Skip to main content
SpringerLink
Log in

Clinical implications of body image among rural African-American women

  • Original Articles
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

OBJECTIVE: To increase understanding of body image among rural, African-American women through open-ended interviews.

DESIGN: Individuals’ perceptions of body image were investigated using open-ended, in-depth interviews that were taperecorded, transcribed, and analyzed to identify common themes and to compare thematic data across three body mass index categories (obese, overweight, and normal).

SETTING: University-affiliated rural community health center.

PARTICIPANTS: Twenty-four African-American women, aged 21 to 47 years.

MAIN RESULTS: Respondents reported the following common themes: dissatisfaction with current weight; fluctuating levels of dissatisfaction (including periods of satisfaction); family and social pressure to be self-accepting; and social and physical barriers to weight loss. The interviews revealed ambivalence and conflicts with regard to body image and weight. Among these women, there was strong cultural pressure to be self-accepting of their physical shape, to “be happy with what God gave you,” and to make the most of their appearance.

CONCLUSIONS: The pressure to be self-accepting often conflicted with these obese women’s dissatisfaction with their own appearance and weight. Although the respondents believed they could lose weight “if [they] put [their] mind to it,” those women wanting to lose weight found that they lacked the necessary social support and resources to do so. The conflicts stemming from social pressures and their own ambivalence may result in additional barriers to the prevention of obesity, and an understanding of these issues can help health care providers better address the needs of their patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL. Increasing prevalence of overweight among US adults: the National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA. 1994;272:205–11.

    Article  PubMed  CAS  Google Scholar 

  2. National Institutes of Health National Heart, Lung, and Blood Institute. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. Obes Res. Sept 1998:6(suppl 2).

  3. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL. Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes. 1998;22:39–47.

    Article  CAS  Google Scholar 

  4. Kumanyika SK. Special issues regarding obesity in minority populations. Ann Intern Med. 1993;119:650–4.

    PubMed  CAS  Google Scholar 

  5. Kumanyika SK. Obesity in black women. Epidemiol Rev. 1987;9:31–50.

    PubMed  CAS  Google Scholar 

  6. Wing RR, Kuller LH, Bunker C, Matthews KA, Caggiula A, Meihlan E, Kelsey S. Obesity, obesity-related behaviors, and coronary heart disease risk factors in black and white premenopausal women. Int J Obes. 1989;12:511–9.

    Google Scholar 

  7. Kumanyika SK. Obesity in minority populations: an epidemiologic assessment. Obes Res. 1994;2:166–182.

    PubMed  CAS  Google Scholar 

  8. Goldstein DJ. Beneficial health effects of modest weight loss. Int J Obes. 1992;16:397–415.

    CAS  Google Scholar 

  9. Kumanyika SK, Obarzanek E, Stevens VJ, Hebert PR, Whelton PK. Weight-loss experience of black and white participants in NHLBI-sponsored clinical trials. Am J Clin Nutr. 1991;53:S1631–8.

    Google Scholar 

  10. Horm J, Anderson K. Who in America is trying to lose weight? Ann Intern Med. 1993;119:672–6.

    PubMed  CAS  Google Scholar 

  11. Kahn HS, Williamson DF, Steven MS. Race and weight change in US women: the roles of socioeconomic and marital status. Am J Public Health. 1991;81:319–23.

    PubMed  CAS  Google Scholar 

  12. Bril PA, Kohl HW, Roberts T, Collingwood TR, Sterling CL, Blair SN. The relationship between sociodemographic characteristics and recruitment, retention, and health improvements in worksite health promotion program. Am J Health Promo. 1991;5:215–21.

    Google Scholar 

  13. Sue S. Ethnicity and mental health: research and policy issues. J Soc Issues. 1992;48:187–205.

    Article  Google Scholar 

  14. Kumanyika SK. Behavioral aspects of intervention strategies to reduce dietary sodium. Hypertension. 1991;17(suppl 1):I-190–I-195.

