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A qualitative analysis of black and white British women's attitudes to weight and weight control

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Abstract

Rates of obesity among black African and black Caribbean women in the UK are consistently higher than among white women. Cultural, attitudinal and behavioural differences may contribute to ethnic variation in weight, and the present study aimed to explore attitudes towards weight and weight control among black and white British women using a qualitative approach. Ethnically homogeneous focus groups were carried out with 25 white women [mean (SD) body mass index (BMI, kg m(-2)) = 26 (7.2) kg m(-2) ] and 24 black women [mean (SD) BMI = 29 (6.6) kg m(-2) ]. Women were recruited from London boroughs (Lambeth, Southwark and Croydon) and Guildford, Surrey, and focus groups were conducted in London. Focus groups were recorded and transcribed verbatim, and were analysed using thematic analysis. All participants had fairly good knowledge of the causes, consequences and treatment of being overweight. However, black women primarily emphasised the health consequences of being overweight, whereas white women were more likely to focus on the perceived social and emotional consequences. White women associated being overweight with negative character traits, whereas black women had a broadly positive attitude towards larger body sizes. Black women were as well-informed about the causes and health risks of obesity as white women in this sample of mainly educated, working women, although they were more accepting of larger body sizes and experienced less social pressure to be slim.

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... high-income countries can manage obesity, body image, and psychological consequences (Shoneye et al., 2011;Smith, Fu and Kobayashi, 2020;Jacob et al., 2021). Nevertheless, the participation of minority ethnic groups, especially British-born Afro-Caribbeans, may be limited by doubts about health, cultural relevance, and traditional African ways (Shoneye et al., 2011;Memon et al., 2016). ...
... high-income countries can manage obesity, body image, and psychological consequences (Shoneye et al., 2011;Smith, Fu and Kobayashi, 2020;Jacob et al., 2021). Nevertheless, the participation of minority ethnic groups, especially British-born Afro-Caribbeans, may be limited by doubts about health, cultural relevance, and traditional African ways (Shoneye et al., 2011;Memon et al., 2016). In addition to feelings, beliefs, and behaviours, body image includes perceptions and attitudes about one's body and appearance (Hosseini and Padhy, 2019;Burychka, Miragall, and Baos, 2021). ...
... Several participants lack discipline and willpower. They blamed diet and self-control (Shoneye et al., 2011;Salemonsen et al., 2018). Self-discipline won't last if the conflict between pleasure and health isn't resolved (Salemonsen et al., 2018). ...
Article
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Obesity, body image, and depression are all biopsychosocial phenomena that are frequently misunderstood across cultures. Body dissatisfaction is a psychological aspect of obesity that has been associated with disordered eating, low self-esteem, and depression. Nevertheless, body image dissatisfaction may affect non-obese individuals too. Those with a positive body image are more likely to participate in physical activity than those with a negative body image. Individuals who are satisfied with their body image are more likely to possess high self-esteem, confidence, and healthy eating habits. Obesity prevention among the black population is increasingly important. This study sought to examine the perceptions and experiences of British-born Afro-Caribbean male students at a West Yorkshire University in England regarding obesity, body image, and mental health. Twelve participants took part in 45-minute semi-structured interviews. The data was transcribed verbatim and analyzed using thematic analysis. Results revealed four major themes: "healthy lifestyle monitoring," "body image attitude," "experiences of attempting to maintain weight," and "reasons for weight change." Clinically obese individuals exhibited dissatisfaction with their body image. Depression was found to be strongly related to dissatisfaction with one's body image. Obesity is stigmatized and associated with low self-esteem in many societies in the United Kingdom, which impacts mental health. Future health promotion programs should teach obese individuals who are dissatisfied with their body image to deal with emotions like shame, guilt, and pride. Furthermore, individuals should adopt healthier eating habits and increase their physical activity, which is a broad strategy to reduce the incidence of obesity.
... Studies have found lower levels of body image dissatisfaction and desire to be thin in Blacks compared to Whites [27,29,45]. According to Bbuffering hypothesis^by Kahn and Powell, lower cultural motivation to be thin in Black communities may function as a protective factor against eating disorders among Blacks [48][49][50]. Under this hypothesis, altered association between body image dissatisfaction and binge eating based on ethnicity may be due to a stronger buffering effect of African American culture against body image dissatisfaction compared to Caribbean Blacks. ...
... Some researchers speculate that the same weight tolerant attitude protective for eating disorders such as anorexia nervosa and bulimia increases risk for binge eating [52]. Under this reasoning, despite low levels of body image dissatisfaction, African Americans show high levels of binge eating which suggests weaker comorbidity between the two [48][49][50][51][52]. In this model, the differential weight tolerant attitudes may contribute to differential susceptibility to binge eating across racial and ethnic groups. ...
Article
Background: The research on binge eating has overwhelmingly focused on Whites. We aimed to study gender and ethnic differences in the association between body image dissatisfaction and binge eating in a nationally representative sample of Black adults in the USA. Methods: This cross-sectional study used data from the National Survey of American Life (NSAL), 2003-2004. Self-identified Caribbean Black (n = 1621) and African American (3570) adults aged 18 and older were enrolled. The independent variable was body dissatisfaction measured with two items. Using the World Health Organization Composite International Diagnostic Interview (WHO-CIDI), outcome was lifetime binge eating without hierarchy according to the DSM-IV criteria. Covariates included age, socioeconomic factors (i.e., education and marital status), and body mass index. Ethnicity and gender were focal moderators. Logistic regressions were used for data analysis. Results: Despite comparable prevalence of lifetime binge eating (5 vs 4 %, p > 0.05), African Americans reported higher body image dissatisfaction than Caribbean Blacks (36 vs 29 %, p > 0.05). In the pooled sample, body dissatisfaction was a strong predictor of lifetime binge eating disorders. There was a significant interaction (p = 0.039) between ethnicity and body image dissatisfaction on binge eating, suggesting a stronger association between body image dissatisfaction and lifetime binge eating for Caribbean Blacks (OR = 11.65, 95 % 6.89-19.72) than African Americans (OR = 6.72, 95 % CI 3.97-11.37). Gender did not interact with body image dissatisfaction on binge eating. Conclusion: Ethnic variation in the link between body image dissatisfaction and binge eating may be due to within-race cultural differences in body image between African Americans and Caribbean Blacks. This may include different definitions, norms, and expectations regarding the body size. Findings suggest that ethnicity may bias relevance of body image dissatisfaction as a diagnostic criterion for binge eating disorders among diverse populations of Blacks.
... For example, a study conducted in a multi-ethnic Caribbean population showed that overweight African women were more likely to be satisfied with their body image than non-African overweight women [15]. It is reported too that overweight and obese African women do not consider themselves as such, thereby reducing the likelihood of them attempting to lose weight [16]. ...
... This study also found that females were more frequent inappropriate users of Cyproheptadine than males. This high attraction to Cyproheptadine use by women can be explained by the fact that African women think that Black men find bigger women more attractive as described by Shoneye [16]. This hypothesis can be confirmed because our study showed that married women used Cyproheptadine less than single women probably because the single women will be more constrained to want to attract men. ...
