Body size values of white and black women

Peer Ethnicity as a Mediator in the Relationship Between Ethnic Identity and Body Appreciation in Black College-Aged Women

Strong ethnic identity is recognized as a protective factor against body image concern and eating pathology in Black women as they tend to hold cultural values in line with an acceptance of a variety of body shapes and sizes. Reinforcement of these cultural ideals may occur via same-race peer relationships. The current study examined the mediating role of same-race versus other-race peers in the relationship between ethnic identity and body appreciation in Black women. Participants were 139 Black undergraduate women (Mage = 18.94 years, MBMI = 25.33) who completed validated measures of ethnic identity and body appreciation and reported on the ethnic makeup of their friends. We conducted mediation analysis examining the role of same-race peers on the relationship between ethnic identity and body appreciation. Same-race peers mediated the relationship between ethnic identity and body appreciation, where having a greater percentage of friends increased both ethnic identity and body appreciation in Black women. The influence of same-race peers should be considered in the development of culturally informed prevention and intervention efforts for eating pathology in Black women.

Measurement invariance of the Broad Conceptualization of Beauty Scale (BCBS) across Black, Hispanic, and White women in the United States

The Broad Conceptualization of Beauty Scale (BCBS) assesses the degree to which women perceive diverse appearances and internal qualities as being beautiful. Although the instrument is increasingly used in diverse national and linguistic contexts, no previous study has examined measurement invariance of the BCBS across racial groups. To rectify this, we asked 395 Black, 406 Hispanic, and 423 White women from the United States to complete the BCBS. Confirmatory factor analysis indicated that a unidimensional model of BCBS scores had poor fit to the data in the total sample, but freely estimating error covariances between six pairs of items resulted in adequate fit. Additionally, full configural and scalar invariance was supported, but metric invariance was not, with further testing indicating that the item loading for one item differed across groups. Comparison of latent means indicated that all between-groups comparisons in BCBS scores were non-significant. However, medium-sized group differences in BCBS scores emerged once group differences in key demographics were controlled for. Overall, these results suggest that the BCBS largely achieves measurement invariance across Black, Hispanic, and White women in the United States, suggestive of similarity in how the construct of broad conceptualisation of beauty is understood and experienced.

Black women's experiences of gendered racial sexual objectification, body image, and depressive symptoms

Black women navigate unique sexual objectification experiences and concerns about their bodies as a consequence of the race- and gender-based marginalization that they face. However, less is known about the influence of gendered racial sexual objectification experiences on Black women's mental health (i.e., depressive symptoms) or the contributions of key body image indicators (i.e., body surveillance and current-ideal body image discrepancy) that reflect Black women's engagement in monitoring and managing their bodies. We surveyed 1595 Black women to test our hypotheses that experiences of gendered racial sexual objectification (i.e., frequency and stress appraisal) would be positively associated with depressive symptoms and that body surveillance and current-ideal body image discrepancy would moderate this association. Analyses showed that more frequent experiences of gendered racial sexual objectification and higher stress appraisal of these experiences were significantly associated with more depressive symptoms. Furthermore, body surveillance and current-ideal body image discrepancy moderated the relation between gendered racial sexual objectification and depressive symptoms. Findings highlight how Black women's objectification and increased engagement in body monitoring and management practices are associated with their experiences of depressive symptoms, and thus, may negatively influence their mental health.

The association between body appreciation and body mass index among males and females: A meta-analysis

To date, a number of studies have reported an association between body appreciation and body mass index (BMI), but the findings are not consistent. Using a meta-analytic approach, the current study aimed to clarify this association as well as to explore what factors might have contributed to the inconsistency across previous studies. By searching and screening potential studies published up to June 2019 in four databases, we identified 26 articles that reported an association between body appreciation and BMI among males, and 59 articles among females. Under a random-effects model, among males the overall estimate of the association between body appreciation and BMI was negative and small, with the pooled r = -.20 (95 % CI: -.25, -.14) and an adjusted (for publication bias) pooled r = -.11 (95 % CI: -.16, -.06). Among females, the overall estimate of the association was negative and small (but close to moderate), with r = -.27 (95 % CI: -.30, -.24). A mixed-effects model identified several moderators that contributed to the inconsistency across previous studies. These results indicate that the overall negative association between body appreciation and BMI is weak among males, and slightly larger among females. Potential explanations, implications, and future research directions are discussed.

Association of Race With Bariatric Surgery Outcomes

Importance

The outcomes of bariatric surgery vary considerably across patients, but the association of race with these measures remains unclear.

Objective

To examine the association of race on perioperative and 1-year outcomes of bariatric surgery.

Design, Setting, and Participants

Propensity score matching was used to assemble cohorts of black and white patients from the Michigan Bariatric Surgery Collaborative who underwent a primary bariatric operation (Roux-en-Y gastric bypass, sleeve gastrectomy, or adjustable gastric banding) between June 2006 and January 2017. Cohorts were balanced on baseline characteristics and procedure. Conditional fixed-effects models were used to evaluate the association of race on outcomes within hospitals and surgeons. Data analysis occurred from June 2006 through August 2018.

Main Outcomes and Measures

Thirty-day complications and health care resource utilization measures, as well as 1-year weight loss, comorbidity remission, quality of life, and satisfaction.