    CAS  Google Scholar 

  15. Williamson DF, Serdula MK, Andra RF, Levy A, Byers T. Weight loss attempts in adults: goals, duration, and rate of weight loss. Am J Public Health. 1992;82:1251–7.

    PubMed  CAS  Google Scholar 

  16. Abrams KK, Allen LR, Gray JJ. Disordered eating attitudes and behaviors, psychological adjustment, and ethnic identity: a comparison of black and white female college students. Int J Eat Disord. 1993;14:49–57.

    PubMed  CAS  Google Scholar 

  17. Allan JD, May K, Michel Y. Body size values of white and black women. Res Nurs Health. 1993;16:323–33.

    Article  PubMed  CAS  Google Scholar 

  18. Hargrove HJ, Keller C. Young black women: defining health. J Natl Black Nurs Assoc. 1993;6:3–14.

    CAS  Google Scholar 

  19. Harris MB, Walters LC, Waschull S. Gender and ethnic differences in obesity-related behaviors and attitudes in a college sample. J Appl Soc Psychol. 1991;21:1545–66.

    Article  Google Scholar 

  20. Keller CS, Hargrove HJ. Factors contributing to perception of health in young black women. Percept Mot Skills. 1992;75:706.

    PubMed  CAS  Google Scholar 

  21. Kemper KA, Sargent RG, Drane JW, Valois RF, Hussy JR. Black and white females’ perceptions of ideal body size and social norms. Obes Res. 1994;2:117–26.

    PubMed  CAS  Google Scholar 

  22. Kumanyika S, Wilson JF, Guilford-Davenport M. Weight-related attitudes and behaviors of black women. J Am Diet Assoc. 1993;93:416–22.

    Article  PubMed  CAS  Google Scholar 

  23. Parker S, Nichter M, Vuckovic N, Sims C, Ritenbaugh C. Body image and weight concerns among African-American and white adolescent females: differences that make a difference. Hum Org. 1995;54:103–14.

    Google Scholar 

  24. Rosen JT, Gross J. Prevalence of weight reducing and weight gaining in adolescent girls and boys. Health Psychol. 1987;6:131–47.

    Article  PubMed  CAS  Google Scholar 

  25. Rucker CE, Cash TF. Body images, body-size perceptions, and eating behaviors among African-American and white college women. Int J Eat Disord. 1992;12:291–9.

    Google Scholar 

  26. Stevens J, Kumanyika SK, Keil JE, Seibert L. Body size perceptions and eating attitudes in elderly men. Obes Res. 1994;2:127–34.

    PubMed  CAS  Google Scholar 

  27. Stevens J, Kumanyika SK, Keil JE. Attitudes toward body size and dieting: differences between elderly black and white women. Am J Public Health. 1994;84:1322–5.

    Article  PubMed  CAS  Google Scholar 

  28. Stephensen MG, Levy AS, Sass NL, McGarvey WE. 1985 NHIS findings: nutrition knowledge and baseline data for the weightloss objectives. Public Health Rep. 1987;102:61–7.

    Google Scholar 

  29. McGee M, Hale HJ. Social factors and obesity among black women. Free Inquiry Creative Sociol. 1980;8:83–7.

    Google Scholar 

  30. Thomas VG, James MD. Body image, dieting tendencies, and sex role traits in urban black women. Sex Roles 1988;18:523–9.

    Article  Google Scholar 

  31. Kumanyika SK, Morssink CB. Cultural appropriateness of weight management programs. In: Dalton S, ed. The health professional’s guide to understanding and practice. Gaithersburg, Md: Aspen Publishers; 1998:69–106.

    Google Scholar 

  32. Croft JB, Strogatz DS, James SA, Keenan NL. Socioeconomic and behavioral correlates of body mass index in black adults: the Pitt County study. Am J Public Health. 1992;82:821–6.

    PubMed  CAS  Google Scholar 

  33. Williamson DF. Descriptive epidemiology of body weight and weight change in US adults. Ann Intern Med. 1993;119:646–9.