Article
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Obesity is one of the main risk factors of non-communicable diseases (NCDs) worldwide, especially in sub-Saharan Africa. The use of Cyproheptadine increases body weight and the risk of becoming obese. The aim of this study is to determine the prevalence of Cyproheptadine misuse in the Kinshasa population and to describe its characteristics. A cross-sectional study was conducted in two town sectors of Kinshasa, Democratic Republic of Congo (DRC), over a 4 month period (May 2011 to August 2011). Data from 499 participants, aged between 13 and 55 years were collected and analyzed. Mean and standard deviation were used for quantitative variables and frequency and percentage for categorical variables. In order to determine the relationship between socio-demographic status and Cyproheptadine use the Chi-square test was conducted. Student’s t-test was used to compare means age of Cyproheptadine users and non-users. Logistic regression was used to determine predictors of Cyproheptadine use. A p-value of <0.05 was considered statistically significant. Overall, 499 participants were enrolled (352 females, 147 males, mean age ± standard deviation 24.9 ± 9.7 years) in the study. The majority of the study participants (72.9 %) had used Cyproheptadine as an appetite stimulant. Females were 11 times more likely to use Cryproheptadine (OR = 11.9; 95 % CI: 7.1–20.1) than males. People aged between 36 and 55 were three times less likely to use Cryproheptadine (OR = 0.3; 95 % CI: 0.2–0.8) compared to teenagers. More than half of the participants (69.0 %) declared to take daily Cyproheptadine. Half of the study participants (50.0 %) used Cyproheptadine for more than a year and also declared to combine it with Dexamethasone (87.6 %). This study shows that the Kinshasa population is significantly misusing Cyproheptadine and is highly exposed to its risk, including obesity.
... Similarly, healthcare professionals consulting with individuals and families from diverse communities need an understanding of a range of 'oppositional gazes' on meanings of health, well-being and fitness that do not easily align with biomedical discourses and that resist the idea of the risk of ill-health residing silently in their body. For example, a UK study that explored attitudes to weight of both Black and White women, Shoneye et al. (2011) found that Black participants had a more favourable opinion of larger body sizes compared to their White counterparts. This finding echoes results of research conducted in African American communities that reports a cultural normalising and acceptance of excess weight and obesity for women (e.g. ...
... In a study that investigated the health beliefs of African Caribbean people, Brown et al. (2007) report that the participants were well aware of the link between excess weight and the onset of Type 2 diabetes. In fact, Shoneye et al. (2011) found that the Black female participants were more likely to identify health as a motivator for weight management than White female participants. However, biomedicine is only one of the lenses through which risks to well-being may be perceived. ...
Article
The aim of this article is to explore how tendencies to stereotype minority ethnic groups intersect with lay discourses about them in ways that can reproduce cultural prejudices and reinforce inequalities in access to services and health outcomes. Drawing upon Black feminist and cultural studies literature, we present a theoretical examination, the stereotypes of the Black woman as 'mammy' and 'matriarch'. We suggest that the influence of these two images is central to understanding the normalisation of the larger Black female body within African Caribbean communities. This representation of excess weight contradicts mainstream negative discourses of large bodies that view it as a form of moral weakness. Seeking to stimulate reflection on how unacknowledged stereotypes may shape clinical encounters, we propose that for Black women, it is the perception of strength, tied into these racial images of 'mammy' and 'matriarch' which may influence when or how health services or advice are both sought by them and offered to them. This has particular significance in relation to how body weight and weight management are/are not talked about in primary care-based interactions and what support Black women are/are not offered. We argue that unintentional bias can have tangible impacts and health outcomes for Black women and possibly other minority ethnic groups. © The Author(s) 2015.
... All interviews were conducted over telephone by author 1, a dietitian (CS; female) who has qualitative research experience [60], with guidance from AB, an established qualitative researcher [61,62]. Participants in the interview completed a consent form and a demographics questionnaire on the web. ...
Preprint
UNSTRUCTURED Excess weight is a major risk factor for chronic diseases. In Australia, over 60% of adults are overweight or obese. The overconsumption of energy-dense nutrient-poor (EDNP) foods and low physical activity (PA) levels are key factors contributing to population obesity. New cost-effective approaches to improve population diet and PA behaviors are needed. This 1-year randomized controlled trial (6-month intervention and 6-month follow-up) aims to investigate whether a tailored intervention using mobile technology can improve diet and PA behaviors leading to weight loss in adults (aged 18-65 years) who are overweight or obese and recruited through a social marketing campaign (LiveLighter). All eligible participants will provide data on demographics and lifestyle behaviors online at baseline, 6 months, and 12 months. Using two-stage randomization, participants will be allocated into one of three conditions (n=200 per group): tailored feedback delivered via email at seven time points, informed by objective dietary (mobile food record app) and activity (wearable activity monitor) assessment; active control receiving no tailored feedback, but undergoing the same objective assessments as tailored feedback; and online control receiving no tailored feedback or objective assessments. Primary outcome measures at 6 and 12 months are changes in body mass, EDNP food and beverage consumption, and daily moderate-to-vigorous PA (measured via accelerometry). Secondary outcomes include change in fruit and vegetable consumption, daily sedentary behaviors, and cost effectiveness. Enrolment commenced in August 2017. Primary outcomes at 12 months will be available for analysis from September 2019. Tailored email feedback provided to individuals may deliver a cost-effective strategy to overcome existing barriers to improving diet and PA. If found to be successful and cost effective, upscaling this intervention for inclusion in larger-scale interventions is highly feasible. Australian New Zealand Clinical Trials Registry ACTRN12617000554369; https://www.anzctr.org.au /Trial/Registration/TrialReview.aspx?id=371325&isReview=true.
... All interviews were conducted over telephone by author 1, a dietitian (CS; female) who has qualitative research experience [60], with guidance from AB, an established qualitative researcher [61,62]. Participants in the interview completed a consent form and a demographics questionnaire on the web. ...
... All interviews were conducted over telephone by author 1, a dietitian (CS; female) who has qualitative research experience [60], with guidance from AB, an established qualitative researcher [61,62]. Participants in the interview completed a consent form and a demographics questionnaire on the web. ...
Article
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Background: LiveLighter© is an Australian government health education and social marketing campaign, specifically targeting obesity. LiveLighter Tailored Diet and Activity (LLToDAy) study aims to build on the campaign, by the addition of a digital intervention with the potential to provide wide-reaching, cost-effective weight management support. Objective: This paper describes the qualitative study and iterative process used to inform the design and message development of LiveLighter Tailored Diet and Activity (LLToDAy), a digital weight management intervention. The main objectives were to 1) identify behavior change techniques for diet and physical activity change for weight loss and 2) explore preferences for digital intervention features that would be effective in changing diet and physical activity behaviors. Methods: This qualitative study used the principles of the person-based approach to intervention development, the behavioral intervention technology framework and capability, opportunity, motivation and behavior (COM-B) framework. Focus groups and telephone interviews were conducted with 56 adults in Western Australia.. Open-ended questions and example intervention features were used to explore the usability and acceptability of the self-monitoring tools, knowledge about effective weight-loss strategies and acceptability of the tailored feedback. Focus group and interview findings were analyzed using thematic analysis. Results: Qualitative findings revealed an awareness of key public health messages but a lack of confidence in how to perform these behaviors to help manage their weight. Four major themes were identified and mapped to the domains of the COM-B framework: 1. Misinformation; 2. Environmental support; 3. Social norms and 4. Confidence. Conclusions: This study explored users' capability, opportunity and motivation to perform the target behaviors for weight loss. Findings suggest that a digital weight management interventions using mobile food records and activity trackers to inform tailored feedback, may be an acceptable and feasible. Participants expressed a preference for simple expert advice, digital self-monitoring tools and visual feedback. Clinicaltrial:
... Research conducted by Shoneye et al. (2011) with women in London found that the while the African Caribbean women had a good understanding of health risks that may be exacerbated by a larger body size, they had a more favorable opinion of a larger female body than their White British counterparts 1 . This apparent cultural normalizing of the larger female body form can be understood as existing in tension with dominant mainstream discourses promoting a slim female figure and constructing the overweight individual as problematic (Puhl and Brownell, 2001) ...