Results

In each group, 7105 patients were included. Black patients had a higher rate of any complication (628 [8.8%] vs 481 [6.8%]; adjusted odds ratio, 1.33 [95% CI, 1.17-1.51]; P = .02), but there were no significant differences in the rates of serious complications (178 [2.5%] vs 135 [1.9%]; adjusted odds ratio, 1.32 [95% CI, 1.05-1.66]; P = .29) or mortality (5 [0.10%] vs 7 [0.10%]; adjusted odds ratio, 0.73 [95% CI, 0.23-2.31]; P = .54). Black patients had a greater length of stay (mean [SD], 2.2 [3.0] days vs 1.9 [1.7] days; adjusted odds ratio, 0.30 [95% CI, 0.20-0.40]; P < .001), as well as a higher rate of emergency department visits (541 [11.6%] vs 826 [7.6%]; adjusted odds ratio, 1.60 [95% CI, 1.43-1.79]; P < .001) and readmissions (414 [5.8%] vs 245 [3.5%]; adjusted odds ratio, 1.73 [95% CI, 1.47-2.03]; P < .001). At 1 year, black patients had lower mean total body weight loss and as a percentage of weight (32.0 kg [26%]; vs 38.3 kg [29%]; P < .001) and this held true across procedures. Remission of hypertension was lower for black patients (564 [40.0%] vs 1096 [56.0%]; P < .001), but the rate of sleep apnea remission (467 [62.6%] vs 615 [56.1%]; P = .005) and gastroesophageal reflux disease (309 [78.6%] vs 453 [75.4%]; P = .049) were higher. There were no significant differences in remission of diabetes with insulin dependence, diabetes without insulin dependence,or hyperlipidemia hyperlipidemia. Fewer black patients than white patients reported a good or very good quality of life (1379 [87.2%] vs 2133 [90.4%]; P = .002) and being very satisfied with surgery (1908 [78.4%] vs 2895 [84.2%]; P < .001) at 1 year.

Conclusions and Relevance

Black patients undergoing bariatric surgery in Michigan had significantly higher rates of 30-day complications and resource utilization and experienced lower weight loss at 1 year than a matched cohort of white patients. While sleep apnea and gastroesophageal reflux disease remission were higher and hypertension remission lower in black patients, comorbidity remission was otherwise similar between matched cohorts. Racial and cultural differences among patients should be considered when designing strategies to optimize outcomes with bariatric surgery.

Does Difference in Physical Activity Between Blacks and Whites Vary by Sex, Income, Education, and Region of Residence? Results from 2008 to 2017 National Health Interview Surveys

OBJECTIVE

To examine how the effect of race (Black versus White) on meeting physical activity (PA) guidelines varies by sex, income, education, and region of residence.

METHODS

We pooled data from 10 consecutive years (2008 to 2017) of the National Health Interview Survey. We used logistic regression to assess the extent to which the effect of race on meeting the U.S. federal guidelines for PA varies by sex, income, education, and region, after controlling for several health-related variables. The analysis sample size was 225,600 (102,348 men and 123,252 women).

RESULTS

Race and most of the other covariates interacted with sex in their effect on meeting PA guidelines; therefore, separate models for men and women were estimated. In each model, race interacted with income and region, but not with education. Among men, Blacks were more likely to meet PA guidelines than Whites in nearly all income categories and regions. The race effect was weakest among the poor and in the Northeast region. Among women, Blacks were generally less likely than Whites to meet the guidelines and the race effect was largest among the poor and in the Northeast region.

CONCLUSION

This study showed that the difference between Blacks and Whites in the extent to which they adhere to federal PA guidelines varies by sex, income, and region of residence. Black women whole live below the poverty threshold are less likely than other demographic groups to meet the PA guidelines. Targeted interventions to promote PA among this population group are warranted.

Equity in Physical Activity: A Misguided Goal

Rates of participation in physical activity are often not the same between groups in a given demographic category. These differences have been termed 'inequities,' and major health organizations are advocating large-scale initiatives to create 'equity' in physical activity. The aim of this paper is to explain why equity in physical activity is a misguided goal. Equity is a misguided goal because it ignores absolute rates of physical activity (i.e., it is a metric of how one group compares with another), and because it is an automated goal that ignores sizes of 'gaps' between groups. Moreover, equity initiatives incorrectly assume that groups with relatively high physical activity rates are always at lower health risk; that non-targeted groups will remain static in their levels of physical activity; that individuals are part of only one demographic category; that complete equity can be achieved; that the causal relationship between equity initiatives and their desired outcome can be known; and that differences in physical activity rates between groups are due to differences in 'opportunity.' Due to these issues, health organizations should abandon the goal of equity. Instead, they should aim to increase physical activity in groups that are most sedentary and/or at greatest health risk to a level that is as high as is feasible and possible, irrespective of how that new level compares with other groups. This goal is objective and not based on the misguided premises that underpin the current equity narrative.

The Weight of Things: Understanding African American Women's Perceptions of Health, Body Image, and Attractiveness

Negative attitudes toward being overweight or obese are widespread, and these notions perpetuate into conceptions about one's health. Clinically, being overweight is associated with health problems such as diabetes, hypertension, heart disease, and many other illnesses. African American women, who are generally larger in body size, are a particular target for health interventions. However, these women have resisted the "obesity" label, arguing that dominant measures of health are White norms and oppressive. Through the use of in-depth interviews, this study investigates how African American women understand and experience healthfulness, body image, and barriers to each. Findings show that African American women are ambivalent in their acceptance of dominant markers of health and expressed an almost universal disdain for the thin ideal as a marker of "good" health and a positive body image. Moreover, participants articulated a suspicion of formal medical measurements of obesity.

Overweight but unseen: a review of the underestimation of weight status and a visual normalization theory

Although overweight and obesity are widespread across most of the developed world, a considerable body of research has now accumulated, which suggests that adiposity often goes undetected. A substantial proportion of individuals with overweight or obesity do not identify they are overweight, and large numbers of parents of children with overweight or obesity fail to identify their child as being overweight. Lay people and medical practitioners are also now poor at identifying overweight and obesity in others. A visual normalization theory of the under-detection of overweight and obesity is proposed. This theory is based on the notion that weight status is judged relative to visual body size norms. Because larger body sizes are now common, this has caused a recalibration to the range of body sizes that are perceived as being 'normal' and increased the visual threshold for what constitutes 'overweight'. Evidence is reviewed that indicates this process has played a significant role in the under-detection of overweight and obesity. The public health relevance of the under-detection of overweight and obesity is also discussed.

