The good body: when big is better

Perception of body size and body dissatisfaction in adults

Self-perception of body size seems to be not always in line with clinical definitions of normal weight, overweight and obesity according to Word Health Organization classification. The effect of self-perception of body size disturbances and body dissatisfaction may be the development of eating disorders, such as anorexia nervosa or binge eating disorder-a major risk factor of obesity development. Therefore, the study aimed to assess separately the perception of weight status and body size as well as body dissatisfaction in adults with normal weight, overweight and obesity. The study included 744 adults (452 women; 35.9 ± 12.4 years; 21 underweight, 326 normal weight, 221 overweight, 176 obese) referred to Metabolic Management Center and volunteers. Body size perception and body dissatisfaction were assessed based on Stunkards' Figure Rating Scale (FRS). Additionally, participants' were asked: 'Do you think you are: underweight/normal weight/overweight/obese?' to assess perception of weight status. Participants' weight and height were measured to calculate body mass index (BMI) after completing the FRS. Individuals within the overweight BMI range have rated themselves as underweight (1.4%), normal weight (30.8%) and obese (2.8%). Also individuals within the obesity BMI range have rated themselves as normal weight (2.6%), and overweight (41.6%). Compatibility of self-assessment of weight status with BMI category according to the measured values was moderate-Kappa coefficient was 0.59 (95% CI: 0.54-0.64). Underestimation of weight status was significantly more common among men than women. There were statistically significant differences in the distribution of body dissatisfaction according to the weight in both women and men. Normal-weight subjects less often than overweight and obese were dissatisfied with their own body size. The degree of body dissatisfaction was greater among women than among men. Adults subjects frequently underestimate their own weight status and body size. Women with overweight and obesity more often than men are dissatisfied with their own body size.

The Effect of Schooling on Women's Overweight and Obesity: A Natural Experiment in Nigeria

An extensive social scientific literature has documented the importance of schooling in preventing overweight and obesity among women. However, prior quasi-experimental studies investigating the causal effect of schooling on women's overweight and obesity have focused almost exclusively on high-income countries (HICs). Schooling effects may differ in low- or middle-income countries (LMICs), where information about the harms of being overweight is often sparse and where larger body sizes can be socially valued. Here I evaluate the causal impact of schooling on women's probability of being overweight or obese in an LMIC, Nigeria, using data from the 2003, 2008, and 2013 Demographic Health Surveys. In 1976, the Nigerian government abolished primary school fees and increased funding for primary school construction, creating quasi-random variation in access to primary school according to an individual's age and the number of newly constructed schools in their state of residence. I exploit both sources of variation and use a two-stage instrumental variables approach to estimate the effect of increased schooling on the probability of being overweight or obese. Each additional year of schooling increased the probability of being overweight or obese by 6%, but this effect estimate was not statistically different from zero. This finding differs from the protective effect of schooling documented in several HICs, suggesting that contextual factors play an important role calibrating the influence of additional schooling on overweight or obesity. Furthermore, my findings contrast markedly with the positive correlation between schooling and overweight/obesity identified in previous studies in Nigeria, suggesting that studies failing to account for selection bias overestimate the causal effect of schooling. More robust causal research is needed to examine the effect of schooling on overweight and obesity in LMIC contexts.

Internalization of Western Ideals on Appearance and Self-Esteem in Jamaican Undergraduate Students

Beauty ideals in the Caribbean are shifting with increased exposure to Western and European standards of appearance. Previous research has shown a consistent link between internalization of Western beauty ideals and depressive symptoms and other forms of psychological disturbance among diverse populations including Caribbeans. We examined the association between internalization of Western beauty ideals and depressive symptoms as well as the potential mediating role of self-esteem on this relation in N = 222 students (155 females, 79 males) attending a tertiary institution in Kingston, Jamaica. Internalization of Western ideals was inversely associated with self-esteem (r =- .35, p < .01) and positively associated with depressive symptoms (r =.13, p < .05). In a model adjusted for age and sex, results revealed a significant indirect effect of internalization of Western ideals of appearance on depressive symptoms via self-esteem (estimate= .21, SE = .05, 95% confidence interval [.13, .32]). The potent effects of culture must be better understood as intercontinental travel becomes less important as a mechanism for cultural exposure and exchange, and there is a significant increase of digital and internet access in the Caribbean. The current study suggest that Caribbeans are at significant risk for internalizing Western ideals of beauty, subsequently diminishing their self-esteem, and ultimately increasing depression symptomatology. The benefits and consequences of cultural exchange should continue to be a topic for research studies.

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.