Article
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African Caribbean women in the UK who are diagnosed with chronic illnesses that are related to overweight and obesity are more likely to experience poorer outcomes than their White British counterparts. It is then important to increase understandings of how women from this ethnic group perceive health with relation to body shape and size so that interventions can be developed to prevent the development of such conditions and to improve outcomes. As such, it is important to develop research methodology that encourages participation in health research from African Caribbean women and enables the capture of in-depth data that gives insight into the nuances of health understandings related to the body and the social realities in which they exist. This paper details the methodological framework of The Big Talk project, an investigation that sought to develop a novel approach to conducting health research with seldom heard communities. The concept of intersectionality, as used in Critical Race Theory, was applied as a theoretical tool for exploring the dynamics of societal power and where this power intersects across the lived realities of race, ethnicity, gender, sexuality, (dis)ability, and class. For this research, these intersections are explored for African Caribbean women and how they relate to concepts of health, body shape, and size. This research study was conducted in spaces identified as liminal spaces for African Caribbean women: talk radio programmes; hairdressing salons and; local community groups. A Black feminist epistemological approach was used to facilitate the collection of data. The data that emerged from these liminal spaces are not necessarily definitive answers on health for African Caribbean women, but rather illuminate alternative ways of understanding the social world from the perspective of those subject to power. This phenomenon makes liminal spaces intersectional in their construction and in taking such an approach to analysis could enable finely grained details of discourses regarding health, wellness and the body to be gathered. The importance of this understanding can help to improve preventive health interventions for African Caribbean women.
... Some qualitative studies have tried to focus on the individual factors and experiences during management of obesity in order to understand how the situation could better be managed (19)(20)(21)(22)(23)(24)(25)(26). ...
Article
Objectives: Obesity is a leading preventable cause of death worldwide. Being overweight or obese has a serious impact on health. Treatment of obesity needs a comprehensive approach. Biopsychosocial approach of family physicians is invaluable in obesity management. This study was performed in order to find answers to “why”, “how’’ and “when’’ our patients became obese. Methods:We conducted in-depth, semi-structured, face to face interviews with 30 participants (BMI>30). Interviews were audio-recorded and transcribed, and qualitatively analysed using a thematic framework method. Results:26 women and 4 men accepted to join our study. Analysis of indepth interviews emerged 5 major themes which were the different perception of obesity among individuals; awareness of obesity; loss of selfconfidence; belief in treatment and effects on quality of life. Conclusion:Each patient has a different need and different expectation while controlling weight. As a part of biopsychosocial approach the family physician needs to understand the factors that bring the patient to current condition and see which approach would be the best for individual patient for weight management.
... Consent Forms: Among the most significant documents recorded and archived by qadis are forms, indicating that the physician was not responsible for any negative consequences of treatment, signed before the qadi and witnesses between a surgeon and a patient to be operated or in some cases between a physician and a patient that required a risky treatment (15,19). ...
Article
Objective: As in many places in the world, surgical practices in the Ottoman Empire as well were performed not by physicians but surgeons. Even it seems that medicine and surgery have been dominated by males from their appearance, the literature shows that the appearances of female physicians and surgeons date back to old times. In this Study, Based on the knowledge achieved on Saliha Hatun, lived in the 17th century and known with the name Kupeli, and on documents available in Uskudar Shari'a Court Records, consent notes of surgical interventions were evaluated in this study. Methods: The consent documents of Saliha Hatun from Uskudar Shari'a Court Records were examined.The transcriptions of selected consent documents of Saliha Hatun were translated into Turkish and assorted. The documents were separately evaluated. Results: Saliha Hatun was hazık in surgery and had a superior position among her peers. The consent forms we examined for the purpose of this study show that there was a female surgeon practicing in the 17th century, and she was performing surgeries and signing consent forms with her patients. The majority of patients visited her for the treatment of hernia. Conclusions: The documents of consent notes, supplied from Court Records, provides evidence of the presence of a female surgeon named Saliha Hatun in the 17th century. The consent forms examined for the purpose of this study show that Saliha Hatun was adept at hernia operations This evidence also shows that Ottoman females had effective roles and positions in these eras.
... As described earlier, differences in dietary behaviour between males and females have been well documented, (19) and sex differences in food motives as identified in the present study may explain the differences in eating behaviour between males and females as observed in other studies. There are a number of studies that have proposed psychological reasons for these differences between males and females, such as greater health beliefs and weight consciousness in women (20) and social pressure about having a slim body (21) , more favourable attitudes and greater behaviour control towards consuming FV as well as higher knowledge on the benefits of FV consumption in women (22,23) . Possible explanations for these differences are differences in biological, social and emotional factors (7) as well as differences in body image between sexes (24) . ...
Article
Dietary behaviour is influenced by a complex web of biological, psychological, physiological, social, economic and cultural factors. Understanding socio-demographic and anthropometric characteristics that influence food choice may be important in guiding dietary interventions. This study aimed to identify whether socio-demographic and anthropometric characteristics influence food choice in an Irish working population. A cross-sectional survey was conducted in 2014 as part of the Food Choice at Work Study (FCW), a large clustered non-randomised, controlled trial based in county Cork, Ireland. Information regarding food motives was collected at the 3-4 months follow-up. The 'Food Choice Questionnaire' was used to measure food motives. Multiple linear regression was conducted to test the association between socio-demographic and anthropometric characteristics (age, gender, body mass index (BMI), education, type of accommodation, living situation, marital status, parental status) and worksite and food motives. A total of 678 employees were included in the analysis. Overall, only a small percentage of food choice was influenced by the characteristics included in this analysis (1.6 to 8.8%). Sensory appeal and satisfaction were scored most important by all sub-populations. Gender was most often associated with differences in food motives (i.e. all food motives except for familiarity and ethical concern were significantly more important to females compared to males; p=0.001/ p<0.001). Worksite, age, body mass index and marital status also seemed to play a small role in influencing food choice. The results show that food choice is complex and not easily explained by differences in socio-demographic or anthropometric population characteristics.
... Cultural background may influence obesity via the influence on health behaviours and related attitudes. Research suggests that this is particularly the case for women from Indian, Pakistani and Bangladeshi cultural backgrounds in relation to diet (Cross-Bardell et al., 2015) and physical activity (Koshoedo, Paul-Ebhohimhen, Jepson, & Watson, 2015) and for Black African and Black Caribbean women in relation to body size ideals, although this is contested (Shoneye, Johnson, Steptoe, & Wardle, 2011;Swami, 2015;Tovee, Swami, Furnham, & Mangalparsad, 2006). Eating habits (Higgins & Dale, 2010;Sproston & Mindell, 2006a), levels of smoking, drinking (Sproston & Mindell, 2006a), and breastfeeding (Leung & Stanner, 2011) differ by ethnic group and are each associated with obesity. ...
Article
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Previous research has identified ethnic differences in abdominal obesity but has not fully explored the pathways that explain these ethnic differences, which may relate to individual and contextual characteristics. This research identifies ethnic differences in waist circumference for eight ethnic groups in England, before and after accounting for a range of individual-level and area-level factors. Three key pathways to obesity are explored: migration status, cultural characteristics, and socio-economic characteristics. Data come from four years of the Health Survey for England (1998, 1999, 2003 and 2004) and linked area-level data from the 2001 Census. The total sample size is 27,946. Multi-level modelling methods are used to account for individual-level and area-level factors. The results show that migration status has a strong association with ethnic differences in waist circumference – in particular, waist circumference increases with length of time since migration to the UK. Cultural characteristics and socio-economic characteristics are also associated with ethnic differences in waist circumference, but not to the same extent as migration status. The strong association between migration status and waist circumference is partly attenuated by cultural characteristics and partly by socio-economic inequality. However, there is still a strong association between migrant status and waist circumference that remains unexplained.
