The Association Between Perceived Discrimination and Body Mass Index (BMI) Among Asian American Women Before and During the COVID-19 Pandemic

We examined the association between perceived discrimination and body mass index (BMI) in Asian American (AA) women before and during the COVID-19 pandemic. The data used were from the Epidemiology/Epigenetics of Asian Women's Action for Resilience and Empowerment (Epi AWARE) study, which enrolled 157 AA women aged 18 to 59 between December 2019 and September 2022. Two sets of questions measured "everyday" (e.g., "How often do people act as if you are dishonest?") and "lifetime" (e.g., "unfair treatment due to your race at school") discrimination. Responses were combined, creating a cumulative score, and dichotomized into "no" versus "any" discrimination. Self-reported height and weight were used to calculate BMI, dichotomized as <25 kg/m² and ≥25 kg/m². Multivariable binomial regression estimated risk ratios (RRs) and 95% confidence intervals (95% CIs). Overall, women reporting any versus no discrimination were more likely to be classified as having a BMI ≥ 25 kg/m² (RR = 2.09; 95% CI: 1.06-4.13). The RR for women who responded during the COVID-19 pandemic (20 March 2020 or later) was 2.65 (95% CI: 0.82-8.58); the RR for pre-pandemic response was 1.93 (95% CI: 0.75-5.01). Our data suggest that experiences of racism may impact BMI among AA women. Further research is needed to identify mechanisms and design appropriate interventions.