Persistent financial hardship, 11-year weight gain, and health behaviors in the Whitehall II study.

Abstract

To ascertain prospectively gender-specific associations between types and amounts of financial hardship and weight gain, and investigate potential behavioral mechanisms. Prospective study of 3701 adult British civil servants with repeated measures of difficulty paying bills or insufficient money to afford adequate for food/clothing (1985-1988; 1989-1990; 1991-1993; 1997-1999), and weight (1985-1988; 1997-1999). Persistent hardships were associated with adjusted mean weight change in women over 10.9 years, but no consistent pattern was seen in men. During follow-up, 46% of women gained ≥5 kg. Women reporting persistent insufficient money for food/clothing had a significantly greater odds of gaining ≥5 kg (1.42 [1.05, 1.92]) compared to no hardship history, which remained after socioeconomic status (SES) adjustment (1.45 [1.05, 2.01]). The association between persistent difficulty paying bills and odds of excess weight gain was also significant (1.42 [1.03, 1.97]) but attenuated after considering SES (1.39 [0.98, 1.97]). Four health behaviors as single measures or change variables did not attenuate associations. Results suggested strategies to tackle obesity must address employed women's everyday financial troubles which may influence weight through more biological pathways than classical correlates of economic disadvantage and weight.