Transitions among BMI States: A Test of Competing Hypotheses

Overweight/obesity and underweight among older adults remain major public health concerns in the United States. This study aims to assess cohort differences in transition among BMI (body mass index) statuses (underweight, normal weight, overweight, and obese) by various cohort and race/ethnicity–gender groups. The empirical work of this study was based on the 1992–2014 Health and Retirement Study (HRS). Multistate life tables (MSLT) were used to assess transitions among different BMI statuses. Results from multistate life tables suggested that the impact of cumulative advantage (disadvantage), persistent inequality, and aging-as-leveler on transition among BMI statuses was shaped along race/ethnicity–gender and cohort lines. Weight management and weight loss strategies should focus on ethnic minorities (i.e., Black and Hispanic populations) and White participants from recent cohorts. Programs aimed at minimizing the negative consequences associated with underweight and weight loss should focus on individuals from earlier cohorts and Black populations.