Designing Culturally Relevant Physical Activity Programs for African-American Women: A Framework for Intervention Development

BACKGROUND

African-American women perform low levels of physical activity and are disproportionally burdened by associated cardiometabolic disease conditions (i.e., 57 % are obese, 49 % have cardiovascular disease). The marked health disparities among African-American women indicate the need for innovative strategies to promote physical activity to help attenuate the chronic disease health disparities in this high-risk population. Culturally tailoring physical activity programs to address the sociocultural norms, values, beliefs, and behaviors of African-American women is an advantageous strategy to enhance physical activity promotion efforts. The purpose of this article is to discuss critical aspects for researchers to consider when designing physical activity programs for African-American women and to present a conceptual framework to guide intervention development.

METHODS

Development of the framework was based on our previous physical activity research with African-American women, seminal literature on the topics of cultural adaptation and health promotion, sociological and theoretical perspectives on the role of women in African-American culture, and key determinants of physical activity engagement among African-American women.

RESULTS

Three key concepts are discussed in the conceptual framework: (1) Developmental milestones and life stage transitions of African-American women; (2) Historical, social, and cultural influences associated with physical activity engagement; and (3) Intervention delivery strategies.

DISCUSSION

Using the framework to guide intervention development has the potential to enhance the physical activity and health outcomes of a physical activity program for African-American women.

Who's that Girl: Television's Role in the Body Image Development of Young White and Black Women

Although findings indicate a connection between frequent media use and greater body dissatisfaction, little attention has focused on the role of race. Accordingly, this study investigates the relation between television viewing and body image among 87 Black and 584 White women. Participants reported monthly viewing amounts of mainstream and Black-oriented television programs as well as body attitudes as measured by the Eating Disorders Inventory, the Body Esteem Scale, and the Body Shape Questionnaire. Results suggest different patterns predicting body image for White and Black women. Among White women, viewing mainstream television predicted poorer body image, while viewing Black-oriented media was unrelated to body image. Among Black women, viewing Black-oriented television predicted healthier body image, while viewing mainstream television was unrelated to body image. Ethnic identity also predicted healthier body image among Black women, and appeared to moderate, to some extent, the contributions of viewing Black-oriented programming.

African American College Women's Body Image: An Examination of Body Mass, African Self-Consciousness, and Skin Color Satisfaction

The purpose of this study was to examine general and cultural factors associated with body image perceptions of African American women college students. A total of 124 African American college women attending a historically Black college completed the following scales: African Self-Consciousness (ASC) scale, the Skin Color Satisfaction Scale (SCSS), the Body Mass Index (BMI), and several body image measures. Results from simultaneous multiple regression analyses suggest that all three factors collectively accounted for a significant amount of variance in dimensions of body image satisfaction. Specifically, SCSS accounted for a significant amount of variance in three body image dimensions (i.e., appearance evaluation, satisfaction with specific body areas, internalization of social cultural messages of appearance), suggesting that the greater satisfaction with one's skin color was associated with more positive, internal perspectives of one's body image. The BMI accounted for a significant amount of variance in measures of appearance evaluation and satisfaction with body areas, such that greater BMI scores were related to a less positive evaluation of overall appearance but more satisfaction with specific body areas. Implications of the findings and suggestions for future research are discussed.

Development and Validation of the Beliefs About Personal Weight Survey Among African American Women

The purpose of this study was to develop the Beliefs about Personal Weight Survey among African American women. Sixty-five items were developed from literature and sample participants to characterize beliefs about personal weight in 3 domains: descriptors, causes, and consequences. The items were administered to 150 community-dwelling African American women, 18 to 40 years old, recruited from 5 sites. Factor analysis supported a 4-factor solution with the following dimensions: overweight acceptance, overweight concern, conventional weight regulation, and circumstantial weight regulation. These factors were significantly associated with weight management behaviors and body mass index. Profile analysis indicated distinct factor belief profiles by 3 weight categories.

Body Image Perception among Women of African Descent: A Normative Context?

The purpose of this article is to integrate research from across the social sciences in order to understand Black women's body image perceptions. To accomplish this goal, the effects of race, ethnicity, class and culture are examined. Cultural differences between African Canadians/Americans and Blacks living in Africa and the Caribbean are outlined and their effects on Black women's experiences of weight and eating are also discussed. Some of the historical underpinnings, and several aspects of the current social context within which Black women live are explored in order to explain body image perceptions.

Beliefs About Personal Weight Among African American Women

The rate of obesity within the United States is dropping, yet the prevalence of obesity among young African American women continues to increase. This increase, in part, may be attributable to weight beliefs. The relationship between beliefs about personal weight and body mass index (BMI) was examined among 150 African American women, 18 to 40 years of age using weight descriptive characteristics, causal attributions, consequences, and calculated BMI. Key results show that the majority of participants described their weight as attractive, healthy, and normal despite a sample mean BMI in the obese category. Key beliefs about the causes of personal weight that were associated and predictive of BMI were unhealthy eating behaviors, limited physical activity, weight left from pregnancy, and not knowing how to maintain a healthy weight. Beliefs about the consequences of personal weight were not predictive of BMI. A discussion of study findings provides important implications for clinical practice.

African American Women and Eating Disturbances: A Meta-Analysis

Eating disturbances are often portrayed as a problem found mainly among White women and nearly absent among African American women. The relationship between ethnicity and eating disturbances is examined using meta-analysis. Data from 18 studies were included to examine the overall relationship between ethnicity and eating disturbances and the specific relationship between African American women and White women. Although White women had a greater risk of eating disturbances than African American women as a group, the effect size was notably small. Specifically, White women had a slightly greater risk for all eating disturbances combined than African American women. African American women did not differ significantly from White women in their risk for bulimia and binge-eating disorder. Implications are discussed.

