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Body size satisfaction may be an important factor associated with physical activity. We analyzed data from the 2002 National Physical Activity and Weight Loss Survey (NPAWLS), a population-based cross-sectional telephone survey of US adults. Multiple logistic regression models were used to examine the association of body size satisfaction on being regularly active. Participants were aged ≥18 years with complete data on weight, race/ethnicity, physical activity level, and body size satisfaction (n = 10,021). More than half of men (55.8%) and women (53.3%) who reported being very satisfied with the body size were regularly active. After adjustment for covariates, participants who reported being somewhat or not satisfied with their body size had a 13 and 44% lower odds of being regularly active, respectively, compared with those very satisfied with their body size. When stratified by race/ethnicity, this association remained in whites (P for trend <0.001), but became weaker and nonsignificant in blacks, Hispanics, or other racial/ethnic groups. Irrespective of actual weight, those who were satisfied with their body size were more likely to engage in regular physical activity than those less satisfied. Further research is needed to explore predictors of physical activity to reduce health disparities.