Body-Shape Perceptions and Body Mass Index of Older African American and European American Women

From double to triple standards of ageing. Perceptions of physical appearance at the intersections of age, gender and class

Since the 1970s, when Susan Sontag coined the term, discussions on the double standard of ageing has continued to evolve. Recently, scholars of feminist gerontology have called for an intersectional approach to address cultural norms of physical appearance and ageing. In this paper, we aim to investigate whether men and women internalise ageist norms differently; that is, double standards of ageing exist. Second, we explore whether self-identified social class affects the internalisation of these norms. To the best of our knowledge, the present study is the first to examine the double and triple standards of ageing with nationally representative data (N = 1600). Drawing from Bourdieusian capital theory, sociology of the body, consumer culture, and feminist gerontology, we suggest that the double standard of ageing exists for women who feel that ageing erodes their appearance, give more importance to their appearance than men, and fear looking old from an early age. Further, a 'triple standard' is also traced. Our results indicate that ageing working-class women are less confident about their appearances than upper-class women. Thus, upper-middle-class women seem less vulnerable to the negative aspects of ageing than women who have less social, cultural, and economic capital to enhance their ageing appearance. The triple standard extends to men as well: appearance is evaluated as equally important by upper-middle-class middle-aged men as by women of similar age and social background. Alternatively, our results could be interpreted as upper-middle-class people experiencing more restrictive norms regarding ageing; that is, such people are compelled to seek anti-ageing solutions and are not allowed to surrender to the natural ageing process.

Disentangling Race, Poverty, and Place to Understand the Racial Disparity in Waist Circumference among Women

In the U.S., 54.8% of non-Hispanic Black women are obese, a rate that is 1.4 times greater than in White women. The drivers of this racial disparity are not yet clearly understood. We sought to disentangle race, household poverty, neighborhood racial composition, and neighborhood poverty to better understand the racial disparity in obesity among women. We used data from the 1999-2004 National Health and Nutrition Examination Survey and the 2000 U.S. Census to examine the role of individual race, individual poverty, neighborhood racial composition, and neighborhood poverty on women's risk of obesity. We found that individual race was the primary risk factor for obesity among women. Neighborhood effects did not account for the racial disparity. Understanding that race is a social, not a biologic construct, more work is needed to uncover what it is about race that produces racial disparities in obesity among women.

Intersectionality in the Liminal Space: Researching Caribbean Women's Health in the UK Context

African Caribbean women in the UK who are diagnosed with chronic illnesses that are related to overweight and obesity are more likely to experience poorer outcomes than their White British counterparts. It is then important to increase understandings of how women from this ethnic group perceive health with relation to body shape and size so that interventions can be developed to prevent the development of such conditions and to improve outcomes. As such, it is important to develop research methodology that encourages participation in health research from African Caribbean women and enables the capture of in-depth data that gives insight into the nuances of health understandings related to the body and the social realities in which they exist. This paper details the methodological framework of The Big Talk project, an investigation that sought to develop a novel approach to conducting health research with seldom heard communities. The concept of intersectionality, as used in Critical Race Theory, was applied as a theoretical tool for exploring the dynamics of societal power and where this power intersects across the lived realities of race, ethnicity, gender, sexuality, (dis)ability, and class. For this research, these intersections are explored for African Caribbean women and how they relate to concepts of health, body shape, and size. This research study was conducted in spaces identified as liminal spaces for African Caribbean women: talk radio programmes; hairdressing salons and; local community groups. A Black feminist epistemological approach was used to facilitate the collection of data. The data that emerged from these liminal spaces are not necessarily definitive answers on health for African Caribbean women, but rather illuminate alternative ways of understanding the social world from the perspective of those subject to power. This phenomenon makes liminal spaces intersectional in their construction and in taking such an approach to analysis could enable finely grained details of discourses regarding health, wellness and the body to be gathered. The importance of this understanding can help to improve preventive health interventions for African Caribbean women.