    PubMed  CAS  Google Scholar 

  34. Wadden TA, Stunkard AJ, Rich L, Rubin CJ, Sweidel G, McKinney S. Obesity in black adolescent girls: a controlled trial of treatment by diet, behavior modification, and parental support. Pediatrics. 1990;85:345–52.

    PubMed  CAS  Google Scholar 

  35. Willems JP, Saunders JT, Hunt DE, Schorling JB. Prevalence of coronary heart disease risk factors among rural blacks: a community-based study. South Med J. 1997;90:814–20.

    Article  PubMed  CAS  Google Scholar 

  36. Baturka NL, Schorling JB. The Alliance of Black Churches Health Project: a model partnership for health promotion in rural African-American communities. In: Suchman AL, Botelho RJ, Hinton-Walker P, eds. The process of partnership: transforming health care delivery. Rochester, NY: University of Rochester Press; 1998: 225–35.

    Google Scholar 

  37. Lincoln YS, Guba EG. Naturalistic Inquiry. Beverly Hills, Calif: Sage; 1985.

    Google Scholar 

  38. Spradley JP. The Ethnographic Interview. New York, NY: Holt, Rinehart & Winston; 1979.

    Google Scholar 

  39. Allan JD. Weight management activities among black women. In: Simopoulous A, VanItallie T, eds. Obesity: New Directions in Assessment and Management. Philadelphia, Pa: The Charles Press; 1995;207–19.

    Google Scholar 

  40. Gray JJ, Ford K, Kelly LM. The prevalence of bulimia in a black college population. Int J Eat Disord. 1987;6:733–40.

    Article  Google Scholar 

  41. Miller WR, Rollnick S. Motivational Interviewing: Preparing People to Change Addictive Behavior. New York, NY: The Guilford Press; 1991.

    Google Scholar 

  42. Velicer WF, DiClemente CC, Prochaska JO, Brandenburg N. Decisional balance scale for assessing and predicting smoking status. J Pers Soc Psychol. 1985;48:1279–89.

    Article  PubMed  CAS  Google Scholar 

  43. Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP. The spread of the obesity epidemic in the United States, 1991–1998. JAMA. 1999;282:1519–22.

    Article  PubMed  CAS  Google Scholar 

  44. Kumanyika SK, Morssink C, Agurs T. Models for dietary and weight change in African-American women: identifying cultural components. Ethnicity Dis. 1992;2:166–175.

    CAS  Google Scholar 

  45. Kanders BS, Ullmann-Joy P, Foreyt JP, et al. The Black American Lifestyle Intervention (BALI): the design of a weight loss program for working-class African-American women. J Am Diet Assoc. 1994;94:310–2.

    Article  PubMed  CAS  Google Scholar 

  46. McNabb W, Quinn M, Kerver J, Cook S, Karrison T. The PATH-WAYS church-based weight loss program for urban African-American women at risk for diabetes. Diabetes Care. 1997;20:1518–23.

    Article  PubMed  CAS  Google Scholar 

  47. Williamson DF. The prevention of obesity. N Engl J Med. 1999;341:1140–1.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Office of Medical Education, University of Virginia Health Sciences Center, P. O. Box 382, 22908, Charlottesville, VA

    Natalie Baturka PhD

  2. the Departments of Health Evaluation Sciences, University of Virginia Health Sciences Center, Charlottesville, Va

    Paige P. Hornsby PhD & John B. Schorling MD, MPH

  3. Internal Medicine, University of Virginia Health Sciences Center, Charlottesville, Va

    John B. Schorling MD, MPH

Authors
  1. Natalie Baturka PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paige P. Hornsby PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John B. Schorling MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This work was supported by grant RO1HL43611 from the National Heart Lung and Blood Institute.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Baturka, N., Hornsby, P.P. & Schorling, J.B. Clinical implications of body image among rural African-American women. J GEN INTERN MED 15, 235–241 (2000). https://doi.org/10.1111/j.1525-1497.2000.06479.x

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1111/j.1525-1497.2000.06479.x

Key words

Search

Navigation