Body Image as a Contributor to Weight in Pregnancy and Postpartum: Racial Differences

  • Tiffany L. Carson
  • Kesha Baptiste-Roberts
  • Tiffany L. Gary-Webb
Chapter

Abstract

The alarming disparities in obesity and related conditions for African-Americans compared to Whites have prompted the investigation of social and cultural influences of the obesogenic environment as potential contributors. One such cultural influence may be body image, which encompasses one’s perception of body size and the emotional attitude toward that perception. While studies show that body image is significantly associated with weight, studies during pregnancy have been few, particularly among minority populations. The concept of body image and its influence on weight control should be considered in various phases of a woman’s life, including pregnancy.

Keywords

Body image Racial/ethnic disparities Cultural influences Weight control Prepregnancy Postpartum 

Notes

Acknowledgment

Dr. Gary-Webb was funded by a grant from NHLBI (K01-HL084700).

References

  1. 1.
    Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA. 2012;307(5):491–7. Epub 2012/01/19.PubMedCrossRefGoogle Scholar
  2. 2.
    Airhihenbuwa CO, Kumanyika S, Agurs TD, Lowe A. Perceptions and beliefs about exercise, rest, and health among African-Americans. Am J Health Promot. 1995;9(6):426–9. Epub 1995/06/07.PubMedCrossRefGoogle Scholar
  3. 3.
    Airhihenbuwa CO, Kumanyika S, Agurs TD, Lowe A, Saunders D, Morssink CB. Cultural aspects of African American eating patterns. Ethn Health. 1996;1(3):245–60. Epub 1996/09/01.PubMedCrossRefGoogle Scholar
  4. 4.
    Kumanyika SK, Morssink C, Agurs T. Models for dietary and weight change in African-American women: identifying cultural components. Ethn Dis. 1992;2(2):166–75. Epub 1992/01/01.PubMedGoogle Scholar
  5. 5.
    Ard JD. Unique perspectives on the obesogenic environment. J Gen Intern Med. 2007;22(7):1058–60. Epub 2007/05/24.PubMedCrossRefGoogle Scholar
  6. 6.
    Anderson LA, Janes GR, Ziemer DC, Phillips LS. Diabetes in urban African Americans. Body image, satisfaction with size, and weight change attempts. Diabetes Educ. 1997;23(3):301–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Liburd LC, Anderson LA, Edgar T, Jack Jr L. Body size and body shape: perceptions of Black women with diabetes. Diabetes Educ. 1999;25(3):382–8. Epub 1999/10/26.PubMedCrossRefGoogle Scholar
  8. 8.
    Patt MR, Lane AE, Finney CP, Yanek LR, Becker DM. Body image assessment: comparison of figure rating scales among urban Black women. Ethn Dis. 2002;12(1):54–62. Epub 2002/03/27.PubMedGoogle Scholar
  9. 9.
    Secord PF, Jourard SM. The appraisal of body-cathexis: body-cathexis and the self. J Consult Psychol. 1953;17(5):343–7. Epub 1953/10/01.PubMedCrossRefGoogle Scholar
  10. 10.
    Cooper PJ, Taylor MJ, Cooper Z, Fairbum CG. The development and validation of the body shape questionnaire. Int J Eat Disord. 1987;6(4):485–94.CrossRefGoogle Scholar
  11. 11.
    Stunkard AJ, Sorensen T, Schulsinger F. Use of the Danish Adoption Register for the study of obesity and thinness. Res Publ Assoc Res Nerv Ment Dis. 1983;60:115–20.PubMedGoogle Scholar
  12. 12.
    Bulik CM, Wade TD, Heath AC, Martin NG, Stunkard AJ, Eaves LJ. Relating body mass index to figural stimuli: population-based normative data for Caucasians. Int J Obes Relat Metab Disord. 2001;25(10):1517–24. Epub 2001/10/24.PubMedCrossRefGoogle Scholar
  13. 13.
    Pulvers KM, Lee RE, Kaur H, Mayo MS, Fitzgibbon ML, Jeffries SK, et al. Development of a culturally relevant body image instrument among urban African Americans. Obes Res. 2004;12(10):1641–51.PubMedCrossRefGoogle Scholar