Body image in relation to nutritional status in adults from the Basque Country, Spain

The aim of this research was to analyse variation in body image perception and satisfaction by age, sex and nutritional status in an adult sample from the Basque Country, Spain. A case-control study was performed for 227 women and 178 men aged 18-70 years. Stunkard's silhouettes were used to evaluate Current Body Image (CBI) and Ideal Body Image (IBI), as well as dissatisfaction and inconsistency scores. Nutritional status was assessed following the WHO criteria for BMI in an adult population. The sample was divided into four groups based on sex and age (early adulthood <45 years, and middle/older adulthood ≥45 years). The Mann-Whitney U test was employed to evaluate sex and age differences, and the Gamma coefficient to assess the association between body image variables and nutritional status. Significant age differences in CBI (p<0.05) and sex differences in IBI (p<0.001) were detected. Both variables showed a positive association with BMI (p<0.01), which indicates that BMI is a biological characteristic related to body image satisfaction and influences participants' perception of themselves. Dissatisfaction scores showed that both sex and age differences (p<0.05) were negatively associated with BMI (p<0.001). Only participants ≥45 years presented sex differences in inconsistency scores (p<0.05); this variable was associated with BMI in women (p<0.01). Preferences in body image showed sexual dimorphism, with women preferring thinner bodies than men - a pattern observed in many Western populations - linked in part to sociocultural pressures. Women were more dissatisfied with their bodies than men; a higher dissatisfaction was observed in older relative to younger participants. The results confirm the association between nutritional status and body size perception and satisfaction, but also the relationship between nutritional status and the reliability with which women can classify themselves; in men, this relationship was not as clear.

A Step toward Understanding Diet Quality in Urban African-American Breast Cancer Survivors: A Cross-sectional Analysis of Baseline Data from the Moving Forward Study

PURPOSE

Little is known about the dietary behaviors of African-American breast cancer survivors (AABCS). We sought to describe dietary intake and quality in AABCS and examine associations with demographic, social, lifestyle, and body composition factors to potentially inform the development of effective dietary interventions.

METHODS

Baseline data from a prospective weight loss trial of 210 AABCS were assessed. A food frequency questionnaire was used to evaluate dietary intake and diet quality via the Healthy Eating Index 2010 (HEI-2010) and Alternative Healthy Eating Index 2010 (AHEI-2010). Linear regression analysis was conducted to determine the most influential variables on diet quality.

RESULTS

Mean HEI- and AHEI-2010 total scores were 65.11 and 56.83 indicating that diet quality needs improvement. Women were the least adherent to recommendations for intake of whole grains, dairy, sodium, empty calories, sugary beverages, red/processed meats, and trans-fat. Increased self-efficacy for healthy eating behaviors, more years of education (AHEI only), negative smoking status, smaller waist circumference, and increased physical activity (HEI only) were significantly associated with higher diet quality scores.

CONCLUSION

Our findings suggest the diet quality of AABCS needs improvement. Intervention programs may achieve higher diet quality in AABCS by focusing on increasing self-efficacy for healthy eating behaviors.

‘I am busy independent woman who has sense of humor, caring about others’: older adults’ self-representations in online dating profiles

Similar to their younger counterparts, older adults (age 60+) are increasingly turning to online dating sites to find potential romantic and sexual partners. In this paper, we draw upon qualitative data from a thematic analysis of 320 randomly selected online dating profiles posted by Canadian heterosexual older adults who self-identified as Asian, Black, Caucasian or Native American. In particular, we examined how the older adults’ self-presentations varied according to race/ethnicity, age and gender, and how the language they used to describe themselves and their preferred potential partners reflected and reinforced idealised images of ageing. Our analysis identified five primary ways in which the older adults portrayed themselves. They depicted themselves as active and busy with cultural/artistic, social and adventurous activities; and also as physically healthy and intellectually engaged. Third, they emphasised the ways in which they were productive through work and volunteer activities. Fourth, they accentuated their positive approach to life, identifying themselves as happy, fun-loving and humorous individuals. Finally, they highlighted their personable characteristics, portraying themselves as trustworthy and caring. We discuss our findings with a particular focus on gender differences, drawing on literature on masculinity and femininity, and also look at capital and power relations by considering the online dating setting as a field in the Bourdieusian sense.