A Comparison Study of United States and African Students on Perceptions of Obesity and Thinness

There is a negative correlation between body weight and income in the United States, and epidemic numbers of people diet to become thin. In developing nations, on the other hand, there is a positive correlation between weight and income, and fatness is associated with wealth and abundance. Although these differing cross-cultural trends have been documented by anthropologists, there has been minimal cross-cultural research on attitudes toward obesity and thinness and corresponding dieting behaviors in the psychological literature. A sample of 349 students at a university in Ghana and 219 students at a U.S. university completed questionnaires about their weight, frequency of dieting and restrained eating, the degree to which their weight has interfered with social activities, their perceptions of ideal bodies, disordered eating, and stereotypes of thin and heavy people. Students in Ghana more often rated larger body sizes as ideal for both males and females and also assumed that these larger sizes were held as ideals in society, than did U.S. students. U.S. students (regardless of weight) were more likely to have dieted than were Ghanaian students, with U.S. females being most likely to diet. Additionally, U.S. females scored significantly higher on restraint, eating-disordered behavior, and experiencing weight as social interference. Findings illustrate that perceptions of ideal body size and corresponding behaviors are influenced by culture and gender.

The Stigma of Obesity in Women: The Difference is Black and White

This study examined whether there is subcultural variation in the stigma of obesity. Black and White women rated photographs of thin, average, and large Black and White women on a number of evaluative dimensions. The photographs depicted professional models dressed in fashionable clothing. Results showed that White women rated large women, especially large White women, lower on attractiveness, intelligence, job success, relationship success, happiness, and popularity than they did average or thin women. By contrast, Black women did not show the same denigration of large women, and this was especially true when they were rating large Black women. A number of possible explanations are offered for these results, such as the difference in Black and White women's social role models, weight salience, subcultural beliefs concerning obesity, and disidentification from mainstream values.

Linking Femininity, Weight Concern, and Mental Health Among Latina, Black, and White Women

Studies examining women's appearance ideals and weight concern have predominantly relied on samples of White women. This study addresses this oversight, examining the different relations among embodied femininity, weight concern, and depressive symptomatology that exist for different groups of women. Using a nationally representative sample of women between the ages of 18 and 45, bivariate analyses were conducted using three samples of Latina, Black, and White women. When sample size allowed, a multivariate model was tested (i.e., for Black and White respondents). Results confirm, as hypothesized, different patterns of relations between embodied femininity, weight concern, and depressive symptomatology for each of the samples. At the bivariate level, embodied femininity, weight concern, and depressive symptomatology were positively intercorrelated among Latina respondents. Whereas weight concern fully mediated the relation between embodied femininity and depressive symptomatology for the White respondents, the mediational model was not borne out for the Black respondents. For the latter, although embodied femininity and weight concern were related, weight concern was unrelated to depressive symptoms. Both of these patterns are discussed, as well as the need for greater empirical sensitivity to various constructions of femininity among women of different ethnicities.

Height and Body Mass on the Mating Market : Associations With Number of Sex Partners and Extra-Pair Sex Among Heterosexual Men and Women Aged 18-65

People with traits that are attractive on the mating market are better able to pursue their preferred mating strategy. Men who are relatively tall may be preferred by women because taller height is a cue to dominance, social status, access to resources, and heritable fitness, leading them to have more mating opportunities and sex partners. We examined height, education, age, ethnicity, and body mass index (BMI) as predictors of sexual history among heterosexual men and women (N = 60,058). The linear and curvilinear associations between self-reported height and sex partner number were small for men when controlling for education, BMI, and ethnicity (linear β = .05; curvilinear β = -.03). The mean and median number of sex partners for men of different heights were: very short (9.4; 5), short (11.0; 7), average (11.7; 7), tall (12.0; 7), very tall (12.1; 7), and extremely tall (12.3; 7). Men who were "overweight" reported a higher mean and median number of sex partners than men with other body masses. The results for men suggested limited variation in reported sex partner number across most of the height continuum, but that very short men report fewer partners than other men.

Racial and ethnic differences in the association between obesity and depression in women

BACKGROUND

It is generally accepted that obesity and depression are positively related in women. Very little prior research, however, has examined potential variation in this relationship across different racial/ethnic groups. This paper examines the association between obesity and depression in non-Hispanic White, non-Hispanic Black, and Mexican American women.

METHODS

The sample included women aged 20 years and older in the 2005-2008 National Health and Nutrition Examination Surveys (n=3666). Logistic regression was used to assess the relationship between obesity and depression syndrome (assessed using the Patient Health Questionnaire-9), after adjusting for covariates. We then investigated whether this association varied by race/ethnicity.

RESULTS

Overall, obese women showed a 73% greater odds of depression (odds ratio [OR]=1.73; 95% confidence interval [CI]=1.19, 2.53) compared with normal weight women. This association varied significantly, however, by race/ethnicity. The obesity-depression associations for both Black and Mexican American women were different from the positive association found for White women (ORBlack*obese=0.24; 95% CI=0.10,0.54; ORMexican American*obese=0.42; 95% CI=1.04). Among White women, obesity was associated with significantly greater likelihood of depression (OR=2.37; 95% CI=1.41, 4.00) compared to normal weight. Among Black women, although not statistically significant, results are suggestive that obesity was inversely associated with depression (OR=0.56; 95% CI=0.28, 1.12) relative to normal weight. Among Mexican American women, obesity was not associated with depression (OR=1.01; 95% CI=0.59, 1.72).

CONCLUSIONS

The results reveal that the association between obesity and depression varies by racial/ethnic categorization. White, but not Black or Mexican American women showed a positive association. Next research steps could include examination of factors that vary by race/ethnicity that may link obesity to depression.