... African and Middle-Eastern Arab cultures particularly value bigger body sizes with African women reporting greater acceptance or satisfaction with their body size and expressing less negativity towards obesity than women from other ethnic groups. However whilst the negative perception of obesity in White European women is focused on emotional and social consequences, Black women are more likely to concentrate on health implications and therefore it is important to approach weight loss with a health promotion focus with these patients (30). ...
Chapter
Lifestyle intervention forms the cornerstone of diabetes management. Environmental, economic and personal barriers, impede the ability to make lifestyle change, and are often greater in minority groups who have a higher burden of disease and fewer resources. The healthcare professional's awareness of the wider cultural influences demonstrates cultural competency that has been shown to increase patient satisfaction and adherence to healthcare management. Dietary habits are complex and influenced by many factors such as availability and affordability of traditional and host foods, income, and food beliefs. Patients from minority backgrounds often state a lack of time, multiple caregiving responsibilities, lack of facilities, and safe areas for exercise, as barriers to taking up physical activity interventions. Healthcare professionals working with individual patients/clients from ethnic minority cultures should focus on the healthy components of traditional cultural diets.
... Second, the present theory provides an explanation for the finding that stereotypes about adipose individuals not only contain negative but also positive traits such as agreeableness and kindness (Butler et al., 1993) and even 'huggability' (Shoneye, Johnson, Steptoe, & Wardle, 2011). ...
Article
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Human babies not only are reliable triggers of tender feelings and protective tendencies, they also happen to be exceptionally fat compared to the newborns of most other species. These two facts are used to formulate a hypothesis predicting that overweight males, due to their great physical resemblance to babies, not only are perceived as cute, but also are associated with negatively evaluated traits (e.g., immaturity, lack of willpower) that are saliently inconsistent with traits required for adults. In this study, a great many physical features of adult males varying widely in weight were measured and correlated with subjective judgements. Providing preliminary support for the hypothesis, it was found that the features that were correlated with objective and perceived fatness (e.g., circularity of body parts, relatively large head, short and thick neck) also correlated with perceived babyishness. Perceived fatness and babyishness had curvilinear influences on the positive and prosocial appraisal of cuteness, but were primarily negatively related to perceived willpower and beauty. Results are used to formulate an alternative evolutionary perspective on social responses to overweight and obese individuals, emphasizing the uniquely human adaptive value of fatness and the misfiring of the underlying response mechanism under modern conditions of living.
... That is, the majority of African American women in this study discussed how perceptions of their body image were influenced by their level of comfort, satisfaction, and happiness with themselves rather than by weight or specific body parts. This is partially consistent with research reports highlighting the fact that African American women consistently display higher levels of body satisfaction, weight satisfaction, and heavier body ideals when compared with women from other racial and ethnic groups (Befort, Thomas, Daley, Rhode, & Ahluwalia, 2008;Chao et al., 2008;Grabe & Hyde, 2006;Kronenfeld et al., 2010;Shoneye, Johnson, Steptoe, & Wardle, 2011). However, although the women in this study reported being internally motivated regarding their body image, the majority of African American women in this study also discussed how some external factors (e.g., media, family, men) equally influenced their views of their body image. ...
Article
Researchers consistently have supported the notion that African American women experience greater body satisfaction and are less likely to engage in unhealthy restrictive eating practices due to broader and more flexible body image norms in the African American community. Yet empirical evidence also suggests that African American women experience high rates of binge-eating behaviors and obesity. The purpose of this qualitative study was to gain a deeper understanding of the factors that influence body image norms, eating practices, and overall appearance of African American women aged 25 years and older. Using consensual qualitative research as the guiding method, 11 semistructured interviews were conducted with African American women who self-identified as struggling with body and weight concerns. Five domains were identified: (a) participants’ perceptions of their body image, (b) challenges with body image, (c) participants’ perceptions of eating attitudes and behaviors, (d) role of food, and (e) perceptions of overall appearance. Implications for research and practice are included.
... Authors of several studies reported a difference in perception of body weight between African Americans and Whites. African American women had a broadly positive cultural attitude toward large body sizes, which may lessen the impact of body dissatisfaction on their health behaviors (Hendley et al., 2011;Shoneye, Johnson, Steptoe, & Wardle, 2011). However, attitudes toward body weight have rarely been studied in Hispanic midlife women. ...
Article
Objectives: To identify racial/ethnic differences in perceived health status and differences in the factors associated with perceived health status of midlife women in four broad racial/ethnic groups in the United States. Design: A secondary analysis of Web-based survey data. Setting: Internet communities/groups among midlife women and Internet communities/groups of racial/ethnic minorities. Participants: Participants included 491 women 40 to 60 years of age who self-identified into four broad racial/ethnic categories (Hispanic, non-Hispanic [N-H] Asian American, N-H African American, or N-H White). Methods: Data related to participants' sociodemographic, behavioral, situational, and individual health factors and their coping resources were selected based on the Comprehensive Health Seeking and Coping Paradigm. Multiple logistic regression analyses were used to identify racial/ethnic differences in perceived health status and race/ethnicity-specific factors associated with perceived health status among midlife women. Results: Perceived health status did not differ by race/ethnicity; however, factors that were associated with perceived health status did vary by race/ethnicity. Among N-H White women, educational level, level of family income, obesity, and menopausal symptoms were significantly associated with perceived not healthy status. In Hispanic women, perceived level of physical activity and obesity were significantly associated with not healthy status. Perceived level of physical activity was the only factor significantly associated with not healthy status in N-H Asian American women, and the level of family income was the only factor associated with not healthy status in N-H African American women. Conclusion: In future intervention development, researchers need to consider differences among racial/ethnic groups in the factors associated with women's perceived health status.
... Participants' comments regarding body size are consistent with the findings of other SA studies (4,7) which have suggested that black SA women prefer a larger body size. Similar findings are evident in other cultures such as Samoan populations of the Pacific Islands (31) , the women of Saudi Arabia (32) , women of Caribbean descent living in the UK (33) and African-American women in the USA (34)(35)(36) . ...
Article
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A higher tolerance for a larger body size has been associated with obesity in black South African (SA) women. The aim of the present study was to explore perceptions regarding body size and weight loss in a sample of black women from a low-income community in Cape Town, SA. Qualitative pilot study including five focus groups. Data were analysed using thematic analysis. Khayelitsha, Cape Town, SA. Twenty-one black SA women. The majority of participants had positive perceptions of overweight/obesity, which were influenced by community and cultural perceptions, but some inconsistencies were observed as overweight/obesity was also associated with ill health. Participants identified many benefits to weight loss, but due to the association with sickness, they were concerned about being stigmatised in their community. Although participants had knowledge about healthy eating, the main barrier to eating healthily included the perceived higher cost of healthier food and food insecurity. All participants saw exercise as a strategy to lose weight and improve health, and were interested in participating in a community-based exercise intervention, but negative community perceptions and conflicting views regarding who should lead the intervention were identified as barriers. These findings highlight the complexities surrounding participants' perceptions regarding body size, weight loss and weight-loss interventions, and emphasise low socio-economic status as a barrier to change. The study also highlights the strong influence of cultural ideals and community perceptions on personal perceptions. These findings underscore the necessity for culturally appropriate weight-loss interventions in low-income, transitioning communities.
... This sex difference could be due to attitudinal and behavioral differences toward weight and weight control. Studies have revealed that many women believe that overweight is both portrayed and perceived as "unattractive"; women feel increasing pressure to be slim and recognize the negative stereotyping of fatness (Craig and Caterson 1990;Shoneye et al. 2011). This could be particularly true of female paramedics considering that their employment includes physically demanding tasks and they must constantly adapt to the physical and mental challenges of the job because every day at work is different and unpredictable (Corbeil and Prairie 2012). ...