Identifying Motives of Midlife Black Triathlete Women Using Survey Transformation to Guide Qualitative Inquiry

Demonstrating health disparities related to race, age, and gender, older Black women (BW) are the most sedentary demographic group in the United States. Increasing PA in mid-life is important, as it improves health as BW age into their later years. Advancing our understanding of the exercise motives of BW triathletes presents a "reverse engineering" opportunity to identify motives that could influence sedentary mid-life BW to increase their activity. The purposes of this study were to: (a) utilize an innovative survey transformation method to adapt a measure developed primarily in Caucasian males, i.e., the Motivations of Marathoners Scale for Triathletes (MOMS-T) into a qualitative interview guide for use with BW triathletes; (b) use this interview guide to identify culturally based motives for triathlon participation among BW not previously addressed by the MOMS-T and; (c) interpret the novel motivational domains of the MOMS-T discovered, in order to gain understanding and influence subsequent interventions. Purposive sampling was used to select 12 interview participants from 121 self-identified Black female US residents aged ≥36 years with recent experience completing or training for a triathlon. The interviews identified four culturally based themes, including improving body composition to become "more lean", physical attractiveness, triathlete family, and camaraderie. These novel themes were related to existing MOMS-T scales, but the current MOMS-T questions did not illuminate their culturally distinct aspects. The process of survey transformation provides a viable approach to identify important culturally based characteristics and to adapt surveys to cultural minority populations, particularly when study resources are limited.

Strong, female and Black: Stereotypes of African Caribbean women’s body shape and their effects on clinical encounters

The aim of this article is to explore how tendencies to stereotype minority ethnic groups intersect with lay discourses about them in ways that can reproduce cultural prejudices and reinforce inequalities in access to services and health outcomes. Drawing upon Black feminist and cultural studies literature, we present a theoretical examination, the stereotypes of the Black woman as ‘mammy’ and ‘matriarch’. We suggest that the influence of these two images is central to understanding the normalisation of the larger Black female body within African Caribbean communities. This representation of excess weight contradicts mainstream negative discourses of large bodies that view it as a form of moral weakness. Seeking to stimulate reflection on how unacknowledged stereotypes may shape clinical encounters, we propose that for Black women, it is the perception of strength, tied into these racial images of ‘mammy’ and ‘matriarch’ which may influence when or how health services or advice are both sought by them and offered to them. This has particular significance in relation to how body weight and weight management are/are not talked about in primary care-based interactions and what support Black women are/are not offered. We argue that unintentional bias can have tangible impacts and health outcomes for Black women and possibly other minority ethnic groups.

Body Image Satisfaction Among Blacks

Satisfaction with body image is a factor related to health outcomes. The purpose of this study is to examine the relationship between body image satisfaction and body size perception in an urban, Black community sample in New Orleans, Louisiana. Only 42.2% of respondents were satisfied with their body image and 44.1% correctly perceived their body size. Most respondents chose an ideal image in the normal body mass index range with over half choosing an ideal image smaller than their actual size. Misperception was greatest among the heaviest respondents. Females, those who overestimated their size, those with an education beyond high school, and those who were active in order to lose weight were less likely to be satisfied ( p < .001). Those who were active but not trying to lose weight were more likely to be satisfied ( p < .001). This suggests that perception of and satisfaction with body size may play a role in health behavior decisions.

Effect of sex and age on the association between suicidal behaviour and obesity in Korean adults: a cross-sectional nationwide study

OBJECTIVES

To examine the hypothesis that the relationship between obesity and the risk of suicidal behaviour would differ according to sex and age.

SETTING

Data from the 2007-2012 Korean National Health and Nutrition Examination Survey (KNHANES) were used.

PARTICIPANTS

36 211 adults with body mass index (BMI) data were included and the mean age was 49.6 years.

INDEPENDENT VARIABLE

BMI.

PRIMARY AND SECONDARY OUTCOME MEASURES

Suicide ideation and attempts.

DESIGN AND ANALYSIS

A cross-sectional study was performed. Multiple logistic regressions after controlling for socioeconomic variables and concomitant diseases were applied to see the relationship between obesity level and suicidal ideation or attempt.