Preference for women's body mass and waist-to-hip ratio in Tsimane' men of the Bolivian Amazon: biological and cultural determinants

The issue of cultural universality of waist-to-hip ratio (WHR) attractiveness in women is currently under debate. We tested men's preferences for female WHR in traditional society of Tsimane'(Native Amazonians) of the Bolivian rainforest (N = 66). Previous studies showed preferences for high WHR in traditional populations, but they did not control for the women's body mass.We used a method of stimulus creation that enabled us to overcome this problem. We found that WHR lower than the average WHR in the population is preferred independent of cultural conditions. Our participants preferred the silhouettes of low WHR, but high body mass index (BMI), which might suggest that previous results could be an artifact related to employed stimuli. We found also that preferences for female BMI are changeable and depend on environmental conditions and probably acculturation (distance from the city). Interestingly, the Tsimane' men did not associate female WHR with age, health, physical strength or fertility. This suggests that men do not have to be aware of the benefits associated with certain body proportions - an issue that requires further investigation.

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.

Judgments of sexual attractiveness: a study of the Yali tribe in Papua

Preferences for waist-to-hip ratio (WHR), sexual dimorphism in stature (SDS), and leg-to-body ratio (LBR) have been investigated predominantly in Western cultures. The aim of the present study was to examine the preferences of a relatively isolated, indigenous population (i.e., Yali of Papua, inhabiting the mountainous terrain east of the Baliem valley). A total of 53 women and 52 men participated in the study. Study sites differed in distance from Wamena, the biggest settlement in the region, and frequency of tourists' visits. We found that the mate preferences among Yali men and women for WHR, LBR, and SDS were not exactly the same as in Western samples. Yali preferred low women's WHR and relatively high women's (but not men's) LBR. Women's and men's ratings of each SDS set were similar, which suggests that the "male-taller norm" in Yali tribe was far weaker than in Western cultures. Additionally, the observed preferences were modified by contact with different cultures, age, and accessibility of food resources (pig possession). Our results suggest that human norms of attractiveness are malleable and can change with exposure to different environments and conditions.

Can Ethnic Differences in Men's Preferences for Women's Body Shapes Contribute to Ethnic Differences in Female Adiposity?

In the United States, obesity is more common among black and Hispanic than white women. One putative cause of this difference is different cultural norms for attractiveness. Two studies assessed ethnic differences in men's perceptions of the attractiveness of females of varying sizes. In the first, 108 men recruited on the New York subway were shown sets of silhouettes depicting female bodies varying in fatness and were asked to pick the silhouette they found most attractive. They were also asked to indicate the thinnest and fattest figures they would consider dating. A measure of "latitude of acceptance" was computed as the difference between the thinnest and fattest figures considered. Results indicated no relationship between ethnicity and preference (F = 1.383, p = .257) or "latitude" (F = .102, p = .903). In Study 2, "personal advertisements" placed by 373 black, 1915 white, 110 Hispanic, and 30 Asian men from 35 newspapers and magazines were coded as: 1) thinness preferred; 2) no information on weight preference; 3) fatness preferred; or 4) states weight or looks unimportant. Results indicated a statistically significant but small association between ethnicity and preference (chi2 = 49.55, df = 9, p < .00001). Relative to white and Asian men, black and Hispanic men more frequently requested fat women, Hispanic men less frequently requested thin women, and black men more frequently stated that looks or weight did not matter. Ethnicity explained only 2.1% of the variance in preference. Thus, it seems unlikely that ethnic differences in men's preferences for women's body shapes contribute substantially to ethnic differences in female adiposity.

Underestimation of weight and its associated factors among overweight and obese adults in Pakistan: a cross sectional study

BACKGROUND

Weight loss is known to decrease the health risks associated with being overweight and obese. Awareness of overweight status is an important determinant of weight loss attempts and may have more of an impact on one's decision to lose weight than objective weight status. We therefore investigated the perception of weight among adults attending primary care clinics in Karachi, Pakistan, and compared it to their weight categories based on BMI (Body Mass Index), focusing on the underestimation of weight in overweight and obese individuals. We also explored the factors associated with underestimation of weight in these individuals.

METHODS

This was a cross sectional study conducted on 493 adults presenting to the three primary care clinics affiliated with a tertiary care hospital in Karachi, Pakistan. We conducted face to face interviews to gather data on a pre-coded questionnaire. The questionnaire included detail on demographics, presence of comorbid conditions, and questions regarding weight assessment. We measured height and weight of the participants and calculated the BMI. The BMI was categorized into normal weight, overweight and obese based on the revised definitions for Asian populations. Perception about weight was determined by asking the study participants the following question: Do you consider yourself to be a) thin b) just right c) overweight d) obese. We compared the responses with the categorized BMI. To identify factors associated with underestimation of weight, we used simple and multiple logistic regression to calculate crude odds Ratios (OR) and adjusted Odds Ratios (AOR) with 95% Confidence Intervals.