  14. 14.
    Williamson DA, Womble LG, Zucker NL, Reas DL, White MA, Blouin DC, et al. Body image assessment for obesity (BIA-O): development of a new procedure. Int J Obes Relat Metab Disord. 2000;24(10):1326–32. Epub 2000/11/28.PubMedCrossRefGoogle Scholar
  15. 15.
    Cox TL, Zunker C, Wingo BC, Thomas DM, Ard JD. Body image and quality of life in a group of African American women. Soc Indic Res. 2010;99:531–40.CrossRefGoogle Scholar
  16. 16.
    Cox TL, Ard JD, Beasley TM, Fernandez JR, Howard VJ, Affuso O. Body image as a mediator of the relationship between body mass index and weight-related quality of life in Black women. J Womens Health (Larchmt). 2011;20(10):1573–8. Epub 2011/08/06.CrossRefGoogle Scholar
  17. 17.
    Cachelin FM. Ethnic differences in body-size preferences: myth or reality? Nutrition. 2001;17(4):353–4. Epub 2001/05/23.PubMedCrossRefGoogle Scholar
  18. 18.
    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(3):291–9.CrossRefGoogle Scholar
  19. 19.
    Altabe M. Ethnicity and body image: quantitative and qualitative analysis. Int J Eat Disord. 1998;23(2):153–9. Epub 1998/03/21.PubMedCrossRefGoogle Scholar
  20. 20.
    Becker DM, Yanek LR, Koffman DM, Bronner YC. Body image preferences among urban African Americans and whites from low income communities. Ethn Dis. 1999;9(3):377–86. Epub 1999/12/22.PubMedGoogle Scholar
  21. 21.
    Derenne JL, Beresin EV. Body image, media, and eating disorders. Acad Psychiatry. 2006;30(3):257–61. Epub 2006/05/27.PubMedCrossRefGoogle Scholar
  22. 22.
    Thesander M. The feminine ideal. London: Reaktion Books; 1997.Google Scholar
  23. 23.
    Schooler D, Ward M, Merriwether A, Caruthers A. Who’s that girl: television’s role in the body image development of young White and Black women. Psych Women Q. 2004;28:38–47.CrossRefGoogle Scholar
  24. 24.
    Kumanyika S, Wilson JF, Guilford-Davenport M. Weight-related attitudes and behaviors of Black women. J Am Diet Assoc. 1993;93(4):416–22. Epub 1993/04/01.PubMedCrossRefGoogle Scholar
  25. 25.
    Baturka N, Hornsby PP, Schorling JB. Clinical implications of body image among rural African-American women. J Gen Inter Med. 2000;15(4):235–41. Epub 2000/04/12.CrossRefGoogle Scholar
  26. 26.
    Brown K, Schreiber G, McMahon R, Crawford P, Ghee K. Maternal influences on body satisfaction in Black and White girls aged 9 and 10: the NHLBI Growth and Health Study (NGHS). Ann Behav Med. 1995;17(3):213–20.PubMedCrossRefGoogle Scholar
  27. 27.
    Lucero K, Hicks RA, Bramlette J, Brassington GS, Welter MG. Frequency of eating problems among Asian and Caucasian college women. Psychol Rep. 1992;71(1):255–8. Epub 1992/08/01.PubMedCrossRefGoogle Scholar
  28. 28.
    Shaw H, Ramirez L, Trost A, Randall P, Stice E. Body image and eating disturbances across ethnic groups: more similarities than differences. Psychol Addict Behav. 2004;18(1):12–8. Epub 2004/03/11.PubMedCrossRefGoogle Scholar
  29. 29.
    Fitzgibbon ML, Blackman LR, Avellone ME. The relationship between body image discrepancy and body mass index across ethnic groups. Obes Res. 2000;8(8):582–9.PubMedCrossRefGoogle Scholar
  30. 30.
    Cox T, Ard J, Beasley TM, Fernandez J, Howard V, Kolotkin R, et al. Examining the association between body mass index and weight related quality of life in Black and White women. Appl Res Qual Life. 2012;7(3):309–22.CrossRefGoogle Scholar
  31. 31.