RESULTS

Women with severe obesity had the highest prevalence of suicide attempts and ideation, whereas among males, underweight men had the highest prevalence. After adjustment, obese men had a lower OR for suicide ideation (OR=0.87, 95% CI 0.76 to 1.00). Among women, the ORs of severely obese and underweight women were 1.27 (95% CI 1.06 to 1.52) and 1.24 (95% CI 1.06 to 1.45), respectively. When grouped by age category, the ORs for suicide ideation in severely obese women aged 18 to <30 years or attempts in severely obese women aged 30 to <50 years were 2.30 (95% CI 1.36 to 3.89) and 3.07 (95% CI 1.50 to 6.31), respectively. However, overweight and obese women aged more than 50 years exhibited significantly less ORs of suicide ideation, when compared with counterparts of normal weight.

CONCLUSIONS

The association between obesity and suicidal behaviour exhibited a different pattern by sex and age in South Korea. In particular, severely obese young women had a substantial risk of suicidal behaviour. Our study results highlighted the importance of obesity management in the prevention of suicide among young women, and may be helpful for the drafting of the health agenda in Asian countries with an obesity prevalence and culture similar to those in Korea.

Relationships Between Body Areas Satisfaction, Exercise, and Mood in Obese African American Women

Despite a rate of morbid obesity that is 2.5 times that of European American women, African American women have higher body areas satisfaction than any other ethnicities. Previous research suggested differences in African American women’s attitudes toward body image may contribute to a lack of motivation to engage in weight management behaviors, such as physical activity. In addition, factors such as self-efficacy, self-regulation, and mood have been shown to affect healthy behavior participation but have not been studied among obese African American women. This study investigated if changes from baseline to posttreatment in self-efficacy and self-regulation for exercise and mood mediatedthe association between changes in body areas satisfaction and physical activity. The study used archival data consisting of 109 obese African American women who participated in a 6-month weight management intervention. The relationship between changes in body areas satisfaction and physical activity was mediated by changes in self-regulation for exercise and mood but not by change in self-efficacy for exercise. These findings may help in devising treatments targeted at this population. Implications are discussed.

Body size perception among African American women

OBJECTIVE

To assess body size perception among African American women using cultural definitions of body size terms.

METHODS

Sixty-nine African American women classified Body Image Scale figures as overweight, obese, and too fat, and independently selected the figure they considered closest to their current body size.

RESULTS

Body size classifications of figures did not vary by participant weight status. Overweight figures were not considered too fat. For 86% of overweight (body mass index [BMI], 25-29.9) women and 40% of obese (BMI > 30) women, the self figure was not defined as overweight, obese, or too fat. Among participants with BMI ≥ 35, 65% did not classify their self figure as obese and 29% did not classify their self figure as overweight.

CONCLUSIONS AND IMPLICATIONS

The difference between cultural (folk) and medical definitions of body size terms may serve as a barrier to effective communication between patients and providers about health effects of excess adiposity.

Treatment-Associated Changes in Body Composition, Health Behaviors, and Mood as Predictors of Change in Body Satisfaction in Obese Women

A lack of satisfaction with one’s body is common among women with obesity, often prompting unhealthy “dieting.” Beyond typically slow improvements in weight and body composition, behavioral factors might also affect change in body satisfaction. Age and race/ethnicity (African American vs. White) might moderate such change. Obese women ( N = 246; Mage = 43 years; MBMI = 39 kg/m2) initiating a 6-month cognitive-behaviorally based physical activity and nutrition treatment were assessed on possible predictors of body satisfaction change. At baseline, African American and younger women had significantly higher body satisfaction. The treatment was associated with significant within-group improvements in mood, health behaviors (physical activity and fruit/vegetable intake), and body composition (waist circumference). A multiple regression analysis indicated that mood, health behavior, and body composition changes explained a significant 27% of the variance in body satisfaction change. Of these predictors, changes in mood (β = −.36, p < .001) and health behaviors (β = .18, p = .01) made significant, unique contributions to the variance in change in body satisfaction that was accounted for, while only the measure of actual physiological change (body composition) did not. Neither age nor race/ethnicity was a significant moderator when each was entered separately into the multiple regression equation. Practical implications for leveraging manageable changes in behavioral factors for improving body satisfaction were discussed.

Obesity and body size perceptions in a Spanish Roma population

BACKGROUND

Roma people are particularly vulnerable to developing overweight and obesity. Self-perception of body image may influence the prevalence of obesity in this ethnic minority.