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Background A significantly higher proportion of UK Black ethnic adults live with overweight or obesity, compared to their White British counterparts. The role of obesity in excess infection rates and mortality from COVID-19 has increased the need to understand if weight management interventions are appropriate and effective for Black ethnic groups. There is a paucity of existing research on weight management services in Black populations, and whether anticipated or experienced institutional and interpersonal racism in the healthcare and more widely affects engagement in these services. Understanding the lived experience of target populations and views of service providers delivering programmes is essential for timely service improvement. Methods A qualitative study using semi-structured interviews was conducted in June–October 2021 among 18 Black African and Black Caribbean men and women interested in losing weight and 10 weight management service providers. Results The results highlighted a positive view of life in the United Kingdom (UK), whether born in the UK or born abroad, but one which was marred by racism. Weight gain was attributed by participants to unhealthy behaviours and the environment, with improving appearance and preventing ill health key motivators for weight loss. Participants relied on self-help to address their overweight, with the role of primary care in weight management contested as a source of support. Anticipated or previously experienced racism in the health care system and more widely, accounted for some of the lack of engagement with services. Participants and service providers agreed on the lack of relevance of existing services to Black populations, including limited culturally tailored resources. Community based, ethnically matched, and flexibly delivered weight management services were suggested as ideal, and could form the basis of a set of recommendations for research and practice. Conclusion Cultural tailoring of existing services and new programmes, and cultural competency training are needed. These actions are required within systemic changes, such as interventions to address discrimination. Our qualitative insights form the basis for advancing further work and research to improve existing services to address the weight-related inequality faced by UK Black ethnic groups.
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To assess the prevalence of cardiovascular risk factors and their level of detection and management in three ethnic groups. Population based survey during 1994 to 1996. Former Wandsworth Health Authority in South London. 1578 men and women, aged 40 to 59 years; 524 white, 549 of African descent, and 505 of South Asian origin. Age adjusted prevalence of hypertension, diabetes, obesity, raised serum cholesterol, and smoking. Ethnic minorities of both sexes had raised prevalence rates of hypertension and diabetes compared to white people. Age and sex standardised prevalence ratios for hypertension were 2.6 (95% confidence interval 2.1 to 3.2) in people of African descent and 1.8 (1.4 to 2.3) in those of South Asian origin. For diabetes, the ratios were 2.7 (1.8 to 4.0) in people of African descent and 3.8 (2.6 to 5.6) in those of South Asian origin. Hypertension and diabetes were equally common among Caribbeans and West Africans and among South Asian Hindus and Muslims. Prevalence of severe obesity was high overall, but particularly among women of African descent (40% (35% to 45%)). In contrast, raised serum cholesterol and smoking rates were higher among white people. Of hypertensives, 49% (216 of 442) had adequate blood pressure control. Overall, 18% (80 of 442) of hypertensives and 33% (62 of 188) of diabetics were undetected before our survey. Hypertensive subjects of African descent appeared more likely to have been detected (p = 0.034) but less likely to be adequately managed (p = 0.085). Hypertension and diabetes are raised two- to threefold in South Asians, Caribbeans, and West Africans in Britain. Detection, management, and control of hypertension has improved, but there are still differences between ethnic groups. Obesity is above the Health of the Nation targets in all ethnic groups, particularly in women of African descent. Preventive and treatment strategies for different ethnic groups in Britain need to consider both cultural differences and underlying susceptibility to different vascular diseases.
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To provide insight into discussions at the Surgeon General's Listening Session, "Toward a National Action Plan on Overweight and Obesity," and to complement The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity. On December 7 and 8, 2000, representatives from federal, state, academic, and private sectors attended the Surgeon General's Listening Session and were given an opportunity to recommend what to include in a national plan to address overweight and obesity. The public was invited to comment during a corresponding public comment period. The Surgeon General's Listening Session was also broadcast on the Internet, allowing others to view the deliberations live or access the archived files. Significant discussion points from the Listening Session have been reviewed by representatives of the federal agencies and are the basis of this complementary document. Examples of issues, strategies, and barriers to change are discussed within five thematic areas: schools, health care, family and community, worksite, and media. Suggested cooperative or collaborative actions for preventing and decreasing overweight and obesity are described. An annotated list of some programmatic partnerships is included. The Surgeon General's Listening Session provided an opportunity for representatives from family and community groups, schools, the media, the health-care environment, and worksites to become partners and to unite around the common goal of preventing and decreasing overweight and obesity. The combination of approaches from these perspectives offers a rich resource of opportunity to combat the public health epidemic of overweight and obesity.
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In this study, the authors examined body image perception and body mass index (weight (kg)/height (m)(2)) among race-gender groups in a biracial (Black-White) population of young adults in Bogalusa, Louisiana. A mail-out survey was completed in 1994 by 3,698 (65%) participants aged 18.5-35 years in the Bogalusa Heart Study (mean age = 27.6 years). As part of the survey, body image perception was determined in terms of body shape representations from a figure rating scale. A body image discrepancy score was calculated from the difference between z-standardized values of body image perception and body mass index. A stepwise proportional odds model including the covariates income, employment, education, and physical activity was used to identify factors influencing lower perception of body shape. Mean body mass index was highest among Black females (p < 0.001). The odds of having a lower perception of body shape (vs. body mass index) were 1.72 times higher in Blacks (p < 0.001), 0.80 times lower in persons who were currently employed (p < 0.001), and 0.86 times lower in persons with a higher education (p = 0.032). Gender, income, and physical activity were not found to be significant predictors of body image perception (p > 0.05). The authors conclude that significant differences exist within racial groups concerning body image perception in relation to overweight status among young adults. This has implications for prevention and education programs.
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Although research has identified various factors that can affect African-American women's weight management efforts, limited attention has been paid to the role of social support. Culling evidence from heretofore disparate studies, this article provides an overview of why adequacy of social support may be among the most critical factors affecting African-American women's weight management behaviors. The empirical evidence suggests that social support can enhance perceived control and/or self-efficacy, and this finding serves as a focal point for looking at aspects of weight loss programs, as well as providing a post-program strategy, in order to maximize this support among African-American women.
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To determine dietary intake and attitude toward weight control of normal weight, overweight, and obese Black women. Cross-sectional survey. Rural village in KwaZulu province, South Africa. A convenience sample (N=187) of 25- to 55-year-old women, of whom 28.9% (N=54) were of normal weight, 41.2% (N=77) were overweight, and 29.9% (N=56) were obese. Dietary intake, attitude toward weight control, perceived causes of overweight, perceived health risks, and self-reported health status. Dietary intake did not differ among the three groups. Overweight and obese women did not view weight control differently than women of normal weight. Most women were unconcerned about their weight. Only 2% of overweight and 30% of obese women thought they were too fat. Most women (96%) agreed that obesity was caused by biological disorders, while 39% and 9% agreed that it was caused by poor eating habits and eating too much food, respectively. Most women did not recognize the relationship between food consumed and degenerative diseases. Compared to normal-weight and overweight women, obese women had a significantly higher prevalence of self-reported high blood pressure and suffered more from back pain. Most of these rural women were unconcerned about their weight and most overweight and obese women did not want to lose weight. The acceptance of overweight and obesity can hinder the effectiveness of weight control programs. A special attempt should be made to target such programs to rural woman.