    Strang VR, Sullivan PL. Body image attitudes during pregnancy and the postpartum period. J Obstet Gynecol Neonatal Nurs. 1985;14(4):332–7. Epub 1985/07/01.PubMedCrossRefGoogle Scholar
  32. 32.
    Skouteris H, Carr R, Wertheim EH, Paxton SJ, Duncombe D. A prospective study of factors that lead to body dissatisfaction during pregnancy. Body Image. 2005;2(4):347–61. Epub 2007/12/20.PubMedCrossRefGoogle Scholar
  33. 33.
    Duncombe D, Wertheim EH, Skouteris H, Paxton SJ, Kelly L. How well do women adapt to changes in their body size and shape across the course of pregnancy? J Health Psychol. 2008;13(4):503–15. Epub 2008/04/19.PubMedCrossRefGoogle Scholar
  34. 34.
    Conti J, Abraham S, Taylor A. Eating behavior and pregnancy outcome. J Psychosom Res. 1998;44(3–4):465–77. Epub 1998/05/20.PubMedCrossRefGoogle Scholar
  35. 35.
    Fairburn CG, Stein A, Jones R. Eating habits and eating disorders during pregnancy. Psychosom Med. 1992;54(6):665–72. Epub 1992/11/01.PubMedGoogle Scholar
  36. 36.
    Franko DL, Walton BE. Pregnancy and eating disorders: a review and clinical implications. Int J Eat Disord. 1993;13(1):41–7. Epub 1993/01/01.PubMedCrossRefGoogle Scholar
  37. 37.
    Rasmussen KM, Yaktine AL, Guidelines CtRIPW, Medicine Io, Council NR, editors. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: The National Academies Press; 2009.Google Scholar
  38. 38.
    Chu SY, Callaghan WM, Bish CL, D’Angelo D. Gestational weight gain by body mass index among US women delivering live births, 2004–2005: fueling future obesity. Am J Obstet Gynecol. 2009;200(3):271 e1–7. Epub 2009/01/10.Google Scholar
  39. 39.
    Fontaine PL, Hellerstedt WL, Dayman CE, Wall MM, Sherwood NE. Evaluating body mass index-specific trimester weight gain recommendations: differences between black and White women. J Midwifery Womens Health. 2012;57(4):327–35. Epub 2012/07/05.PubMedCrossRefGoogle Scholar
  40. 40.
    Schieve LA, Cogswell ME, Scanlon KS. An empiric evaluation of the Institute of Medicine’s pregnancy weight gain guidelines by race. Obstet Gynecol. 1998;91(6):878–84. Epub 1998/06/04.PubMedCrossRefGoogle Scholar
  41. 41.
    Caulfield LE, Witter FR, Stoltzfus RJ. Determinants of gestational weight gain outside the recommended ranges among black and White women. Obstet Gynecol. 1996;87(5 Pt 1):760–6. Epub 1996/05/01.PubMedCrossRefGoogle Scholar
  42. 42.
    Vahratian A. Prevalence of overweight and obesity among women of childbearing age: results from the 2002 national survey of family growth. Matern Child Health J. 2009;13(2):268–73. Epub 2008/04/17.PubMedCrossRefGoogle Scholar
  43. 43.
    Thompson JK, Heinberg LJ, Altabe M, Tantleff-Dunn S. Exacting beauty: theory, assessment, and treatment of body image disturbance. Washington, DC: American Psychological Association; 1999.CrossRefGoogle Scholar
  44. 44.
    Hofmeyr GJ, Marcos EF, Butchart AM. Pregnant women’s perceptions of themselves: a survey. Birth. 1990;17(4):205–6. Epub 1990/12/01.PubMedCrossRefGoogle Scholar
  45. 45.
    Davies K, Wardle J. Body image and dieting in pregnancy. J Psychosom Res. 1994;38(8):787–99. Epub 1994/11/01.PubMedCrossRefGoogle Scholar
  46. 46.
    Fox P, Yamaguchi C. Body image change in pregnancy: a comparison of normal weight and overweight primigravidas. Birth. 1997;24(1):35–40. Epub 1997/03/01.PubMedCrossRefGoogle Scholar
  47. 47.
    Boscaglia N, Skouteris H, Wertheim EH. Changes in body image satisfaction during pregnancy: a comparison of high exercising and low exercising women. Aust N Z J Obstet Gynaecol. 2003;43(1):41–5. Epub 2003/05/21.PubMedCrossRefGoogle Scholar
  48. 48.