Body Mass Index, Self-Esteem, and Suicide Risk in Clinically Depressed African American and White American Females

Self-esteem and depression, as well as depression and body mass index (BMI), have consistently been found to be significantly associated for African American and White American females. The results are dissimilar when BMI and self-esteem are studied. Historically, the relationship between BMI and self-esteem is weak or nonexistent for African American females; however, for White American females, the relationship is usually significant. The goal of this study was to determine whether clinically depressed, healthy-weight, overweight, and obese females would differ significantly on self-esteem and suicide risk measures. In a voluntary hospital-based inpatient psychiatric unit, 165 clinically depressed females completed the self-esteem rating scale and the suicide risk scale. Healthy-weight, overweight, and obese African American females did not differ significantly on measures of self-esteem and suicide risk. However, depressed, obese White American females had significantly lower self-esteem and increased suicide risk than depressed healthy-weight and overweight White American females. Implications of the current results are discussed.

African American Beliefs About Diabetes

In this presentation, a diabetes explanatory model of rural, African American adults at high risk for diabetes is described. Kleinman’s explanatory model of illness was used as the organizing framework. African American men and women ( N = 42), between the ages of 18 and 51, participated. Participants described their knowledge and beliefs about diabetes, preventing diabetes, and whether diabetes could be cured or controlled. A common explanatory model of diabetes was not shared among the participants, and gender and age differences were apparent. Common themes included diabetes “running in families,” “eating too much sugar,” and “not taking care of yourself” as causes of diabetes. Weight and physical activity or exercise were not seen as contributing to the development of diabetes. Participants were not sure if diabetes could be prevented. These results provide information to address primary prevention of diabetes in this at-risk group.

Engaging High-Risk Populations in Community-Level Fitness Promotion: ROCK! Richmond

The purpose of this study was to determine whether ROCK! Richmond, a healthy nutrition and physical activity promotion initiative of the Richmond (Virginia) City Department of Public Health was effectively recruiting the high-risk individuals for whom this lifestyle change intervention was intended. The effectiveness of recruitment, participant demographic and health status characteristics were compared with those of respondents to a random sample survey conducted 18 months earlier. Relatively high-risk residents were recruited. ROCK! Richmond participants were disproportionately African American and female, had significantly higher body mass indices (BMIs), and were more likely to report a family history of chronic disease. However, their employment, education, and income levels were higher than those of the citywide sample. Certain high-risk segments of the population were successfully reached and involved in community fitness activities. Different recruitment methods may need to be used to recruit more from among the lowest socioeconomic strata.

Becoming Overweight Without Gaining a Pound: Weight Evaluations and the Social Integration of Mexicans in the United States

Mexican women gain weight with increasing duration in the United States. In the United States, body dissatisfaction tends to be associated with depression, disordered eating, and incongruent weight evaluations, particularly among white women and women of higher socioeconomic status. However, it remains unclear how overweight and obesity is interpreted by Mexican women. Using comparable data of women ages 20-64 from both Mexico (the 2006 Encuesta Nacional de Salud y Nutricion; N=17,012) and the United States (the 1999-2009 National Health and Nutrition Examination Surveys; N=8,487), we compare weight status evaluations among Mexican nationals, Mexican immigrants, U.S.-born Mexicans, U.S.-born non-Hispanic Whites, and U.S.-born non-Hispanic blacks. Logistic regression analyses, which control for demographic and social-economic variables and measured body mass index and adjust for the likelihood of migration for Mexican nationals, indicate that the tendency to self-evaluate as overweight among Mexicans converges with levels among non-Hispanic whites and diverges from blacks over time in the United States. Overall, the results suggest a U.S. integration process in which Mexican-American women's less critical self-evaluations originate in Mexico but fade with time in the United States as they gradually adopt U.S. white norms for thinner body sizes. These results are discussed in light of social comparison and negative health assimilation.

Weight status and perception of body image in children: the effect of maternal immigrant status

BACKGROUND

Recent studies have shown that body image perception is an important factor in weight control and may be influenced by culture and ethnicity. The aim of the present study was to assess the relationship between immigrant status of the mother and weight status and body image perception of the child.

METHODS

In total, 2706 schoolchildren (1405 boys and 1301 girls) aged 8-9 years and their mothers participated in a cross-sectional survey in Emilia-Romagna region (northern Italy). Weight and height of the children were measured and Body Mass Index (BMI) was calculated. Actual and ideal body image perception by the children and by the mothers with respect to their children was evaluated according to Collins' body image silhouettes.

RESULTS

The BMI values were significantly lower in children of immigrants than in children of Italian mothers (F:17.27 vs 17.99 kg/m²; M:17.77 vs 18.13 kg/m²). The prevalence of overweight/obesity was lower, and the prevalence of underweight higher, in children of immigrant mothers than in those of Italian mothers (overweight- F:21.3 vs 29.1%; M. 28.3 vs 31.4%; underweight- F:5.16 vs 3.84%; M:6.63 vs 2.82%). The children's body image perception was consistent with the differing pattern of nutritional status. In the comparison between actual and ideal figures, the Feel-Ideal Difference Index (FID) scores resulted different between the subsample with foreign-born mother in comparison to the native one (significantly lower in daughters of immigrants) (FID- F: 0.31 vs 0.57; M: 0.35 vs 0.32). There were significant differences in the choice of the ideal figure of the child between immigrant mothers and Italian mothers (FID- F: -0.05 vs 0.19; M: -0.35 vs -0.03): the ideal figure values were higher in the immigrant mothers of male children and lower in the Italian mothers of female children.

CONCLUSION

Our results suggest that cultural and behavioral factors linked to ethnicity play an important role in the nutritional status of children and in the perceived and ideal body image.

