Ethnic differences in self-rated overweight and association with reporting weight loss action: the SUNSET study

Aim: To investigate ethnic differences in self-rated overweight and self-reported weight loss action. Methods: Cross-sectional study (conducted in 2001-03) of 1441 residents (35-60 years) of Amsterdam, The Netherlands: Surinamese of South Asian (SA-Sur) and African (Afr-Sur) origin and ethnic Dutch. Self-rated overweight and self-reported weight loss action assessed by questionnaire. Height, weight and waist circumference (WC) measured in a clinic setting. Results: Compared with ethnic Dutch and adjusting for BMI, Afr-Sur men [odds ratio (OR) 0.32; 95% CI 0.19-0.57] and women (OR 0.54; 95% CI 0.34-0.86) were less likely to rate themselves as overweight. However, adjustment for WC reduced differences in self-rated overweight (men: OR 0.79; 95% CI 0.46-1.35; women: OR 0.89; 95% CI 0.59-1.36). SA-Sur participants did not differ significantly from ethnic Dutch when adjusting for either BMI or WC. Surinamese participants were significantly more likely to report weight loss action independent of BMI, WC or self-rated overweight. In Afr-Sur men, elevated WC, not BMI was associated with reported weight loss action (OR 2.31; 95% CI 1.35-3.99 vs. OR 1.52, 95% CI 0.89-2.58, respectively). Conclusion: In this population, differences in self-rated overweight were explained by measured weight variables (BMI or WC). Our results do not support the hypothesis that Surinamese migrants would be less likely to be attempting weight loss than their Dutch peers. Further research into the reasons underlying this finding and associated weight loss behaviour seems indicated