Resilience to obesity amongst socioeconomically disadvantaged women: the READI study

Objective: This cross-sectional study aimed to identify sociodemographic and behavioural characteristics of 32 ‘overweight-resilient’ women, i.e., women who were in a healthy body weight range, despite living in 33 socioeconomically disadvantaged neighbourhoods that place them at increased risk of obesity. The study also 34 aimed to test a comprehensive theoretically-derived model of the associations between intrapersonal, social and 35 environmental factors and obesity amongst this target group. 36 Participants: 3 235 women aged 18-45 years from 80 urban and rural neighbourhoods throughout Victoria, 37 Australia, participating in the Resilience for Eating and Activity Despite Inequality (READI) study. 38 Measurements: Women reported height, weight, sociodemographic characteristics, leisure-time physical 39 activity, dietary behaviours, and a range of theoretically-derived cognitive, social and neighbourhood 40 environmental characteristics hypothesized to influence obesity risk. A theoretical model predicting body mass 41 index was tested using structural equation models. 42 Results: Women classified as ‘resilient’ to obesity tended to be younger, born overseas, more highly educated, 43 unmarried, and to have higher or undisclosed household incomes. They engaged in more leisure-time physical 44 activity, and consumed less fast foods and soft drinks than overweight/obese women. Neighbourhood 45 characteristics, social characteristics and cognitive characteristics all contributed to explaining variation in BMI in 46 the hypothesized directions. 47 Conclusions: These results demonstrate several characteristics of women appearing ‘resilient’ to obesity, despite 48 their increased risk conferred by residing in socioeconomically disadvantaged neighbourhoods. Acknowledging 49 the cross-sectional study design, the results advance theoretical frameworks aimed at investigating obesity risk 50 by providing evidence in support of a comprehensive model of direct and indirect effects on obesity of 51 neighbourhood as well as social, cognitive, and behavioural characteristics.