    Clark A, Skouteris H, Wertheim EH, Paxton SJ, Milgrom J. The relationship between depression and body dissatisfaction across pregnancy and the postpartum: a prospective study. J Health Psychol. 2009;14(1):27–35. Epub 2009/01/09.PubMedCrossRefGoogle Scholar
  49. 49.
    Berk B. Body image and pregnancy: bridging the mind-body connection. A guide for health care professionals. J Perinatol. 1993;13(4):300–4. Epub 1993/07/01.PubMedGoogle Scholar
  50. 50.
    Chang SR, Chao YM, Kenney NJ. I am a woman and i’m pregnant: body image of women in Taiwan during the third trimester of pregnancy. Birth. 2006;33(2):147–53. Epub 2006/05/31.PubMedCrossRefGoogle Scholar
  51. 51.
    Goodwin A, Astbury J, McMeeken J. Body image and psychological well-being in pregnancy. A comparison of exercisers and non-exercisers. Aust N Z J Obstet Gynaecol. 2000;40(4):442–7. Epub 2001/02/24.PubMedCrossRefGoogle Scholar
  52. 52.
    Richardson P. Women’s experiences of body change during normal pregnancy. Matern Child Nurs J. 1990;19(2):93–111. Epub 1990/01/01.PubMedGoogle Scholar
  53. 53.
    Harris R. Cultural differences in body perception during pregnancy. Br J Med Psychol. 1979;52(4):347–52. Epub 1979/12/01.PubMedCrossRefGoogle Scholar
  54. 54.
    Slade PD. Awareness of body dimensions during pregnancy: an analogue study. Psychol Med. 1977;7(2):245–52. Epub 1977/05/01.PubMedCrossRefGoogle Scholar
  55. 55.
    Anderson VN, Fleming AS, Steiner M. Mood and the transition to motherhood. J Reprod Infant Psychol. 1994;12(2):69–77.CrossRefGoogle Scholar
  56. 56.
    Dipietro JA, Millet S, Costigan KA, Gurewitsch E, Caulfield LE. Psychosocial influences on weight gain attitudes and behaviors during pregnancy. J Am Diet Assoc. 2003;103(10):1314–9. Epub 2003/10/02.PubMedCrossRefGoogle Scholar
  57. 57.
    Campbell A, Hausenblas HA. Effects of exercise interventions on body image: a meta-analysis. J Health Psychol. 2009;14(6):780–93. Epub 2009/08/19.PubMedCrossRefGoogle Scholar
  58. 58.
    Marquez-Sterling S, Perry AC, Kaplan TA, Halberstein RA, Signorile JF. Physical and psychological changes with vigorous exercise in sedentary primigravidae. Med Sci Sports Exerc. 2000;32(1):58–62. Epub 2000/01/27.PubMedCrossRefGoogle Scholar
  59. 59.
    Walker LO, Freeland-Graves J. Lifestyle factors related to postpartum weight gain and body image in bottle- and breastfeeding women. J Obstet Gynecol Neonatal Nurs. 1998;27(2):151–60. Epub 1998/04/29.PubMedCrossRefGoogle Scholar
  60. 60.
    Jenkin W, Tiggemann M. Psychological effects of weight retained after pregnancy. Women Health. 1997;25(1):89–98. Epub 1997/01/01.PubMedCrossRefGoogle Scholar
  61. 61.
    Leifer M. Psychological changes accompanying pregnancy and motherhood. Genet Psychol Monogr. 1977;95(1):55–96. Epub 1977/02/01.PubMedGoogle Scholar
  62. 62.
    Rallis S, Skouteris H, Wertheim EH, Paxton SJ. Predictors of body image during the first year postpartum: a prospective study. Women Health. 2007;45(1):87–104. Epub 2007/07/07.PubMedCrossRefGoogle Scholar
  63. 63.
    Gjerdingen D, Fontaine P, Crow S, McGovern P, Center B, Miner M. Predictors of mothers’ postpartum body dissatisfaction. Women Health. 2009;49(6):491–504. Epub 2009/12/17.PubMedGoogle Scholar
  64. 64.
    Walker LO. Weight-related distress in the early months after childbirth. West J Nurs Res. 1998;20(1):30–44. Epub 1998/02/25.PubMedCrossRefGoogle Scholar
  65. 65.
    Morin KH, Brogan S, Flavin SK. Attitudes and perceptions of body image in postpartum African American women. Does weight make a difference? MCN Am J Matern Child Nurs. 2002;27(1):20–5.PubMedCrossRefGoogle Scholar