Obesity in Minority Populations: An Epidemiologic Assessment

This article reviews issues relating to the prevalence, health implications, and prevention and treatment perspectives of obesity in U.S racial and ethnic minority groups. The growing interest in obesity in minority populations reflects an awareness of the high prevalence of obesity among black, Hispanic, Asian and Pacific Islander and Native Americans as well as a generally increased interest in minority health. In addition, the fact that some aspects of obesity among minorities differ from those in whites suggests that new insights may be gained from studying obesity in diverse populations. However, there are many methodological problems to be overcome, including some that arise from the way minority groups are defined. Under the assumption that all obesity results from a period of sustained positive energy balance at the individual level, an epidemiologic explanation for the excess of obesity in minorities at the population level seems readily apparent. A surplus of obesity-promoting forces and a deficit of obesity-inhibiting forces, caused by secular changes in food availability and physical activity, accompany the early phases of modernization and economic advancement. The high prevalence of obesity in minority populations can be viewed as a function of the slope and timing of these secular changes. Genetic predisposition, cultural attitudes, and exposure to maternal obesity and diabetes in utero may be potentiating factors. In this context, interventions targeting individuals would seem inevitably to put racial and ethnic minority groups on the path toward the same weight control crisis now observed in the majority white population. This suggests that the underlying causes of the societal energy balance problem must be addressed at the population level in order for effective clinical approaches to be developed for minority populations with a high obesity prevalence.

Intergenerational differences in food, physical activity, and body size perceptions among African migrants

We assessed intergenerational differences in food, physical activity, and body size perceptions among refugees and migrants from the Horn of Africa living in Victoria, Australia. We used a qualitative design and obtained data from 48 participants (18 individual interviews; 3 semistructured focus groups). Three major themes emerged: (a) food and physical activity, (b) preference of body size and social expectations, and (c) perceived consequences of various body sizes. For parents, large body size was perceived to equate with being beautiful and wealthy; slimness was associated with chronic illness and poverty. Parents adopted strategies that promoted weight gain in children. These included tailored food practices and restricting children's involvement in physical activity. For young people, slimness was the ideal body size endorsed by their peers, and they adopted strategies to resist parental pressure to gain weight. Obesity-prevention programs in this subpopulation need to adopt a multigenerational approach.

Acceptance of Cosmetic Surgery Among British Female University Students

Although patients of cosmetic surgery are increasingly ethnically diverse, previous studies have not examined ethnic differences in attitudinal dispositions toward cosmetic surgery. In the present study, 751 British female university students from three ethnic groups (Caucasians, South Asians, and African Caribbeans) completed measures of acceptance of cosmetic surgery, body appreciation, self-esteem, and demographic variables. Initial between-group analyses showed that Caucasians had lower body appreciation and self-esteem than Asian and African Caribbean participants. Importantly, Caucasians had higher acceptance of cosmetic surgery than their ethnic minority counterparts, even after controlling for body appreciation, self-esteem, age, and body mass index. Further analyses showed that ethnicity accounted for a small proportion of the variance in acceptance of cosmetic surgery, with body appreciation and self-esteem emerging as stronger predictors. Possible reasons for ethnic differences in acceptance of cosmetic surgery are discussed in Conclusion.

Racial/ethnic differences in predictors of PSA screening in a tri-ethnic population

BACKGROUND

This study was carried out to identify racial/ethnic differences in predictors of prostate-specific antigen (PSA) screening in a group of prostate cancer patients.

METHODS

In this cross-sectional study, a total of 935 prostate cancer patients were recruited from the Texas Medical Center, Houston, between 1996 and 2004. It included 372 Caucasians, 346 African Americans and 217 Hispanics. A structured questionnaire was used to collect data on socio-demographic and life-style related variables, and self-reported PSA screening history through personal interview.

RESULTS

African American (54.4%) and Hispanic patients (42.3%) were significantly less likely (p = 0.004 and p < 0.001, respectively) to report having had PSA screening than Caucasian patients (63.2%). Only annual check-up was found to be a significant predictor of PSA screening in Hispanics. Among Caucasians, education and annual check-up were significant predictors of PSA screening; whereas in African Americans, education, annual check-up, marital status and BMI were significant predictors of PSA screening.

CONCLUSIONS

The rates of PSAscreening and its predictors varied by race/ethnicity in this tri-ethnic population. Health-education programs and culturally appropriate educational outreach efforts, especially targeted for high-risk groups, are needed to reduce these disparities.

Counseling African Americans in Cardiac Rehabilitation: Implications for Comprehensive Lifestyle Modification

African Americans are more likely to die of a myocardial infarction than any other racial group and have higher rates of sudden cardiac death, and in comparison to whites, these deaths are likely to occur at a younger age. Because secondary prevention interventions have been reported to reduce overall mortality, it is important that health care providers understand and respond with sensitivity to the needs and preferences that African Americans bring to cardiac rehabilitation. Providing culturally appropriate cardiac rehabilitation services to African Americans has the potential to improve access to care, quality of care, and health outcomes. This article reviews the historical legacy and general values and beliefs that African Americans bring to their participation in cardiac rehabilitation and examines values and beliefs about diet, weight, body image, exercise, rest, and preferences for depression treatment that should be considered when counseling African Americans. Social-ecological factors that influence the ability to commit to and maintain cardiovascular risk—reducing behaviors are also discussed. Strategies for responding to the health-related beliefs and cultural values of African Americans are examined.

Body image and body satisfaction differ by race in overweight postpartum mothers

BACKGROUND

Body image (BI) and body satisfaction may be important in understanding weight loss behaviors, particularly during the postpartum period. We assessed these constructs among African American and white overweight postpartum women.

METHODS

The sample included 162 women (73 African American and 89 white) in the intervention arm 6 months into the Active Mothers Postpartum (AMP) Study, a nutritional and physical activity weight loss intervention. BIs, self-reported using the Stunkard figure rating scale, were compared assessing mean values by race. Body satisfaction was measured using body discrepancy (BD), calculated as perceived current image minus ideal image (BD<0: desire to be heavier; BD>0: desire to be lighter). BD was assessed by race for: BD(Ideal) (current image minus the ideal image) and BD(Ideal Mother) (current image minus ideal mother image).

