A biomedical and feminist perspective on women's experiences with weight management

Monitoring the Normal Body: Ideals and Practices among Normal-Weight and Moderately Overweight People

INTRODUCTION

An extensive body of literature is concerned with obese people, risk, and weight management. However, little is known about weight management among people not belonging to the extreme BMI categories. Management of weight among normal-weight and moderately overweight individuals provides us with knowledge about how to prevent future overweight or obesity. This paper investigates body size ideals and monitoring practices among normal-weight and moderately overweight people.

METHODS

The study is based on in-depth interviews combined with observations. 24 participants were recruited by strategic sampling based on self-reported BMI 18.5-29.9 kg/m2 and socio-demographic factors. Inductive analysis was conducted.

RESULTS

Normal-weight and moderately overweight people have clear ideals for their body size. Despite being normal weight or close to this, they construct a variety of practices for monitoring their bodies based on different kinds of calculations of weight and body size, observations of body shape, and measurements of bodily firmness. Biometric measurements are familiar to them as are health authorities' recommendations. Despite not belonging to an extreme BMI category, they translate such measurements and recommendations in meaningful ways to fit their everyday life.

CONCLUSIONS

Normal-weight and moderately overweight people are concerned with their body size and continuously monitor it. Future health promotion work should consider the kind of practices already established in daily life when recommending ways of conducting body management.

The monster in the mirror: reasons for wanting to change appearance

PURPOSE

Many adults are dissatisfied with their body, regardless of their weight, and weight loss is commonly perceived as an effective solution to this dissatisfaction. The main purpose of this study was to examine the reasons for wanting to modify one's bodily appearance (shape and weight), and to compare these reasons by sex, age, and weight group.

METHODS

The sample consisted of 796 French-speaking Canadian adults (100 men, 696 women; M age = 27.00 years, SD = 7.88, range 18-64; M body mass index = 24.99 kg/m(2), SD = 6.37, range 12.6-66.5 kg/m(2)) who were asked online whether or not they wanted to change their appearance and if so, why. Answers were subjected to a content analysis wherein recurrent themes were grouped and labeled.

RESULTS

Most participants (83.2%) wanted to change their appearance. Women, participants with a higher BMI, and older participants were significantly more likely to report this desire. The three most frequently evoked reasons were body dissatisfaction, well-being, and health/shape.

CONCLUSIONS

The results suggest that body dissatisfaction constitutes the primary motive for change for both men and women of all ages, especially for those who are of healthy weight or underweight. Women and younger adults seem to be under the impression that in changing their appearance they will be more comfortable in their own skin. Men, older adults, and overweight adults, on the other hand, are more preoccupied by their health/shape and seldom relate their appearance to their psychological balance.

Literature review: perceptions and management of body size among normal weight and moderately overweight people

Improved understanding of how normal weight and moderately overweight people manage their body weight and shape could be used to inform initiatives to prevent and treat obesity. This literature review offers a thorough appraisal of existing research into perceptions and management of own body size among normal weight and moderately overweight people. The studies reported in the 47 publications reviewed here address various themes based on different conceptualizations. The studies point out that normal weight and moderately overweight people are much concerned about their body size, but huge discrepancies are found between their own perceptions and study categorizations. The studies also indicate that normal weight and moderately overweight people are actively engaged in managing their body size through numerous managing strategies, and dieting is widespread. Together the studies do not form a unified and coherent research field, and there is a bias towards North American study populations. Methodological problems were identified in some publications, raising questions about generalizability of the findings. Moreover, only few studies give deeper insight into the specific perceptions and actions. Repeated studies are needed in broader and more differentiated geographical, social and cultural contexts, and longitudinal studies and more in-depth explorations are especially needed.

Concept analysis: prenatal obesity, a psychoneuroimmunology perspective

PURPOSE

To analyze the concept of prenatal obesity within a psychoneuroimmunology framework.

CONCLUSION

By considering the psychosocial, neurological, endocrine, and immunological contributions, a psychoneuroimmunology framework maintains a holistic focus. Identifying the multidirectional mechanisms linking these systems will provide valuable insight into the mechanisms by which prenatal obesity increases the rate of adverse pregnancy outcomes.

PRACTICE IMPLICATIONS

Utilization of the concept of prenatal obesity within a psychoneuroimmunology framework will facilitate multidisciplinary research to identify underlying mechanisms by which prenatal obesity leads to adverse pregnancy outcomes, as well as the development of interventions to treat obesity before, during, and after pregnancy.

Practical guidelines for feminist research in nursing

With increasing interests in oppressed groups, the number of feminist studies in nursing has steadily increased. Despite the increasing number of feminist studies, very few articles have been written to provide practical guidelines for feminist research in nursing. In this article, guidelines for feminist research in nursing are proposed on the basis of 3 previous feminist studies. First, characteristics of feminist research are concisely described. Then, the 3 studies that are the basis for the guidelines are described. Finally, practical guidelines for feminist nursing research are proposed on the basis of 10 idea categories related to issues/concerns from the 3 studies.

Current trends in feminist nursing research

Despite an increasing number of feminist studies in nursing, few reviews on current trends in feminist nursing research have been published. This article aims to explore the current trends in feminist nursing research and provide recommendations for future feminist studies in nursing. In multiple database searches, 207 articles were retrieved. These were reviewed based on 5 criteria: (1) epistemological background, (2) research questions, (3) research participants, (4) research methods, and (5) implications for changes. The review indicated that feminist nurse researchers with diverse epistemological backgrounds adopted new research methods to ask new questions; expanded their focus to include differences in ethnicity, class, sexual preference, and disability; and incorporated these diversities among women in a global context in their research. Based on these findings, recommendations for future feminist research in nursing are outlined.