RESULTS

Overall 45.8% (n = 226) of the study participants were obese and 18% (n = 89) were overweight. There was poor agreement between self perception and actual BMI (Kappa = 0.24, SE = 0.027, p < 0.001). Among obese participants a large proportion (73%) did not perceive themselves as obese, although half (n = 102) of them thought they may be overweight. Among the overweight participants, half (n = 41) of them didn't recognize themselves as overweight. Factors associated with misperception of weight in overweight and obese participants were age ≥ 40 years (AOR = 3.4; 95% CI: 1.8-6.4), male gender (AOR = 2.97; 95% CI: 1.6-5.5), being happy with ones' weight (AOR = 6.4; 95% CI: 3.4-12.1), and not knowing one's ideal weight (AOR = 2.45, 95% CI: 1.10-5.47).

CONCLUSION

In this cross sectional survey, we observed marked discordance between the actual and perceived weight. Underestimation of individual weight was more common in older participants (≥ 40 years), men, participants happy with their weight and participants not aware of their ideal weight. Accurate perception of one's actual weight is critical for individuals to be receptive to public health messages about weight maintenance or weight loss goals. Therefore educating people about their correct weight, healthy weights and prevention of weight gain are important steps towards addressing the issue of obesity in Pakistan.

The attractive female body weight and female body dissatisfaction in 26 countries across 10 world regions: results of the international body project I

This study reports results from the first International Body Project (IBP-I), which surveyed 7,434 individuals in 10 major world regions about body weight ideals and body dissatisfaction. Participants completed the female Contour Drawing Figure Rating Scale (CDFRS) and self-reported their exposure to Western and local media. Results indicated there were significant cross-regional differences in the ideal female figure and body dissatisfaction, but effect sizes were small across high-socioeconomic-status (SES) sites. Within cultures, heavier bodies were preferred in low-SES sites compared to high-SES sites in Malaysia and South Africa (ds = 1.94-2.49) but not in Austria. Participant age, body mass index (BMI), and Western media exposure predicted body weight ideals. BMI and Western media exposure predicted body dissatisfaction among women. Our results show that body dissatisfaction and desire for thinness is commonplace in high-SES settings across world regions, highlighting the need for international attention to this problem.

Estimated nutrient intakes from food generally do not meet dietary reference intakes among adult members of Pacific Northwest tribal nations

Diet is influential in the etiology of chronic diseases in many populations including Native Americans. The objective of this report is to present the first comprehensive dietary survey, to our knowledge, of a representative sample of nonpregnant adults from Pacific Northwest tribal nations participating in the Communities Advancing the Studies of Tribal Nations Across the Lifespan (CoASTAL) cohort. Only participants who completed 1-4 d of dietary records and had weights and heights measured in the laboratory were eligible for this analysis (n = 418). Mean nutrient intakes were stratified by gender for the total sample, those with plausibly reported energy intakes (rEI), and those with implausibly rEI. Estimates of nutrient intakes were compared with Dietary Reference Intakes (DRI). Nutrient estimates from NHANES 2001-2002 were used as a reference. Among both men and women, total fat contributed 34-37% of energy intake and saturated fat contributed 11-12% of energy intake. Daily cholesterol intakes ranged from 262 to 442 mg. A majority of men and women were not meeting recommendations for vitamins A, C, and E, magnesium, and sodium. For a majority of the nutrients examined, plausibility resulted in higher mean estimates. The CoASTAL cohort nutrient profile is similar to NHANES 2001-2002, with a majority of DRI recommendations not being met. Adequate dietary intake information may be more important for this population, because Native Americans experience a disproportionate burden for diseases.

Evaluation of dietary assessment tools used to assess the diet of adults participating in the Communities Advancing the Studies of Tribal Nations Across the Lifespan cohort

BACKGROUND

Accurate assessment of dietary intake is essential for researchers and public health practitioners to make advancements in public health. This is especially important in Native Americans who display disease prevalence rates that are dramatically higher than the general US population.

OBJECTIVE

To evaluate three dietary assessment tools: dietary records, a food frequency questionnaire (FFQ), and a shellfish assessment survey among Native American adults from the Communities Advancing the Studies of Tribal Nations Across the Lifespan (CoASTAL) cohort.

DESIGN

The CoASTAL cohort was composed of randomly selected individuals from three tribal registries of Pacific Northwest Tribal Nations. This cross-sectional study used data from the baseline of CoASTAL and was restricted to the non-pregnant adults (aged 18 years or older) who completed the shellfish assessment survey (n=500), an FFQ (n=518), dietary records (n=444), weight measures (n=493), and height measures (n=496). Paired t tests, Pearson correlation coefficients, and percent agreement were used to evaluate the dietary records and the FFQ with and without accounting for plausibility of reported energy intake (rEI). Sensitivity and specificity as well as Spearman correlation coefficients were used to evaluate the shellfish assessment survey and the FFQ compared to dietary records.