RESULTS

Compared with white women, African American women were younger and were less likely to report being married, having any college education, or residing in households with annual incomes >$30,000 (all p < 0.01). They also had a higher mean body mass index (BMI) (p = 0.04), although perceived current BI did not differ by race (p = 0.21). African Americans had higher mean ideal (p = 0.07) and ideal mother (p = 0.001) BIs compared with whites. African Americans' mean BDs (adjusting for age, BMI, education, income, marital status, and interaction terms) were significantly lower than those of whites, indicating greater body satisfaction among African Americans (BD(Ideal): 1.7 vs. 2.3, p = 0.005; BD(Ideal Mother): 1.1 vs. 1.8, p = 0.0002).

CONCLUSIONS

Racial differences exist in postpartum weight, ideal images, and body satisfaction. Healthcare providers should consider tailored messaging that accounts for these racially different perceptions and factors when designing weight loss programs for overweight mothers.

Prevalence of overweight and obesity, and dieting attitudes among Caucasian and African American college students in Eastern North carolina: A cross-sectional survey

A cross-sectional survey was used to investigate the rates of overweight and obesity (BMI >/= 25), and eating attitudes among college students. Data were collected at a large southeastern university. Adolescents (ages 18-25) self-reported weight and height (to calculate BMI), and, in addition to demographic information, completed the eating attitudes (EAT 26) scale to assess dieting tendencies. Significance of the mean BMI differences between gender and ethnic background were assessed by one-way analysis of variance (one-way ANOVA). Chi-square was used to determine whether the rate of those with BMI>/=25 between gender and ethnic background was statistically significant. While 52.7% of the students' BMI were within the normal weight category, 15.2% were underweight, 21.3% were overweight, and 10.8% were obese. The rate of BMI>/=25 differed by gender and ethnicity, with males and African Americans having higher rates. About 12 % of the participants reported disturbed eating behavior, which is lower than previously reported. Even so, results support the generally held belief that disturbed eating attitudes and unhealthy dieting are common among college students, especially among females. At the same time, disturbed eating attitudes are not just the domain of young female students; about 10% of college males reported disturbed eating attitudes. Findings of this study call for obesity prevention/intervention and lifestyle modification outreach programs among college students. Weight status and unhealthy eating behaviors of college students should be a concern to health care professionals. While obese young adults will likely remain obese throughout their adult life, excessive dieting among students, which is linked to eating disorders and other health hazards, does not provide healthy and adequate alternatives for maintaining a normal BMI. Implications for obesity prevention programs are discussed.

Attractiveness in African American and Caucasian women: is beauty in the eyes of the observer?

Traditional body image studies have been constrained by focusing on body thinness as the sole component of attractiveness. Evidence suggests that African American women may hold a multifactorial view of attractiveness that extends beyond size to include factors such as dress attire and race. The current study employed a culturally sensitive silhouette Model Rating Task (MRT) to examine the effects of attire, body size, and race on attractiveness. Unexpectedly, minimal differences on attractiveness ratings emerged by attire, body size, or model race between African American and Caucasian women. Overall, participants preferred the dressed, underweight, and African American models. Factors such as exposure to diverse groups and changes in African American culture may explain the present findings. Future studies to delineate the components of attractiveness for African American and Caucasian women using the MRT are needed to broaden our understanding and conceptualization of attractiveness across racial groups.

Ethnicity, body mass, and genome-wide data

This article combines social and genetic epidemiology to examine the influence of self-reported ethnicity on body mass index (BMI) among a sample of adolescents and young adults. We use genetic information from more than 5,000 single nucleotide polymorphisms in combination with principal components analysis to characterize population ancestry of individuals in this study. We show that non-Hispanic white and Mexican-American respondents differ significantly with respect to BMI and differ on the first principal component from the genetic data. This first component is positively associated with BMI and accounts for roughly 3% of the genetic variance in our sample. However, after controlling for this genetic measure, the observed ethnic differences in BMI remain large and statistically significant. This study demonstrates a parsimonious method to adjust for genetic differences among individual respondents that may contribute to observed differences in outcomes. In this case, adjusting for genetic background has no bearing on the influence of self-identified ethnicity.

Appearance Self-Attitudes of African American and European American Women: Media Comparisons and Internalization of Beauty Ideals

African American (AA) women have reported less body image disturbance than European American (EA) women, but questions remain about the nature and extent of this difference. This study examined differences in the body image of 80 AA women and 89 EA women with an improved methodology that controlled for body size, distinguished between satisfaction with and importance of body features, and included nonweight (e.g., hair texture, skin color) as well as weight-related features. Results provide evidence that, in contrast to AA women, EA women (a) were more dissatisfied with both weight and specific appearance features, (b) compared themselves more often to media beauty figures and internalized Western beauty standards more, and (c) showed a significant relation between media comparisons and body dissatisfaction. Internalization of Western beauty ideals was related to body dissatisfaction in both groups of women.

Understanding body image in African American and Caucasian first-graders: a partnership with the YMCA

BACKGROUND

Research suggests that body dissatisfaction can develop by first grade or 6 years of age. Few studies have examined the relationship between parental body image factors on child body image among this population using a CBPR approach.

OBJECTIVE

We sought to examine parental influence on body image in African American and Caucasian first-graders through a community-based participatory research (CBPR) partnership with the YMCA of Metropolitan Washington, DC.

METHODS

Quantitative data were collected by after-school teachers and academic researchers. Children were administered a silhouette measure to assess body image. Body image and eating behavior measures were given to parents. Correlational and descriptive analyses were employed to examine the association and characteristics of child body image factors.

RESULTS

Participants were 58 child-parent dyads attending YMCA after-school programs in the Washington, DC, area. Descriptive analyses found significant body dissatisfaction among first graders. Only 12.1% of first graders were satisfied with their bodies, and among the 38 children of normal weight, 89.5% were dissatisfied with their current body size. No significant correlations emerged between child body image and parental eating factors. However, correlations did emerge between child and parent body image indices.