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Focus groups stratified by race and socioeconomic status were used to examine obese women's experiences with weight-loss methods. Six themes emerged: failure of weight maintenance, use of psychological and spiritual approaches, role of family influences and societal expectations, role of African American subculture, method affordability, and racial differences in weight-loss methods. Tailored weight-management interventions for women, particularly African Americans and those of low socioeconomic status, should account for features of African American subculture and address affordability concerns, include maintenance strategies that incorporate psychological and spiritual principles, and target family attitudes and behaviors.
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Designing culturally relevant weight-reduction programs requires understanding of ethnic variations and illness beliefs. Preliminary data on the values and beliefs about obesity and weight reduction were obtained from women of different ethnic/racial backgrounds. Purposive sampling was used to recruit African American (AA) and Caucasian (C) women with a body mass index (BMI)>or= 30 from the general internal medicine clinics of a large tertiary care facility. Four focus groups (2 with AA women and 2 with C women) consisting of a total of 20 subjects were conducted in a 2-month period. AA women cited culture specific barriers to weight loss more so than did C women. AA women and C women also differed on how health care professionals could help them with weight loss. These findings have implications for nursing's role in the design of culturally relevant weight-loss programs.
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Obesity is disproportionately prevalent among many racial/ethnic minority communities. The efficacy of weight control efforts in these groups may depend on individual's ability to accurately perceive their weight status. We examined whether racial/ethnic differences exist in weight status misperception among overweight adults. Nationally-representative data from the National Health and Nutrition Examination Survey (NHANES) 1999-2002 were examined. Participants included overweight and obese adult men (n = 3115) and women (n = 3437). Weight status misperception was identified among respondents who self-reported being "about the right weight/underweight." Blacks (OR = 2.06, 95% CI: 1.71, 2.54) were twice as likely and Hispanics (OR = 1.70, 95%CI: 1.33, 2.17) were 70-percent more likely than Whites to misperceive their weight, in models adjusted for age, education, income, marital status, self-reported health, and self-reported medical diagnosis of overweight. Black overweight (OR = 2.03, 95% CI: 1.26, 3.26) and obese (OR = 3.56, 95% CI: 1.57, 8.11) women were considerably more likely to exhibit misperception compared to their White female counterparts. Odds of misperception were higher among overweight Black (OR = 2.20, 95%CI: 1.54, 3.15), Hispanic (OR = 1.89, 95% CI: 1.30, 2.75), and obese Black men (OR = 2.84, 95% CI: 1.54, 5.22), compared to White men. Weight status misperceptions among the overweight are more common among Blacks, and Hispanic men. The persistence of racial/ethnic differences after adjustment for medical diagnosis of overweight may suggest some resistance to physician weight counseling. Identifying strategies to correct weight status misperceptions status may be necessary to ensure the efficacy of clinical and public health obesity interventions conducted among these groups.
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Proponents of the sociocultural model of eating disorders have suggested that ethnic differences in body dissatisfaction may be diminishing as the thin ideal of beauty becomes more widely disseminated among minority women. In a meta-analysis, the authors examined temporal trends in Black–White differences and also examined whether these differences generalize across various age groups and measures. Results confirmed more favorable body image evaluations among Black than White females, with the greatest differences at the age period of the early 20s. Although results confirmed that ethnic differences have diminished, this trend was limited to weight-focused measures. On more global body image measures, ethnic differences actually increased. These results suggest that the relationship between Black–White ethnicity and body image is more complex than previously suggested.
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African-American women are disproportionately affected by obesity. Weight loss can occur, but maintenance is rare. Little is known about weight loss maintenance in African-American women. (1) To increase understanding of weight loss maintenance in African-American women; (2) to use the elicitation procedure from the theory of planned behavior (TPB) to define the constructs of attitude, subjective norms, and perceived behavioral control regarding weight loss and maintenance; and (3) to help develop a relevant questionnaire that can be used to explore weight loss and maintenance in a large sample of African Americans. Seven focus groups were conducted with African-American women: four with women successful at weight loss maintenance, three with women who lost weight but regained it. Discussions centered on weight loss and maintenance experiences. Thirty-seven African-American women. Content analysis of focus group transcripts. Weight loss maintainers lost 22% of body weight. They view positive support from others and active opposition to cultural norms as critical for maintenance. They struggle with weight regain, but have strategies in place to lose weight again. Some maintainers struggle with being perceived as sick or too thin at their new weight. Regainers and maintainers struggle with hairstyle management during exercise. The theoretical constructs from TPB were defined and supported by focus group content. A weight loss questionnaire for African Americans should include questions regarding social support in weight maintenance, the importance of hair management during exercise, the influence of cultural norms on weight and food consumption, and concerns about being perceived as too thin or sick when weight is lost.
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African-American (AA) women have higher rates of obesity and obesity-related diseases but are less likely than other women to undergo bariatric surgery or have success with conventional weight loss methods. To explore obese AA women's perceptions regarding barriers to weight loss and bariatric surgery. Focus groups to stimulate interactive dialogue about beliefs and attitudes concerning weight management. PARTICIPANTS AND APPROACH: We partnered with a community organization to recruit women who were AA, were > or = 18 years old, and had a body mass index (BMI) of > or = 30 kg/m2. We audiotaped the 90-minute focus groups and used content analysis for generating and coding recurring themes. In our sample of 41 participants, the mean age was 48.8 years and mean BMI was 36.3. Most participants were unmarried, had some postsecondary education, and reported good or fair health. About 85% knew someone who had undergone bariatric surgery. Qualitative analysis of 6 focus group sessions revealed that the most common barriers to weight loss were lack of time and access to resources; issues regarding self-control and extrinsic control; and identification with a larger body size. Common barriers to bariatric surgery were fears and concerns about treatment effects and perceptions that surgery was too extreme or was a method of last resort. Only through the elimination of barriers can AA women receive the care needed to eliminate excess weight and prevent obesity-related morbidity and mortality.
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This review of the obesity epidemic provides a comprehensive description of the current situation, time trends, and disparities across gender, age, socioeconomic status, racial/ethnic groups, and geographic regions in the United States based on national data. The authors searched studies published between 1990 and 2006. Adult overweight and obesity were defined by using body mass index (weight (kg)/height (m)(2)) cutpoints of 25 and 30, respectively; childhood "at risk for overweight" and overweight were defined as the 85th and 95th percentiles of body mass index. Average annual increase in and future projections for prevalence were estimated by using linear regression models. Among adults, obesity prevalence increased from 13% to 32% between the 1960s and 2004. Currently, 66% of adults are overweight or obese; 16% of children and adolescents are overweight and 34% are at risk of overweight. Minority and low-socioeconomic-status groups are disproportionately affected at all ages. Annual increases in prevalence ranged from 0.3 to 0.9 percentage points across groups. By 2015, 75% of adults will be overweight or obese, and 41% will be obese. In conclusion, obesity has increased at an alarming rate in the United States over the past three decades. The associations of obesity with gender, age, ethnicity, and socioeconomic status are complex and dynamic. Related population-based programs and policies are needed.
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Research suggests that exposure to mass media depicting the thin-ideal body may be linked to body image disturbance in women. This meta-analysis examined experimental and correlational studies testing the links between media exposure to women's body dissatisfaction, internalization of the thin ideal, and eating behaviors and beliefs with a sample of 77 studies that yielded 141 effect sizes. The mean effect sizes were small to moderate (ds = -.28, -.39, and -.30, respectively). Effects for some outcome variables were moderated by publication year and study design. The findings support the notion that exposure to media images depicting the thin-ideal body is related to body image concerns for women.