RESULTS

Statistically significant correlations between the FFQ and dietary records for selected nutrients were not the same by sex. Accounting for plausibility of rEI for the dietary records and the FFQ improved the strength of the correlations for percent energy from protein, energy from carbohydrate, and calcium for both men and women. In addition, the association between rEI (dietary records and FFQ) and weight became significant when the sample was limited to plausible rEI. The shellfish assessment survey was found to similarly assess shellfish consumption in comparison to the FFQ.

CONCLUSIONS

These results support the benefit of multiple measures of diet, including regional and culturally specific surveys, especially among Native Americans. Accounting for plausibility of rEI may ensure more accurate estimations of dietary intakes.

Why is muscularity sexy? Tests of the fitness indicator hypothesis

Evolutionary scientists propose that exaggerated secondary sexual characteristics are cues of genes that increase offspring viability or reproductive success. In six studies the hypothesis that muscularity is one such cue is tested. As predicted, women rate muscular men as sexier, more physically dominant and volatile, and less committed to their mates than nonmuscular men. Consistent with the inverted-U hypothesis of masculine traits, men with moderate muscularity are rated most attractive. Consistent with past research on fitness cues, across two measures, women indicate that their most recent short-term sex partners were more muscular than their other sex partners (ds = .36, .47). Across three studies, when controlling for other characteristics (e.g., body fat), muscular men rate their bodies as sexier to women (partial rs = .49-.62) and report more lifetime sex partners (partial rs = .20-.27), short-term partners (partial rs = .25-.28), and more affairs with mated women (partial r = .28).

The epidemiology of obesity

In the United States, obesity among adults and overweight among children and adolescents have increased markedly since 1980. Among adults, obesity is defined as a body mass index of 30 or greater. Among children and adolescents, overweight is defined as a body mass index for age at or above the 95th percentile of a specified reference population. In 2003-2004, 32.9% of adults 20-74 years old were obese and more than 17% of teenagers (age, 12-19 y) were overweight. Obesity varies by age and sex, and by race-ethnic group among adult women. A higher body weight is associated with an increased incidence of a number of conditions, including diabetes mellitus, cardiovascular disease, and nonalcoholic fatty liver disease, and with an increased risk of disability. Obesity is associated with a modestly increased risk of all-cause mortality. However, the net effect of overweight and obesity on morbidity and mortality is difficult to quantify. It is likely that a gene-environment interaction, in which genetically susceptible individuals respond to an environment with increased availability of palatable energy-dense foods and reduced opportunities for energy expenditure, contributes to the current high prevalence of obesity. Evidence suggests that even without reaching an ideal weight, a moderate amount of weight loss can be beneficial in terms of reducing levels of some risk factors, such as blood pressure. Many studies of dietary and behavioral treatments, however, have shown that maintenance of weight loss is difficult. The social and economic costs of obesity and of attempts to prevent or to treat obesity are high.

O corpo cúmplice da vida: considerações a partir dos depoimentos de mulheres obesas de uma favela carioca

O presente artigo apresenta conclusões de uma pesquisa desenvolvida na ENSP/Fiocruz, como parte do curso de mestrado, sobre a relação entre pobreza e obesidade a partir da apreensão da construção simbólica em torno do corpo. A pesquisa teve por objetivo investigar as percepções acerca do corpo de um grupo de mulheres obesas moradoras de uma favela carioca, a partir do emprego da metodologia qualitativa, utilizando a técnica da entrevista semi-estruturada. Os resultados obtidos neste trabalho revelaram que entre as mulheres da Rocinha vigoravam padrões próprios de corpo que pouco se vinculavam a atributos estéticos. A obesidade era percebida de forma diferenciada pelas mulheres investigadas. Ela era sentida através de sintomas clínicos tais como: "dor nas pernas", "dor na coluna", "falta de ar", "menor disposição". Foi possível, ainda, verificar que o corpo obeso era por vezes valorizado no grupo, vinculando-se ao trabalho e à condição social. Tais resultados nos conduzem a acreditar que a obesidade assume contornos próprios nos diferentes contextos e grupos sociais. Por essa razão, acreditamos ser necessária a realização de novas agendas de investigação sobre a temática da obesidade no Brasil.

THE CULTURAL POLITICS OF BODY SIZE

Scholarly interest in body size has increased in concert with recent efforts to shape and assess bodies in particular ways within industrialized social contexts. Attending to both overt and covert references to Eurocentric body projects, this chapter reviews literature in anthropology, sociology, and cultural studies that addresses the cultural politics of body size in various parts of the world. It begins with a discussion of biocultural paradigms, which accept certain biomedical categories even when challenging or reconfiguring their hegemonic power. Next is a survey of works analyzing body size within “non-Western” groups as well as European and North American subgroups. These studies often employ culturally powerful “Western” constructs as foils, an approach that risks cultural othering. The analysis then turns to the extensive literature that unpacks dominant Euro-American body practices and discourses. Here, diverse perspectives on several key concerns in sociocultural anthropology are considered; concepts of culture and power, theories of the body and embodiment, and understandings of human agency vary in instructive ways. The chapter concludes with a review of scholarship on postcolonial processes and representations that incorporates a critical perspective on Eurocentric preoccupations with body size.