CONCLUSION

Findings from this study were used to develop programming focused on promoting positive body image and self-esteem for young children in YMCA sites in the DC metro area. Additionally, future studies should further delineate body image among young children and the clinical and educational implications of early onset of body dissatisfaction in this population using a CBPR approach.

Are There Ethnic Differences in Positive Body Image Among Female British Undergraduates?

Numerous studies have examined ethnic differences in body image, although the literature has tended to focus on a negative orientation toward one’s body. The present study examined whether there were differences in positive body image among 131 Caucasian, 122 South Asian, 67 African Caribbean, and 67 Hispanic female undergraduates in Britain. Participants completed several scales measuring body appreciation, societal influence on body image, and self-esteem. Results showed that, after controlling for age, Hispanic women had the highest body appreciation scores, followed by African Caribbean, Caucasian, and South Asian women, respectively. Results also showed that Hispanics had the lowest score on media influence and the highest self-esteem. Finally, regressional analyses showed that self-esteem was a strong predictor of body appreciation, over-and-above ethnic affiliation. These results are discussed in relation to the extant literature on ethnic differences in body image.

Big beautiful women: the body size preferences of male fat admirers

This study examined the body size ideals of a group of male fat admirers (FAs) in comparison with an age- and body mass index (BMI)-matched control sample. Forty-seven men, who were involved in the fat acceptance community, and 64 control individuals rated a series of 10 images of women that varied in BMI from emaciated to obese. As expected, the results showed that FAs rated a significantly higher BMI as the most physically attractive compared with the control sample. FAs also rated figures with higher BMIs, particularly those in overweight and obese categories, more positively than did the control group. In addition, FAs perceived a wider range of body sizes to be physically attractive than the control group. Participant demographics did not predict ratings over and above affiliation with either the FA or control groups. These results are discussed in relation to the growing body of work examining fat admiration.

Media Contributions to African American Girls' Focus on Beauty and Appearance: Exploring the Consequences of Sexual Objectification

The media are dominated by images of women as sex objects whose value is based on their appearance. These portrayals can potentially limit girls' self-perceptions and influence their attitudes regarding the importance of appearance. However, relatively little is known about how African American adolescent girls are affected by these images. Using data from a survey of 176 African American adolescent girls (mean age = 15), this project examined associations between Black media use and African American girls' focus on beauty and appearance. Results suggest that both exposure to and identification with portrayals of Black women as sex objects contribute to African American adolescent girls emphasizing the importance of appearance in their own lives and for girls in general. When all the media variables were tested together in hierarchical regression analyses, identification with favorite television character, identification with more objectifying female music artists, and identification with less objectifying female artists emerged as the more consistent predictors of the outcomes examined. Findings are discussed in terms of their implications for girls' overall development.

BMI percentiles and body image discrepancy in black and white adolescents

The purpose of this study was to investigate the relationship between body image discrepancy (BID) and weight status as measured by BMI percentiles (BMI%) among adolescents. A cross-sectional survey was conducted among 265 adolescents at an urban clinic (females: 116 blacks and 63 whites; males: 62 blacks and 24 whites). BID was the difference between ideal and current body images selected from a 13-figure rating scale, and BMI% were calculated from measured weight and height. Regression analyses were conducted separately for girls and boys. Over half of the female and one-third of male adolescents wanted a thinner body. BID was positively related to BMI% with a one-unit increase in BID associated with a 4.84-unit increase in BMI% among females and a 3.88-unit increase in BMI% in males. Both female and male adolescents reported BID beginning at a BMI% corresponding to a normal weight. At zero BID, white females had a BMI% of 62.6, statistically different from black females (BMI% 69.7). At zero BID, white males had a mean BMI% of 69 and black males at a BMI% of 75.8, not statistically different. While black and white differences exist in BID, black female adolescents like their white counterparts are reporting BID at a weight range that is within the "normal". Our study portends the increase in BID with the increasing prevalence of obesity and highlights the need for interventions to help adolescents develop a healthy and realistic body image and healthy ways to manage their weight.

Factors that influence body image representations of black Muslim women

Research on the body image perceptions of black women is limited. Although previous body image studies have explored the intersection between race and gender, the influence of religion has been neglected. Guided by a grounded theory framework, the focus of this investigation, conducted in Upstate New York, USA, was to examine the role of race and religion in the body image perceptions of 22 African-American Sunni Muslim women. Analysis of individual interviews revealed that, in contrast to using standard medical guidelines, participants' views about their bodies were largely based on positive images of an earlier body size/shape, social and family expectations and contexts, cultural norms and values, and spirituality and religious beliefs. Although the body image perceptions of black Muslim women were similar to those expressed in previous body image studies with black women, participants expressed the importance of highlighting the spiritual versus physical self by adhering to religious guidelines regarding proper dress and appearance. These findings suggest that religion, race, and gender are all important factors to be considered when conducting body image studies with black women.

The change in weight perception of weight status among the overweight: comparison of NHANES III (1988-1994) and 1999-2004 NHANES

Objectives

This study seeks to determine whether perception of weight status among the overweight has changed with the increasing overweight/obesity prevalence.

Methods

The perception of weight status was compared between overweight participants (BMI between 25.0–29.9 kg/m²) from NHANES III (1988–1994) and overweight participants from NHANES 1999–2004. Perception of weight status was assessed by asking participants to classify their weight as about the right weight, underweight or overweight. Comparisons were made across age groups, genders, race/ethnicities and various income levels.

Results

Fewer overweight people during the NHANES 1999–2004 survey perceived themselves as overweight when compared to overweight people during the NHANES III survey. The change in distortion between the survey periods was greatest among persons with lower income, males and African-Americans.

Conclusion

The increase in overweight/obesity between the survey years (NHANES III and NHANES 1999–2004 has been accompanied with fewer overweight people perceiving themselves as overweight.

