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Obese African-American Women’s Perspectives on Weight Loss and Bariatric Surgery

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Abstract

Background

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.

Objective

To explore obese AA women’s perceptions regarding barriers to weight loss and bariatric surgery.

Design

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 ≥18 years old, and had a body mass index (BMI) of ≥30 kg/m2. We audiotaped the 90-minute focus groups and used content analysis for generating and coding recurring themes.

Results

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.

Conclusions

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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Acknowledgments

This research was supported by the EXPORT Health Project at the Center for Minority Health (CMH), Graduate School of Public Health, University of Pittsburgh, NIH/NCMHD Grant No. P60 MD-000-207-03 and the Division of General Internal Medicine, School of Medicine, University of Pittsburgh. Sincerest thanks to our collaborating partners for their efforts with recruitment and data management and analysis—CMH and Black Women’s Health and Outreach for Longer Life and Empowerment (BWHOLE) and University Center for Survey and Urban Research, University of Pittsburgh—R. Schulz, S. Shulman. Finally, we express our gratitude to Laurel Person, Natalie Solomon, and Andrea Arrington who assisted in data collection and analysis.

Conflict of Interest

None disclosed.

Author information

Authors and Affiliations

  1. Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Cheryl Sterling Lynch MD, MPH, Judy C. Chang MD, MPH & Said A. Ibrahim MD, MPH

  2. Departments of Obstetrics, Gynecology and Reproductive Sciences and Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Judy C. Chang MD, MPH

  3. Center for Minority Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    Angela F. Ford PhD, MSW

  4. Center for Health Equity Research and Promotion (151-C), VA Pittsburgh Healthcare System, Pittsburgh, PA, 15240, USA

    Said A. Ibrahim MD, MPH

Authors
  1. Cheryl Sterling Lynch MD, MPH
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  2. Judy C. Chang MD, MPH
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  3. Angela F. Ford PhD, MSW
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  4. Said A. Ibrahim MD, MPH
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Corresponding author

Correspondence to Said A. Ibrahim MD, MPH.

Appendix

Appendix

Focus Group Interview Guide

Opening question:

  1. (1)

    What are your thoughts or opinions about weight and how it relates to health?

Transitional questions:

  1. (2)

    What comes to mind when you think about ways to lose weight?

  2. (3)

    What would be some positive changes in your life if you lost weight?

  3. (4)

    What goes on in your life that makes it difficult for you to lose weight?

Key questions:

  1. (5)

    How much weight do you think you need to lose to be satisfied?

  2. (6)

    How hard do you think you need to work at losing weight?

  3. (7)

    Have you heard about weight loss surgery? If so, what comes to mind when you think of it?

  4. (8)

    What would influence you to consider weight loss surgery for yourself?

Concluding question:

  1. (9)

    What is the one burning comment or piece of information that you want to add that I did not ask about?

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Lynch, C.S., Chang, J.C., Ford, A.F. et al. Obese African-American Women’s Perspectives on Weight Loss and Bariatric Surgery. J GEN INTERN MED 22, 908–914 (2007). https://doi.org/10.1007/s11606-007-0218-0

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  • DOI: https://doi.org/10.1007/s11606-007-0218-0

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