Genetic analysis of tall stature

Tall stature is less often experienced as an important problem than short stature. However, a correct diagnosis may be of eminent importance, especially when interventions are planned, or to know the natural history. Overgrowth can be caused by endocrine disorders and skeletal dysplasias, but also by several genetic syndromes. Despite a systematic diagnostic approach, there will be patients with tall stature who do not fit a known diagnosis. In this group of patients possibilities of genetic analysis do exist, but are not common practice. The FMR1 gene should be analyzed in patients with tall stature and mental retardation, and in these patients the NSD1 gene can be considered whenever some features of Sotos syndrome do exist. In tall patients without mental retardation and some features of Sotos or Beckwith-Wiedemann syndrome it may still be useful to look for mutations in the NSD1 gene, but also for changes in the 11p15 region. The various possibilities are discussed and placed in a flowchart.

Overweight and stunting in migrant Hispanic children in the USA

In order to evaluate the need for preventive interventions to improve nutrition, the BMI/sex/age percentile, height/sex/age percentile, prevalence of stunting, at-risk-for-overweight and overweight in a group of migrant Hispanic children, aged 2-18, in southern New Jersey, USA, was assessed using anthropometric measurements of height, weight and skinfold thickness with reference to the NHANES 1999-2000. Results showed that the frequency of overweight in this sample--20%--exceeds that of the general U.S. pediatric population and equals or exceeds (in 2-5-year olds) that of settled Mexican-Americans. Being born in the U.S. significantly diminished the prevalence of stunting, especially in boys. The children of migrant Hispanic agricultural workers belong to a marginalized, poor and insecure population who are not included in the National Health and Nutrition Examination studies, because of their transience. This is the first anthropometric study to evaluate growth in this population in over 20 years.

Emic perspectives of body weight in overweight and obese white women with limited income

OBJECTIVE

The purpose of this study was to develop an understanding of body weight from emic perspectives of limited-income overweight and obese white women.

DESIGN

In-depth individual interviews, including the use of contour drawings and body dissatisfaction parameters.

SETTING

All methods were conducted in the homes of the research participants.

PARTICIPANTS

A purposeful sample of limited-income white women (N=25), ages 19 to 44 years.

PHENOMENA OF INTEREST

Personal perceptions of attractiveness, health, body weight, and body dissatisfaction.

ANALYSIS

Transcripts were analyzed using content analysis. Triangulation of data was achieved by comparing data elicited by different methods in different sections of the interview.

RESULTS

Disordered eating habits were common and considered consequences of social, economic, and familial pressures. Food was often used as a means of coping with life pressures. Social and economic barriers were identified as impeding the adoption of more healthful lifestyles. Weight loss was a low priority owing to financial, emotional, familial, and health care constraints.

CONCLUSIONS AND IMPLICATIONS

Multidisciplinary programs addressing financial, emotional, and nutritional concerns may be the most effective for weight management among white limited-income women. Additional research is necessary to verify the results of this study with larger samples.

Perceptions of body image among Japanese and Croatian children of preschool age

This study examined the differences in current and ideal body size among 108 Japanese and 129 Croatian preschool children (M=4.9 yr.). Boys and girls in both samples showed similarities by selecting the figure representing their current body size. Significant sex differences were found in selection of an ideal figure in the Japanese sample but not in the Croatian group. Japanese girls showed greater preference for a thinner figure than boys. In selection of an ideal body size significant cultural differences were found only for boys: Japanese boys preferred thinner figures. Results relating to body discrepancy (Current minus Ideal figures) indicated that there were fewer satisfied Japanese girls than Croatian girls whereas for the boys, a significantly larger number of Japanese than Croatian boys wished to be heavier.

Epidemiologic trends in overweight and obesity

Obesity in adults is associated with excess mortality and excess risk of coronary heart disease, hypertension, hyperlipidemia, diabetes, gallbladder disease, certain cancers, and osteoarthritis. Overweight children often become overweight adults, and overweight in adulthood is a health risk. Although childhood overweight may not always result in excess adult health risk, immediate consequences of overweight in childhood are psychosocial and also include cardiovascular risk factors such as hypertension, high cholesterol, and abnormal glucose tolerance. The causes of obesity are poorly understood, and both the prevention and the treatment of obesity are difficult. In this context, the ability to track epidemiologic trends in overweight and obesity is important.

Dietary, evolutionary, and modernizing influences on the prevalence of type 2 diabetes

An evolutionary perspective is used to elucidate the etiology of the current epidemic of type 2 diabetes estimated at 151 million people. Our primate legacy, fossil hominid, and hunting-gathering lifestyles selected for adaptive metabolically thrifty genotypes and phenotypes are rendered deleterious through modern lifestyles that increase energy input and reduce output. The processes of modernization or globalization include the availability and abundance of calorically dense/low-fiber/high-glycemic foods and the adoption of sedentary Western lifestyles, leading to obesity among both children and adults in developed and developing countries. These trends are projected to continue for a number of decades.

