Association between perceived stress and obesity: Implications for community-based obesity prevention programs

INTRODUCTION: Perceived stress has been associated with obesogenic behaviors such as emotional eating and consumption of high-fat foods. We assessed perceived stress and its association with obesity in a random sample of residents living in communities participating in Mass in Motion (MiM) and non-MiM communities. MiM uses environmental approaches to promote healthy eating and active living in 52 Massachusetts communities. METHODS: Data were collected using a telephone survey of 1,262 residents age 18 and older. Perceived stress was measured using Cohen’s Perceived Stress Scale (PSS-10). Body mass index (BMI) was calculated using self-reported height and weight. Logistic regression was used to estimate odd ratios for being obese (BMI ≥ 30) based on continuous perceived stress score while adjusting for gender, age, race/ethnicity, income, education, employment status, and marital status, as well as living in an MiM community. RESULTS: Mean PPS-10 score was 14.40, SD 4.72, with higher scores associated with obesity status, income, education, employment status, and marital status. 28.5% of the respondents were obese. In the model, higher levels of perceived stress were significantly associated with obesity (adjusted OR, 1.04; 95% CI 1.01 – 1.08, p=0.02); also associated with obesity were age group, employment status, marital status, and educational attainment. CONCLUSIONS: While increasing access to healthier options and promoting healthy behaviors, community-based obesity prevention programs should also assess residents’ perception of their environment and barriers to healthy living such as experience of stress as part of program design and implementation.