Perceptions of children's body sizes among mothers living on the Texas-Mexico border (La Frontera)

OBJECTIVES

The objectives of this study were to quantify mothers' perceptions of their children's sizes and explore mothers' views of child growth, diet, activity, and health. Photographs of children from the Berkeley Longitudinal Growth Study (on Centers for Disease Control and Prevention [CDC] Web site) were used to stimulate discussion with mothers about child sizes.

DESIGN

A descriptive, cross-sectional study examined mothers' perceptions of their children's size and their beliefs about child size, growth, and health.

SAMPLE

The convenience sample included 25 mother-child dyads of 3-year-old children at two Head Start Centers in a county on the Texas-Mexico border. All mothers self-identified as Hispanic.

MEASUREMENT

Photographs of children were shown to elicit mothers' perceptions of children's body sizes. The children and mothers were weighed and measured and their body mass indices (BMIs) were computed. The mothers were interviewed about their beliefs on child health, growth, and feeding.

RESULTS

No congruence was found between mothers' perceptions of child sizes in the pictures and their children's sizes.

CONCLUSIONS

Using CDC photographs does not appear to be a useful way to educate mothers about child body sizes. A child who is happy, active, and can accomplish normal childhood activities is not considered by mothers as overweight, regardless of the child's BMI.

Dimensional analysis of the concept of obesity

AIM

The aim of this paper is to explore the evolution of the concept of obesity and to identify variations in its meaning and use from the perspectives of healthcare professionals and Black Americans, Caucasian Americans, and Latino Americans.

BACKGROUND

Obesity constitutes an emerging global healthcare epidemic. Little convergence is found between the meaning and use of the concept of obesity by healthcare professionals and those they are trying to serve. This lack of convergence points to the need for exploration of the assumptions, use and various meanings associated with this important concept.

METHOD

The analysis included 20 papers from 18 research studies from the fields of nursing, psychology, epidemiology, medicine, and sociology. Caron and Bowers' dimensional analysis method guided the analysis.

RESULTS

Eight dimensions were identified: objective measure, attractiveness, sexual desirability, health, body image, strength or goodness, self-esteem, and social acceptability. Substantial differences in assumptions, use, and meanings of this concept were found within and between the perspectives studied. However, there were insufficient data to fully assess use and meaning of the concept of obesity from the Latino American perspective.

CONCLUSION

This analysis contributes to the development of an understanding of the meaning and use of the concept of obesity within varied socio-cultural contexts as well as from a healthcare perspective. Culture was found to play a significant role in how obesity is understood by the individual.

Perceived body image among African Americans with type 2 diabetes

OBJECTIVE

To assess current, desired and best body image in the opposite sex and examine correlates of body image dissatisfaction.

METHODS

We conducted a cross-sectional analysis at baseline of 185 (141 women, 44 men) African Americans with type 2 diabetes in Project Sugar 1, a randomized controlled trial of primary care-based interventions to improve diabetic control.

RESULTS

Women had a significantly lower desired body image compared to their current body image (BMI approximately 27.7 versus approximately 35.3). Men preferred a body image for women that was similar to the body image that women desired for themselves (BMI approximately 28.3 versus approximately 27.7). Significant correlates of body image dissatisfaction included self-perception of being overweight and attempting weight-loss (P < 0.05).

PRACTICAL IMPLICATIONS

Among overweight and obese African-American women with diabetes, it is important to first address an individual's perceived body image, perceived risk of disease, desired body image, and weight-loss perceptions. In addition to the aesthetic benefits of weight-loss, there is a need to focus on the health benefits in order to intervene among African Americans with diabetes.

BMI and cervical cancer screening among white, African-American, and Hispanic women in the United States

OBJECTIVES

We examined cervical cancer screening by BMI in white, African-American, and Hispanic women and explored women's reasons for not undergoing screening.

RESEARCH METHODS AND PROCEDURES

We used logistic regression to examine Pap testing in the preceding 3 years across BMI groups for white (n = 6419), African-American (n = 1715), and Hispanic women (n = 1859) age 18 to 75 years who responded to the 2000 National Health Interview Survey. We used bivariable analyses to describe women's reasons for not undergoing testing and examined whether unscreened women received physician recommendations for screening.

RESULTS

Of 12,170 women, 50% were normal weight, 26% were overweight, and 21% were obese. The proportion who reported Pap testing in the last 3 years was 86% in whites, 88% in African Americans, and 78% in Hispanics. After adjustment for sociodemographics, health care access, and illness burden, severely obese white women (BMI = 40+ kg/m2) were significantly less likely to undergo Pap testing (relative risk, 0.92; 95% CI, 0.83 to 0.99) compared with normal weight women. BMI was not associated with screening in African Americans or Hispanics. A higher proportion of obese white women than normal weight women cited putting off the test or embarrassment or discomfort as the primary reason for not undergoing screening. Among the unscreened, obese women were as likely as normal weight women to receive a physician recommendation to undergo screening.

DISCUSSION

Disparities in cervical cancer screening by body weight persist for white women with severe obesity. Disparities were not explained by differences in the rate of physician recommendations for screening, but obese white women may be more likely to delay screening or to find screening painful, uncomfortable, or embarrassing than normal weight white women. Efforts to increase screening among obese women should address women's reservations about screening.

Ethnicity and body dissatisfaction among women in the United States: A meta-analysis

The prevailing view in popular culture and the psychological literature is that White women have greater body dissatisfaction than women of color. In this meta-analysis, 6 main effect sizes were obtained for differences among Asian American, Black, Hispanic, and White women with a sample of 98 studies, yielding 222 effect sizes. The average d for the White-Black comparison was 0.29, indicating that White women are more dissatisfied, but the difference is small. All other comparisons were smaller, and many were close to zero. The findings directly challenge the belief that there are large differences in dissatisfaction between White and all non-White women and suggest that body dissatisfaction may not be the golden girl problem promoted in the literature. Implications for theory and treatment are discussed.