Ethnic differences in exercise among adults with diabetes

The purposes of this secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES) III Household Adult Data File (1988-1994) were to describe and compare exercise practices and preferences of adult Caucasians, African Americans, and Hispanics with diabetes and to relate that information to diabetes treatment modalities. The research questions were: (a) What proportion of ethnically diverse adults with diabetes do and do not exercise? (b) What are the preferred types of exercise by ethnicity, gender, and age? and (c) What are the relationships among exercise participation, exercise preference, and treatment of diabetes by ethnic group? More than one third of the total sample reported no exercise within the last month. There were no significant differences in amount of exercise by ethnic group. Gardening and walking were the preferred forms of exercise across age, gender, ethnicity, and treatment.

Functional consequences of adult malnutrition in developing countries: a review

Credible concepts of malnutrition depend critically on evidence that functional impairment differentiates variation in size from unacceptable abnormality. This paper reviews functional studies on capacity for work, mortality, reproductive outcomes, competitive success, and cultural preferences. Future research priorities should include the comparative significance of simple physical dimensions in distinct ethnic groups for long-term biological and socioeconomic outcomes, and the relationships between the biological and cultural significance of variation in physique.

Short normal stature and psychosocial disadvantage: a critical review of the evidence

Physicians and parents alike are under increasing pressure to identify and to treat short stature, but intervention implies the presence of some pathology, physical or psychological, that can be corrected. Where there is true GH deficiency, the argument for replacement is uncontroversial. It is less compelling where GH 'insufficiency' is diagnosed. In the case of the short, but otherwise normal, child the indications for therapy are even less clear. Short stature, per se, is clearly not a disease, in spite of the perception by some practitioners that the rate of growth of such children is abnormal. Short stature is, however, commonly perceived to be associated with social and psychological disadvantage, yet many of these misperceptions about short stature can be challenged. A critical review of the literature pertaining to the psychosocial correlates of short stature uncovers much flawed evidence. Most importantly, the belief, widely held by paediatricians, that short children are likely to be significantly disadvantaged, has been founded largely on data from clinic-referred samples. In such studies, children with real (or perceived) behavioural or academic problems are likely to be overly represented. Publications arising from such studies, however, inevitably lead to an increase in the demand for treatment both from and for those who previously had no such concern. In contrast, data from a well controlled, prospective population-based study suggest the essential normality of the short normal child. Parents and children alike should be reassured by these findings. In the absence of clear pathology, physical or psychological, GH therapy for short but otherwise normal children must therefore, in most cases, be deemed cosmetic, raising issues as to the ethics of so-called "plastic endocrinology".

The relationship between body image discrepancy and body mass index across ethnic groups

OBJECTIVE

This study sought to examine at what body mass index (BMI) body image discrepancy (BD) was reported in a community sample of 389 white, Hispanic, and black women. In addition, we assessed the trajectory of the BMI-BD relationship as BMI increases by ethnic group.

RESEARCH METHODS AND PROCEDURES

All participants were assessed on height and weight and completed the Figure Rating Scale.

RESULTS

We found no difference in the proportion of women in each ethnic group reporting BD. However, white women experienced BD at a lower BMI level (BMI = 24.6), and below the criterion for overweight (BMI = 25). In contrast, black and Hispanic women did not report BD until they were overweight (BMIs of 29.2 and 28.5, respectively). Compared with black and white women, Hispanic women registered increases in BD at smaller increases in BMI.

DISCUSSION

These findings could have unhealthful implications for weight control behavior. The results encourage a closer look at ethnicity and BD, and their relationship to obesity and weight control.

Phenotype and genetic analysis of a syndrome caused by an inactivating mutation in the growth hormone-releasing hormone receptor: Dwarfism of Sindh

We report, in detail, a new form of familial dwarfism, including its phenotypic features, hormonal profile, and molecular basis. Following a newspaper report of severe dwarfism in two villages in the province of Sindh, Pakistan, we organized an expedition to study its clinical, genetic, and molecular characteristics. We identified 18 dwarfs (15 male, 3 female), all members of a consanguineous kindred, ranging in age from newborn to 28 yr. Mean height was 7.2 SD below the norm, with mean adult heights of 130 cm for males and 113.5 cm for females. Body proportions and habitus were normal; but head circumference was 4.1 SD, and blood pressure approximately 3 SD below the norm. There was no dysmorphism, no microphallus, and no history of hypoglycemia. Serum GH did not respond to provocative stimuli (GHRH, L-dopa, or clonidine). Insulin-like growth factor I (IGF-I) and IGF-binding protein 3 were low (5.2 +/- 2.0 ng/mL and 0.42 +/- 0.13 microg/mL, respectively; mean +/- SD) but rose normally with GH treatment. One affected, dwarfed couple had a son, demonstrating fertility in both sexes. Clinical and endocrinological evidence suggested isolated GH deficiency with a recessive inheritance pattern. The GH-N gene was found to be intact. Linkage analysis of microsatellite chromosomal markers near other candidate genes yielded a high LOD score (6.26) for the GHRH receptor (GHRH-R) locus. DNA sequencing revealed a nonsense mutation (Glu50-->Stop) in the extracellular domain of the GHRH-R. This mutation predicts a severely truncated GHRH-R; it is identical to that recently reported in four patients from two other families. Inheritance is autosomal recessive (chromosome 7p) with a high degree of penetrance. Relatives heterozygous for the mutation had moderately decreased IGF-I levels and slightly blunted GH responses to GHRH and L-dopa, but they showed only minimal or no height deficit. This syndrome represents the human homologue of the little (lit/lit) mouse and closely resembles its phenotype. It demonstrates the absolute requirement of GHRH signaling for pituitary GH secretion and postnatal growth in humans, and its relatively minor (but discernible) biological importance in extrapituitary sites. The syndrome is distinct from other forms of GH deficiency with respect to microcephaly, asymptomatic hypotension, and absence of features such as facial dysplasia, significant truncal obesity, microphallus, or hypoglycemia. Its discovery raises the possibility of milder mutations in the GHRH-R gene as potential causes for partial GH insufficiency and idiopathic short stature.