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Dietary advice emphasizes that some dietary fats increase the risk of heart disease, whereas other dietary fats decrease risk if they are substituted for more risk-increasing fats. Thus, it is important that consumers understand the differences between dietary fats. Existing evidence in the United States suggests troublesome consumer misunderstanding. As part of its continuing effort to promote public health, the US Food and Drug Administration measured consumer awareness and understanding of dietary fats in its Health and Diet Survey- 2004 Supplement. After cognitive interviews and pretests of the questionnaire, telephone interviews of randomly selected noninstitutionalized adults aged 18 years and older in the United States were conducted between October 12, 2004, and January 21, 2005. Using cross-sectional data collected from 1,798 respondents who completed the survey, this study estimated the prevalence of awareness and understanding of six dietary fats among US adults and identified the characteristics of adults with different levels of awareness and understanding. Descriptive analyses were used, along with logistic regression models, developed to accommodate the survey design and responses. There was a wide disparity among US consumers in their awareness and understanding. Saturated fat was most recognized and understood, whereas awareness of other fats was much lower. Most importantly, having heard of a fat did not necessarily mean understanding its relationship to heart disease. Only half of those who had heard of trans fat and n-3 fatty acids understood that the fats raise and lower the risk of heart disease, respectively. Only a minority of those who had heard of partially hydrogenated oil and polyunsaturated fat knew the fats raise and lower the risk of heart disease, respectively. Many admitted being uncertain about how a fat relates to the risk of heart disease. College or more-educated adults had better awareness and understanding. Nonwhite adults were less knowledgeable. Findings on the awareness and understanding and how they are related to individual characteristics can inform deliberations about educational messages, nutrition programs, and food labeling about dietary fats to promote public health.
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It is controversial whether weight loss reduces resting energy expenditure (REE) to a different magnitude in black and white women. This aim of this study was to determine whether changes in REE with weight loss were different between black and white postmenopausal women, and whether changes in body composition (including regional lean and fat mass) were associated with REE changes within each race. Black (n = 26) and white (n = 65) women (age = 58.2 +/- 5.4 years, 25 < BMI < 40 kg/m(2)) completed a 20-week weight-loss intervention. Body weight, lean and fat mass (total body, limb, and trunk) via dual-energy X-ray absorptiometry, and REE via indirect calorimetry were measured before and after the intervention. We found that baseline REE positively correlated with body weight, lean and fat mass (total, limb, and trunk) in white women only (P < 0.05 for all). The intervention decreased absolute REE in both races similarly (1,279 +/- 162 to 1,204 +/- 169 kcal/day in blacks; 1,315 +/- 200 to 1,209 +/- 185 kcal/day in whites). REE remained decreased after adjusting for changes in total or limb lean mass in black (1,302-1,182 kcal/day, P = 0.043; 1,298-1,144 kcal/day, P = 0.006, respectively), but not in white, women. Changes in REE correlated with changes in body weight (partial r = 0.277) and fat mass (partial r = 0.295, 0.275, and 0.254 for total, limb, and trunk, respectively; P < 0.05) independent of baseline REE in white women. Therefore, with weight loss, REE decreased in proportion to the amount of fat and lean mass lost in white, but not black, women.
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To better understand similarities and differences in Black and White women's perceptions about obesity, we conducted race-matched focus groups with thirty physician-referred, obese women. Participants completed demographic questionnaires and body image assessments. Analysis yielded some common themes. Unique themes for Black women included disagreement with the thin ideal and their own and family members' satisfaction with their weight; dislike of physical activity because of perspiration and appearance; program access barriers; and difficulties with clothing. White women desired support during weight loss from other obese individuals. Results support education and intervention programs that respond to specific needs of each group.
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Prevalence of obesity has increased worldwide in the past 20 years, but it is not known whether this has resulted in increased numbers of young adults feeling overweight. This study evaluated weight self-perception in a large, multi-ethnic sample of 14-15 years old (n=4167) in London, UK as part of a longitudinal, school-based study of health behaviours. Weight perceptions were recorded on a simple scale from 'too thin' to 'too fat'. Results indicated that under-estimation was more common than over-estimation, with more than a quarter of overweight or obese adolescents unaware of their excess weight. Under-estimation was greatest among boys and ethnic minorities. It may be timely to reassess weight control advice given to adolescents.
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The purpose of this descriptive study was to seek directly from college-educated African American women factors which they perceived influenced their individual weight control behavior, and those that influenced African American women collectively. Face-to-face, in-depth interviews were conducted, primarily in their homes, with 36 African American women. Thirteen major categories were identified. Six factors that influenced the women's individual weight control behavior were emotions/feelings, beliefs, life events, self-control, discipline, and commitment. Perceived benefits of the behavior and perceived barriers to the behavior were influential in determining the attractiveness, the type, and the extent of the weight control behavior. Five factors related to the African American culture were identified and described by the women. Recognition of psychosocial determinants of weight control behavior may enable health professionals to design unique interventions relevant to African American women.
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Eating restraint and body size perceptions of 404 White and African-American women 66 to 105 years of age (mean age = 73 years) were assessed by questionnaire. Compared with overweight White women, overweight Black women were 0.6 times as likely to feel guilty after overeating, 0.4 times as likely to diet, 2.5 times as likely to be satisfied with their weight, and 2.7 times as likely to consider themselves attractive. Among those who were not overweight, Black women were half as likely as White women to consider themselves overweight. Compared with Black women, White women perceived themselves to be larger and reported a lower ideal body weight.
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To identify African-American women's definitions and descriptions of body weight, using King's General Systems Framework and Combs and Snygg's concept of perception as a guide, focus group methodology was utilized. These women's frame of reference for "normal body weight" was much larger than the standard indicator for weight and defined weight, normal weight, ideal weight, underweight, overweight, and obesity in terms of their cultural, social, and individual context. By understanding individual perceptions of weight, advanced practice nurses can devise strategies to facilitate weight management in African-American women who may want to lose or need to lose weight for such health-related illnesses as diabetes, cardiovascular disease, or hypertension.
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The purpose of this study was to assess the health-promoting practices of young black women at risk for type 2 diabetes. The sample consisted of 30 black women from an urban area who had a history of gestational diabetes and/or a first-degree relative with diabetes. Participants completed the Health-Promoting Lifestyle Profile II Survey and an interview. Both were used to categorize health-promoting practices, exercise, diet, knowledge of diabetes prevention, and general health. Demographic information and interview revealed a propensity towards obesity, despite education and income levels. The results for the Lifestyle II Survey showed a higher average total score for healthy nutrition than physical activity, which were inconsistent with the qualitative data obtained by interview. Fifty percent stated that they exercised as a general health-promoting behavior. Self-reported daily caloric, fiber, and fat intake was high to moderate; 60% reported initiating diet modifications secondary to a desire to lose weight or for medical problems; and 26% reported receiving information on diabetes prevention from a healthcare provider. A systematic approach of planning and actively incorporating health-promoting activities into one's lifestyle as a young adult may protect or delay the onset of diabetes and prevent complications.
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In this study we examined the influence of ethnicity on weight, body image, and self-esteem among adult women while controlling for socioeconomic status (SES). Fifty women of African American (AA), European American (EA), and Mexican American (MA) descent completed interviews and questionnaires related to body size and self-esteem, and were measured for weight and height. AA women were significantly heavier than EA women, but MA women did not differ materially from either grouping. Regardless of ethnic descent, all reported congruence between real and ideal body size. In addition no differences were found in self-esteem. This new comparative study calls into question variations previously attributed to race or ethnicity. It also provides a view of middle-class women missing from recent research. Based on the outcomes of our research, we suggest that socioeconomic differences could be more important than ethnic background. Health educators and providers may find these data helpful when designing prevention and intervention strategies for middle-class women regardless of their ethnic origin.