  66. 66.
    Carter-Edwards L, Bastian LA, Revels J, Durham H, Lokhnygina Y, Amamoo MA, et al. Body image and body satisfaction differ by race in overweight postpartum mothers. J Womens Health (Larchmt). 2010;19(2):305–11. Epub 2010/02/02.CrossRefGoogle Scholar
  67. 67.
    Boyington J, Johnson A, Carter-Edwards L. Dissatisfaction with body size among low-income, postpartum Black women. J Obstet Gynecol Neonatal Nurs. 2007;36(2):144–51. Epub 2007/03/21.PubMedCrossRefGoogle Scholar
  68. 68.
    Morin KH. Obese and nonobese postpartum women: complications, body image, and perceptions of the intrapartal experience. Appl Nurs Res. 1995;8(2):81–7. Epub 1995/05/01.PubMedCrossRefGoogle Scholar
  69. 69.
    Baptiste-Roberts K, Gary TL, Bone LR, Hill MN, Brancati FL. Perceived body image among African Americans with type 2 diabetes. Patient Educ Couns. 2006;60(2):194–200. Epub 2006/01/31.PubMedCrossRefGoogle Scholar
  70. 70.
    Pliner P, Chaiken S, Flett GL. Gender differences in concern with weight and physical appearance over the lifespan. Pers Soc Psychol Bull. 1990;16:10.CrossRefGoogle Scholar
  71. 71.
    Webster J, Tiggemann M. The relationship between women’s body satisfaction and self-image across the life span: the role of cognitive control. J Genet Psychol. 2003;164(2):241–52. Epub 2003/07/15.PubMedCrossRefGoogle Scholar
  72. 72.
    McLean SA, Paxton SJ, Wertheim EH. Factors associated with body dissatisfaction and disordered eating in women in midlife. Int J Eat Disord. 2010;43(6):527–36. Epub 2009/09/01.PubMedCrossRefGoogle Scholar
  73. 73.
    Paxton SJ, McLean SA, Gollings EK, Faulkner C, Wertheim EH. Comparison of face-to-face and internet interventions for body image and eating problems in adult women: an RCT. Int J Eat Disord. 2007;40(8):692–704. Epub 2007/08/19.PubMedCrossRefGoogle Scholar
  74. 74.
    Gollings EK, Paxton SJ. Comparison of internet and face-to-face delivery of a group body image and disordered eating intervention for women: a pilot study. Eat Disord. 2006;14(1):1–15. Epub 2006/06/08.PubMedCrossRefGoogle Scholar
  75. 75.
    Stewart TM, Bachand AR, Han H, Ryan DH, Bray GA, Williamson DA. Body image changes associated with participation in an intensive lifestyle weight loss intervention. Obesity (Silver Spring). 2011;19(6):1290–5. Epub 2010/12/15.CrossRefGoogle Scholar
  76. 76.
    Dalle Grave R, Cuzzolaro M, Calugi S, Tomasi F, Temperilli F, Marchesini G. The effect of obesity management on body image in patients seeking treatment at medical centers. Obesity (Silver Spring). 2007;15(9):2320–7. Epub 2007/09/25.CrossRefGoogle Scholar
  77. 77.
    Ramirez EM, Rosen JC. A comparison of weight control and weight control plus body image therapy for obese men and women. J Consult Clin Psychol. 2001;69(3):440–6. Epub 2001/08/10.PubMedCrossRefGoogle Scholar
  78. 78.
    Kuhlmann AK, Dietz PM, Galavotti C, England LJ. Weight-management interventions for pregnant or postpartum women. Am J Prev Med. 2008;34(6):523–8. Epub 2008/05/13.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2014

Authors and Affiliations

  • Tiffany L. Carson
    • 1
  • Kesha Baptiste-Roberts
    • 2
  • Tiffany L. Gary-Webb
    • 3
  1. 1.Division of Preventive MedicineUniversity of Alabama at Birmingham School of MedicineBirminghamUSA
  2. 2.School of Nursing and College of Medicine, Department of Public Health SciencesThe Pennsylvania State UniversityHersheyUSA
  3. 3.Department of EpidemiologyColumbia University Mailman School of Public HealthNew YorkUSA

Personalised recommendations