: The CHAT Study

ABSTRACT

Background: Studies on associations between body weight status and specific substance use have provided conflicting findings. Objectives: This paper investigated the association between substance use and body weight status among African American women. Methods: We analyzed the data from 328 African American women who were enrolled in a HIV prevention intervention in Baltimore, MD, USA, in order to investigate the association between substance use and their body weight status. Participants' anthropometry was measured by trained research staff. Substance use information was collected via self-administered and interviewer-administered questionnaires. Results: About 33.4% were classified as normal/underweight, 24.2% overweight, and 42.4% obese. Compared to overweight (38.5%) and obese (29.2%) participants, the normal/underweight women had significantly higher prevalence of drug use (52.8%) (χ²= 14.11, p < 0.05). BMI was significantly negatively associated with current heroin use (t = −2.21, p < 0.05). The risk of being overweight and obesity was lower among active marijuana (z = −2.05, p < 0.05) and heroin users (z = −1.91, p < 0.10) than among non-marijuana/non-heroin users. Heroin smokers had lower body weight (t = −3.02, p < 0.05) and BMI (t = −2.47, p < 0.05) than non-heroin smokers. The decrease in BMI appeared to be greater among more frequent (≥once/day) heroin users (t = −2.39, p <0.05) as compared to the less frequent heroin users (<once/day) (t = −1.71, p < 0.10), but this difference was not statistically significant. Conclusions: The results are comparable to existing findings. Active marijuana and heroin users were less likely to be overweight and obese compared to their counterparts. The impact of substance use on body weight status differed by the frequency and route of administration.

KEYWORDS:

• Obesity
• overweight
• African American
• women
• substance use

Glossary

• Active drug user: A participant used speedball, crack, cocaine, or heroin within the past 6 months

• Active marijuana user: A participant used marijuana in the past 6 months

• ANOVA: Analysis of variance

• ASI: Addiction Severity Index

• CES-D: Center for Epidemiologic Studies Depression Scale

• Nonactive drug user: A participant used speedball, crack, cocaine or heroin more than 6 months ago

• Nonactive marijuana user: A participant used marijuana more than 6 months ago

• Obesity: Body mass index (BMI) of adults greater than or equal to 30

• Overweight: Body mass index (BMI) of adults greater than or equal to 25

• RAB: Risk Assessment Battery

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Funding

The study was supported by the National Institutes of Health (NIH) grants R01MH66810, K01MH096611 and K99/R00AA020782, and the Johns Hopkins Center for AIDS Research (1P30AI094189).

Additional information

Notes on contributors

Ji Li

Dr. Ji Li was a Research Data Analyst in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health. Currently she is a Postdoctoral Research Fellow in the Department of Pathology at the Johns Hopkins University School of Medicine. Her main research focuses on international nutrition, substance abuse, HIV prevention and intervention, and cardiovascular complications of HIV infection and cocaine use.

Cui Yang

Dr. Cui Yang is an Assistant Professor in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health. Her research is concerned with HIV and substance use, particularly with disadvantaged communities in both domestic and international settings. Her research interests have centered around three major areas: (1) to explore social determinants of health disparities of substance use and HIV; (2) to develop and test mHealth research and programs to reduce risks associated with HIV and substance use; (3) to utilize advanced statistical techniques to evaluate HIV and substance use risk reduction interventions.

Melissa Davey-Rothwell

Dr. Melissa Davey-Rothwell is an Associate Scientist in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health. Her main research interest is the relationship between risk behaviors and social networks and norms. In addition, her work focuses on evaluation, translation and dissemination of behavioral interventions into the community.

Carl Latkin

Dr. Carl Latkin is a Professor in the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health. His research focuses on HIV prevention and care among disadvantaged populations, domestic and international approaches to behavior change, social and personal network analysis, neighborhood factors and health behaviors, injection drug users, STIs, alcohol, harm reduction, mental health, social support, social context and risk behavior, integrating qualitative and quantitative methods.