Understanding women's journey of recovering from anorexia nervosa

Previous studies of recovery from anorexia nervosa (AN) have concentrated on discrete behavioral responses of individual women. Little is understood about the subjective process of women's recovery in the context of family, community, or society. In this feminist grounded theory study, the authors explored the perceptions of 12 women who considered themselves recovered or recovering from AN. They discovered a substantive theory of self-development that explains, within the current social context, women's journey from the perilous self-soothing of devastating weight loss to the informed self-care of healthy eating and problem-solving practices. The findings provide an urgently needed explanatory framework to inform women, clinicians, and health policy makers in their prevention and recovery efforts.

Weight management in women

With 61% of the American population overweight or obese, the need for treatment far exceeds the capacity of the health care system to provide care on an individual basis. Moreover, the most effective method for the delivery of treatment, and the best ways to induce and sustain client adherence to such a program, remain elusive. Obesity stands in the ignominious position of being the only epidemic in the latter decades of the twentieth century and into the new millennium that nurses--clinicians, academicians, and investigators alike seem to have virtually ignored. There are few past or present clinical descriptions, curriculum examples, or research results that have been presented or published by nurses that demonstrate the discipline's recognition of and commitment to this pervasive health problem. With the ever-increasing prevalence of obesity and obesity-related diseases, the burgeoning expansion of health care delivery in outpatient care, and the growing emphasis on health promotion, it is imperative that nurses in all roles give their long overdue and concerted attention to grappling with this unrelenting epidemic.

Physical activity beliefs, behaviors, and cardiovascular fitness of Mexican immigrant women

This descriptive study examined physical activity beliefs, behaviors, and cardiovascular fitness of a convenience sample of 51 married Mexican immigrant women (MIW) with children in Northern California. Standardized tools/procedures were used to measure the variables of interest and to determine cardiovascular fitness levels. The majority (78%) was not involved in regular physical activity and had below average or poor cardiovascular fitness (76%). However, 93% had a positive attitude, were well-informed of the benefits, and perceived physical activity to be a health-promoting behavior. Cultural values and beliefs about physical activity, gender roles, and social and physiological factors were described as barriers to women's intention to engage in physical activity.

Exploring the association between body weight, stigma of obesity, and health care avoidance

PURPOSE

To explore the stigma of obesity and its effect on health care utilization, associations between self-esteem, attribution for weight, body mass index (BMI), satisfaction with medical care and the behavior of delaying/avoiding health care were examined.

DATA SOURCES

A convenience sample of 216 women recruited from church sites in Las Vegas completed self-administered questionnaires.

CONCLUSIONS

The findings show an increase in BMI is associated with an increase in the delay/avoidance of health care. Weight-related reasons for delaying/avoiding health care included having "gained weight since last health care visit," not wanting to "get weighted on the provider's scale," and knowing they would be told to "lose weight."

IMPLICATIONS FOR PRACTICE

The obese are a stigmatized and vulnerable population. Nurse practitioners are challenged to be aware of attitudes towards obesity and to identify ways to promote continuity of care and regular health maintenance. The goals of Healthy People 2010 to reduce obesity-related morbidity cannot be met if health care is delayed/avoided.

Hoping to maintain a balance: the concept of hope and the discontinuation of anorexiant medications

The secondary analysis of transcripts from a study of 9 women who used prescription anorexiant medications described in this article was conducted to discover the role that hope played in the women's weight-loss initiatives. It was found that hope grew throughout the women's weight-loss initiative but peaked once the medications were discontinued. Seven components of the concept of hope were described in the context of the women's weight-loss experiences. Characteristics of hope in women who have discontinued anorexiant medications are different than those associated with hope in other contexts. A unique pattern of hope, hoping to maintain a balance, describes the women's experiences as they strove to maintain the weight they had lost.

The decision to lose weight

The purpose of this article is to describe the reasons people give for deciding to lose weight compared by weight history and gender. The sample consisted of 162 Caucasian community volunteers. Data were obtained from an extensive open-ended interview that was analyzed using content analysis. Respondents were categorized into five groups, according to their success at weight loss: Successful, Always Normal Weight, Underweight, Clinically Successful, and Always Obese. The Clinically Successful and Always Obese were included in the category Unsuccessful Dieter. Reasons given for entering a weight-loss regime included attractiveness or appearance, health, fear, self-esteem issues, age, and competition. For the Successful Dieter, attractiveness and health were the two major motivations. Men and women were similar in their reasons for entering a weight-loss program. The issue of what makes a decision of sufficient importance to maintain weight loss remains unexplained. "Centrality" is offered as a possible explanation.

Evaluation of two nondieting interventions for obese women

A randomized trial was conducted to see if there could be effective alternatives to dieting for obese women. It compared a 12-week (1 h/week) education intervention, a 12-week (2 h/week) psychoeducational intervention, and a control group on self-esteem, body dissatisfaction, and restrained eating of obese women. Secondary variables of interest were social adjustment, symptoms of depression, scores on bulimia, and drive for thinness, weight, and blood pressure. Complete data were available at pre- and posttest time for 78 women. A MANCOVA indicated that the psychoeducation group improved over the control group on self-esteem, restraint, and body dissatisfaction. The education group did not differ statistically from the control group at posttest. Means of weight and blood pressure did not change. A nondieting approach can be beneficial to the emotional health of obese women without changing weight and blood pressure risk factors for other morbidity.

Toward an integrative science of women's health

For too long, the health care of women has separated childbearing from health promotion and management of chronic health problems. A critical dimension of an integrative science of women's health is bringing together childbearing with women's health during the life span. This integration is needed in areas such as preconception care, reproductive weight management, and gestational diabetes. An integrative science enhances research promoting women's health and patterns of care aimed at disease prevention.

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.