Childhood obesity has reached epidemic proportions in the U.S., and young African American females are particularly vulnerable. In government statistics from the years 1999 though 2002, 23.6 percent of African American females between the ages of 12 to 19 were overweight, compared to 12.7 percent of whites and 19.9 percent of Mexican Americans. Along with overweight comes a sedentary lifestyle and poor nutrition and again, AfricanAmerican girls are more likely to experience both. Obesity is a problem because it is associated with increases in childhood diabetes and cardiovascular disease, and overweight teenagers tend to have more limited social and economic opportunities.
The researchers in the Centers for Disease Control and Prevention (CDC) study, from multiple institutions, used a small sample—12 adolescents and their mothers—from a local hospital-based pediatric diabetes screening and prevention program in North Carolina. The subjects were interviewed for attitudes and perceptions toward body image, food and physical activity. The pilot study "sought to qualitatively explore cultural attitudes and perceptions toward body image, food, and physical activity among a sample of overweight African American girls." The research found:
• The individual's immediate social and familial circle largely influenced body size and weight, not her peers.
• Close friends around the teenagers are more accepting of being overweight and there is little social pressure for the teens to alter their habits.
• Nutrition was not a factor in choosing what to eat; texture, taste, appearance and "context" were more important.
• Physical activity was limited by time constraints, access to exercise opportunities, and by neighborhood safety.
• Structured exercise was limited by its cost and because of the time involved in maintaining personal aesthetics, such as tending to their hair and nails.
• Celebrities were not perceived as role models for diet and physical activity habits.
According to the study, led by Josephine E. A. Boyington of Shaw University of Raleigh, N.C., the attitudes of the subjects reflects cultural norms. Food choices also reflect values that can compete with healthy foods. As the authors stated, “Family and peer considerations often superseded personal judgment to eat healthfully as the girls strove to preserve cohesion in various social contexts." As one young woman said, "And like who’s going to pass up their grandma’s cooking? She’s cooking like Sunday, and it be like she’s cooking chicken, collard greens, corn bread, and you know it’s your grandma. She's old-fashioned so you don’t . . . you be like, 'Grandma, can you kind of cut back on the grease?'"
The subjects seemed to have a different definition of "overweight" than the researchers and did not believe their weight to be a critical issue. Most of all, the subjects told the researchers, they wanted to be “comfortable” with their bodies, and they were comfortable being "big." "I am not like at the obese stage yet," one said, "and I don't think I’m going to be in the obesity stage." All the subjects were selected because they had a body mass index greater than 95th percentile for their age, the federal standard for overweight.
Food was judged on how it tasted rather than whether it was good for them. Since fat-free food usually has less taste, they rejected it at schools when offered. "There’s no seasoning [in] the mashed potatoes," one said. "There's no flavor." They also found healthy foods less filling.
Celebrity role models
The researchers wrote they were surprised at how little influence celebrities had on the young women. While they admired Oprah Winfrey who has had weight issues, the admiration centered less on what she looked like than on what she had accomplished. The subjects appeared far more impressed by the comedienne Mo'Nique who promotes her large size and appeared to the young women to be a more realistic role model.
Admitting the number of subjects was small and that the results could not be generalized, the researchers said that health professionals attempting to stem the wave of obesity among African American adolescents needed to consider the findings when establishing programs. "Future intervention efforts should assess girls’ knowledge, perceptions, and self-efficacy levels related to nutrition and physical activity to inform program design,” they wrote. "Assessments should specifically target identifying girls' perceptions of context specific barriers (availability, cost, access, safety, health status) and facilitators (preferred foods, activities, role models) of adopting healthy behaviors."
The authors suggest that "approaches favoring school- or home-based physical activities have not been well explored in this population and may be useful for these girls, who perceived lack of opportunities because of limited access to activities and because of unsafe neighborhoods. Furthermore, concerns about personal aesthetics indicate that activities perceived as less disruptive might be more easily adopted than those perceived to be aesthetically costly."
The study, "Cultural Attitudes Toward Weight, Diet, and Physical Activity Among Overweight African American Girls" by Josephine E. A. Boyington and colleagues is found at http://www.cdc.gov/pcd/issues/2008/apr/07_0056.htm?s_cid=pcd52a36_e