Article
Notes that pediatricians lack information on proven practices for preventing childhood obesity but can address the growing dilemma by talking with families about four behaviors: (1) limiting television viewing, (2) encouraging outdoor play, (3) encouraging breastfeeding, and (4) limiting consumption of sugar-sweetened soft drinks.
Article
To determine the terms that obese individuals find undesirable or desirable for their doctors to use to describe excess weight of 27.3 kg (i.e., 50 lb) or more. The study surveyed 167 women and 52 men with a mean BMI of 35.3 and 35.1 kg/m(2), respectively, who participated in one of two randomized trials on the treatment of obesity. An additional sample consisted of 105 extremely obese women (i.e., mean BMI of 52.5 kg/m(2)) who sought bariatric surgery. Patients rated the desirability of 11 terms used to describe excess weight. Ratings were made on five-point scales, ranging from very desirable (+2) to neutral (0) to very undesirable (-2). Obese women (N = 167) rated as undesirable to very undesirable the terms fatness (mean rating = -1.8), excess fat (-1.4), obesity (-1.4), and large size (-1.3). These four terms were rated as significantly more (all p < or = 0.001) undesirable than the seven remaining descriptors, which included weight, heaviness, BMI, excess weight, unhealthy body weight, weight problem, and unhealthy BMI. The term weight received a mean rating of 1.1, a value significantly more (all p < or = 0.001) desirable than that for all other descriptors. Highly similar ratings of the terms were provided by obese men (N = 52) and extremely obese women (N = 105). Practitioners may wish to avoid the use of potentially derogatory terms such as fatness and obesity when broaching the topic of weight management with patients.
Article
The purpose of this qualitative study was to explore perceptions and beliefs about body size, weight, and weight loss among obese African American women in order to form a design of weight loss intervention with this target population. Six focus groups were conducted at a community health clinic. Participants were predominantly middle-aged with a mean Body Mass Index of 40.3 +/- 9.2 kg/m(2). Findings suggest that participants (a) believe that people can be attractive and healthy at larger sizes; (b) still feel dissatisfied with their weight and self-conscious about their bodies; (c) emphasize eating behavior as the primary cause for weight gain; (d) view pregnancy, motherhood, and caregiving as major precursors to weight gain; (e) view health as the most important reason to lose weight; (f) have mixed experiences and expectations for social support for weight loss; and (g) prefer treatments that incorporate long-term lifestyle modification rather than fad diets or medication.
Article
The purpose of this study was to evaluate trends in women's awareness, knowledge, and perceptions related to cardiovascular disease (CVD) since 1997, when the American Heart Association initiated a national campaign for women. A nationally representative sample of 1,005 women identified through random digit dialing (mean age 50 years, 71% white) was surveyed in 2006, and results were compared with results of similar surveys conducted in 2003, 2000, and 1997. Awareness, knowledge, and perceptions related to CVD were evaluated using a standardized interviewer-assisted questionnaire. In 2006, awareness of heart disease as the leading cause of death among women was 57%; significantly higher than in prior surveys (p < 0.001). Awareness was lower among black and Hispanic women compared with white women (31% and 29% vs. 68%, p < 0.05), and the racial/ethnic difference has not appreciably changed over time. More than twice as many women felt uninformed about stroke compared to heart disease in 2006 (23% vs. 11%, p < 0.05). Hispanic women were more likely than white women to report that there is nothing they can do to keep themselves from getting CVD (22% vs. 11%, p < 0.05). The majority of respondents (> or = 50%) reported confusion related to basic CVD prevention strategies. CVD awareness has increased significantly among women since 1997, yet the racial/ethnic gap in awareness has not narrowed. Educational efforts to increase heart disease and stroke awareness should be targeted to racial/ethnic minorities, especially Hispanics. Methods to reinforce basic CVD prevention strategies are needed.
Article
The authors assessed the associations of ethnicity and socioeconomic status (SES) with body size judgments in Black and White young adults. Self-perceived and ideal body size judgments were measured using the Stunkard nine-figure scale (higher value = larger body) at the year 7 examination (1992-1993) of the Coronary Artery Risk Development in Young Adults (CARDIA) Study. In sex-specific adjusted multiple regression models, the difference between self-perceived and ideal body size judgments was larger for Whites than for Blacks: 0.74 vs. 0.57 for White men vs. Black men (p < 0.05) and 1.48 vs. 0.96 for White women vs. Black women (p < 0.0001). This ethnic difference was evident in all body mass index-stratified adjusted models (all p's < 0.05). In ethnicity/sex-specific adjusted models, lower education was associated with a smaller difference between self-perceived and ideal body size for all groups except White women (p's for trend: White women, 0.57; Black women, <0.0001; White men, 0.0007; Black men, 0.016). Judgments of self-perceived body size differed by ethnicity but not by SES, and judgments of ideal body size differed by SES but not by ethnicity. Learning to make medically accurate judgments of healthy body size may increase the motivation to lose weight in some persons.
Article
Lower birth weight, often found in infants from minority ethnic groups, may be partly because of the disproportionate representation of ethnic minority groups in low-income areas. To develop an intervention, to improve the nutritional intake of young women from populations at risk of low-birth-weight babies, which would be culturally sensitive and well received by the intended recipients, a community development approach was used to investigate factors that might influence food choice and the nutritional intake of girls and young women from ethnic minority groups. Focus group discussions were conducted across the UK, to explore factors that might affect the food choices of girls and young women of African and South Asian decent. The data was analysed using deductive content analysis (Qual. Soc. Res., 1, 2000, 1). Discussions were around the broad themes of buying and preparing food, eating food and dietary changes, and ideas for an intervention to improve diet. The focus group discussions indicated that all the communities took time, price, health and availability into consideration when making food purchases. The groups were also quite similar in their use of 'Western' foods which tended to be of the fast food variety. These foods were used when there was not enough time to prepare a 'traditional' meal. Many issues that affect the food choice of people who move to the UK are common within different ethnic groups. The idea of a practical intervention based on improving cooking skills was popular with all the groups.
Ethnicity and weight attitudes ª 2011 The Authors Journal of Human Nutrition and Dietetics ª 2011 The British Dietetic Association Ltd
  • C Shoneye
C. Shoneye et al. Ethnicity and weight attitudes ª 2011 The Authors Journal of Human Nutrition and Dietetics ª 2011 The British Dietetic Association Ltd. 2011 J Hum Nutr Diet, 24, pp. 536–542
Summary of the 2000 Surgeon General's listening session
  • Y Jackson
  • W H Dietz
  • C Sanders
  • L J Kolbe
  • J J Whyte
  • H Wechsler
  • B S Schneider
  • L A Mcnally
  • J Charles-Azure
  • M Vogel-Taylor
  • P Starke-Reed
  • V S Hubbard
  • W L Johnson-Taylor
  • R P Troiano
  • K Donato
  • S Yanovski
  • R J Kuczmarski
  • L Haverkos
  • K Mcmurry
  • R F Wykoff
  • V Woo
  • A S Noonan
  • J Rowe
  • K Mccarty
  • C B Spain
Jackson, Y., Dietz, W.H., Sanders, C., Kolbe, L.J., Whyte, J.J., Wechsler, H., Schneider, B.S., Mcnally, L.A., Charles-Azure, J., Vogel-Taylor, M., Starke-Reed, P., Hubbard, V.S., Johnson-Taylor, W.L., Troiano, R.P., Donato, K., Yanovski, S., Kuczmarski, R.J., Haverkos, L., Mcmurry, K., Wykoff, R.F., Woo, V., Noonan, A.S., Rowe, J., Mccarty, K. & Spain, C.B. (2002) Summary of the 2000 Surgeon General's listening session: toward a national action plan on overweight and obesity. Obes. Res., 10, 1299-1305.