Smoking status and relative weight by educational level in Finland, 1978-1995

BACKGROUND

The aim of the present study was to examine the association between smoking status and relative body weight at different educational levels in Finland during 1978-1995.

METHODS

The data for the study were derived from separate cross-sectional health behavior surveys conducted annually by the National Public Health Institute (n = 3,418-5,037, response rate 68-84%). Relative weight was compared among current smokers, ex-smokers, and never smokers. Mean body mass index (BMI) was used as the measure of relative weight. Educational level was measured by the number of school years.

RESULTS

During 1978-1995, relative weight increased in all smoking categories. Among men, ex-smokers weighed most, irrespective of study year or educational level, whereas among women ex-smokers showed a mean BMI comparable with that of never smokers. Among current and never smokers, both men and women, the association between smoking status and mean BMI varied according to educational level: current smokers weighed less than never smokers at the lowest educational level, whereas at the highest educational level they weighed more than never smokers.

CONCLUSIONS

The association between smoking status and relative weight varied according to educational level. The finding suggests that the association between smoking status and relative weight is modified by social and behavioral factors.

Realistic weight perception and body size assessment in a racially diverse community sample of dieters

Recently, a shift in obesity treatment away from emphasizing ideal weight loss goals to establishing realistic weight loss goals has been proposed; yet, what constitutes "realistic" weight loss for different populations is not clear. This study examined notions of realistic shape and weight as well as body size assessment in a large community-based sample of African-American, Asian, Hispanic, and white men and women. Participants were 1893 survey respondents who were all dieters and primarily overweight. Groups were compared on various variables of body image assessment using silhouette ratings. No significant race differences were found in silhouette ratings, nor in perceptions of realistic shape or reasonable weight loss. Realistic shape and weight ratings by both women and men were smaller than current shape and weight but larger than ideal shape and weight ratings. Compared with male dieters, female dieters considered greater weight loss to be realistic. Implications of the findings for the treatment of obesity are discussed.

Psychosocial factors influencing weight control behavior of African American women

The purpose of this descriptive study was to seek directly from college-educated African American women factors which they perceived influenced their individual weight control behavior, and those that influenced African American women collectively. Face-to-face, in-depth interviews were conducted, primarily in their homes, with 36 African American women. Thirteen major categories were identified. Six factors that influenced the women's individual weight control behavior were emotions/feelings, beliefs, life events, self-control, discipline, and commitment. Perceived benefits of the behavior and perceived barriers to the behavior were influential in determining the attractiveness, the type, and the extent of the weight control behavior. Five factors related to the African American culture were identified and described by the women. Recognition of psychosocial determinants of weight control behavior may enable health professionals to design unique interventions relevant to African American women.

Social science theory and methods in the study of alternative and complementary medicine

Anthropology is a holistic science with theory, data, and methods that can be of great service to researchers on alternative medicine. In this paper useful models and methodologic stances were identified that can help researchers to deal creatively with the stresses imposed on science by worldview preferences that differ among both scientists and healthcare systems. I have argued that rather than prefer one paradigm over another, researchers should select techniques based on a rationale featuring deep knowledge of the context of the healthcare issue they want to study. This will not only produce the most accurate and useful data, but should also help free science of its current strictures and allow expansion into a wider conversation about human and medical realities.

The nutrition transition in low-income countries: an emerging crisis

Scientists have long recognized the importance of the demographics and epidemiologic transitions in higher income countries. Only recently has it become understood that similar sets of broadly based changes are occurring in lower income countries. What has not been recognized is that concurrent changes in nutrition are also occurring, with equally important implications for resource allocation in many low-income countries. Several major changes seem to be emerging, leading to a marked shift in the structure of diet and the distribution of body composition in many regions of the world: a rapid reduction in fertility and aging of the population, rapid urbanization, the epidemiologic transition, and economic changes affecting populations in different and uneven ways. These changes vary significantly over time. In general, we find that problems of under- and overnutrition often coexist, reflecting the trend in which an increasing proportion of people consume the types of diets associated with a number of chronic diseases. This is occurring more rapidly than previously seen in higher income countries, or even in Japan and Korea. Examples from Thailand, China, and Brazil provide evidence of the changes and trends in dietary intake, physical activity, and body composition patterns.