RESEARCH Current Research Overweight Adolescent African-American Mothers Gain Weight in Spite of Intentions to Lose Weight MAUREEN M. BLACK, PhD; MIA A. PAPAS, MS; MARGARET E. BENTLEY, PhD; PAMELA CURETON, RD; ALICIA SAUNDERS; KATHERINE LE, MPH; JEAN ANLIKER, PhD, RD; NONI ROBINSON, MS ABSTRACT Objective This study sought to determine how dietary pat- terns, self-esteem, depressive symptoms, and intention to lose weight were associated with body size among adoles- cent African-American mothers 1 year after delivery and with changes in body size over the next year. Design Cross-sectional and longitudinal self-reported measures were collected 1 year after delivery. Weight and height were collected 1 and 2 years after delivery. Subjects The subjects were 118 low-income, African-Amer- ican adolescent mothers recruited after the birth of their first child. Statistical analyses Multivariate analysis of covariance and multivariate regression analysis were conducted to exam- ine predictors of body size 1 year after delivery and changes in body size over the next year. Analyses were adjusted for maternal age, education, breastfeeding his- tory, and intervention. Results One year after delivery, 33.0% of mothers were overweight (body mass index [BMI] 95th percentile) and 23.7% were at risk for overweight (BMI 85th and 95th percentile). Mothers consumed a daily average of 2,527 kcal and 4.1 high-fat snacks. A total of 11% of normal-weight mothers, 22% of mothers at risk for over- weight, and 44% of overweight mothers reported inten- tion to lose weight,  2 =10.8, P.01. Average maternal BMI z score increased 0.13 (3.9 kg) between 1 and 2 years after delivery, P.01. Dietary patterns, self-esteem, de- pressive symptoms, and intention to lose weight were not related to body size or increase in body size. Conclusions One year after delivery, overweight among adolescent mothers was common and increased over time. Although nearly half of overweight mothers reported an intention to lose weight, their weight gain did not differ from that of other mothers, suggesting that they lack effective weight-loss behaviors, and may be good candi- dates for intervention. African-American adolescent mothers have high rates of overweight and snack con- sumption and may benefit from strategies to identify nutritious, palatable, affordable, and accessible alterna- tives to high-fat snack food. J Am Diet Assoc. 2006;106:80-87. I n the past decade, the prevalence of overweight (body mass index [BMI] 95th percentile) has increased steadily among American youth and is a serious public health problem (1-5). Evidence shows that 22% of se- verely overweight children and adolescents have im- paired glucose tolerance, an early sign of type 2 diabetes (6). In addition, overweight during adolescence increases the risk for multiple health problems during adulthood, including obesity, diabetes, sleep apnea, hypertension, and cardiovascular disease (7,8). The association between adolescent overweight and psychopathology, particularly depression, is less clear, but may be an important factor in the success of health promotion and overweight pre- vention programs (9). In a society in which thinness is almost a virtue, over- weight can be a social disadvantage (9-15). Although re- ports from clinic-based studies find that overweight ado- lescents have elevated rates of depressive symptoms and M. Black is a professor, Department of Pediatrics, Uni- versity of Maryland School of Medicine, Baltimore, MD. M. Papas is a doctoral candidate, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; at the time of the study, she was a research analyst, De- partment of Pediatrics, University of Maryland School of Medicine, Baltimore. M. Bentley is a professor, De- partment of Nutrition, University of North Carolina at Chapel Hill, School of Public Health, Chapel Hill, NC. P. Cureton is a research dietitian, Department of Pediat- rics, University of Maryland School of Medicine, Balti- more. A. Saunders is a medical student at the Univer- sity of Pittsburgh, Pittsburgh, PA; at the time of the study, she was a research assistant, Department of Pedi- atrics, University of Maryland School of Medicine, Bal- timore. K. Le is a medical student at Wake Forest Medi- cal Center, Winston-Salem, NC; at the time of the study, she was a project coordinator, Department of Pediatrics, University of Maryland School of Medicine, Baltimore. J. Anliker is an associate professor, Department of Nu- trition, University of Massachusetts Amherst, Che- noweth Laboratory, Amherst, MA. N. Robinson is a re- search assistant, Department of Pediatrics, University of Maryland School of Medicine, Baltimore. Address correspondence to Maureen M. Black, PhD, 737 W Lombard St, Room 161, Baltimore, MD 21201. E-mail: mblack@peds.umaryland.edu Copyright © 2006 by the American Dietetic Association. 0002-8223/06/10601-0007$32.00/0 doi: 10.1016/j.jada.2005.09.049 80 Journal of the AMERICAN DIETETIC ASSOCIATION © 2006 by the American Dietetic Association