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

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.