AIM

The objectives of this study are to estimate the prevalence of obesity, to analyse body size perceptions and preferences and to assess the relationship between body size perceptions and obesity in the Roma population.

SUBJECTS AND METHODS

The analyses were carried out on 372 men, women and children from the Roma population residing in the Greater Bilbao region (Basque Country, Spain). In adults, a standard figural scale was used to analyse body size perceptions and preferences in this ethnic minority.

RESULTS

Overall 51.7% of adult and 24.4% of minor Roma individuals were obese. Both Roma men and women had inaccurate self-perceptions of their body size. Significant differences on body size perceptions were detected based on age, sex, nutritional status and socioeconomic characteristics.

CONCLUSION

This Roma population presents one of the highest rates of obesity worldwide. Although a certain awareness of the correct weight status was appreciated, the inability of Roma individuals to see themselves as overweight or obese may be a significant factor on the high prevalence of obesity in this population.

Innovative care delivery model to address obesity in older African-American women: Senior Wellness Initiative and Take Off Pounds Sensibly collaboration for health (SWITCH)

OBJECTIVES

To determine the feasibility and acceptability of integrating Take Off Pounds Sensibly (TOPS), a national nonprofit weight-loss program through which people have lost a clinically significant amount of weight, into a community program that serves African Americans (AAs) and to determine weight change.

DESIGN

Single-group pilot design.

SETTING

Denver, Colorado.

PARTICIPANTS

Community-dwelling participants aged 51 to 85.

INTERVENTION

Participants were recruited through a program that serves AAs, and new TOPS chapters were started at a church, senior center, and senior residence for independent living.

MEASUREMENTS

Feasibility was measured by determining the ease of recruitment and acceptability was measured according to retention. The secondary outcome was weight change.

RESULTS

Sixty-four percent of people who were referred to the program or attended an information session participated in the study. The retention rate at 52 weeks was 79%. At 52 weeks, 16 of 48 participants had lost 5% or more of their initial weight, and 23 had lost 0% to 4.9% of their initial weight.

CONCLUSIONS

Recruiting AA women through the Center for African American Health was feasible, and the program was acceptable. One-third of participants lost a clinically significant amount of weight. TOPS may be one way to combat the health disparity of obesity in AA women.

Weight misperceptions and racial and ethnic disparities in adolescent female body mass index

This paper investigated weight misperceptions as determinants of racial/ethnic disparities in body mass index (BMI) among adolescent females using data from the National Survey of Youth 1997. Compared to their white counterparts, higher proportions of black and Hispanic adolescent females underperceived their weight status; that is, they misperceived themselves to have lower weight status compared to their clinically defined weight status. Compared to their black counterparts, higher proportions of white and Hispanic adolescent females misperceived themselves to be heavier than their clinical weight status. Oaxaca-Blinder decomposition analysis showed that accounting for weight misperceptions, in addition to individual and contextual factors, increased the total explained portion of the black-white female BMI gap from 44.7% to 54.3% but only slightly increased the total explained portion of the Hispanic-white gap from 62.8% to 63.1%. Weight misperceptions explained 13.0% of the black-white female BMI gap and 3.3% of the Hispanic-white female BMI gap. The regression estimates showed that weight underperceptions were important determinants of adolescent female BMI, particularly among black and Hispanic adolescents. Education regarding identification and interpretation of weight status may play an important role to help reduce the incidence and racial disparity of female adolescent obesity.

Is ideal body image related to obesity and lifestyle behaviours in African American adolescents?

BACKGROUND

Childhood obesity epidemic has become a public health issue in the USA, especially among African American youths. Research on the association between ideal body image (IBI) and obesity and related lifestyle factors among African American children and adolescents is limited.

METHODS

Data collected from 402 low-income African American adolescents aged 10-14 years in four Chicago public schools were used. Questionnaires were used to assess IBI, weight perception, weight control practices, and self-efficacy towards food and physical activity. Body mass index was calculated using measured weight and height. Associations between IBI and weight perception, overweight/obesity and lifestyle behaviours were assessed using linear and logistic regression models.

RESULTS

The most frequently chosen ideal body size was the fourth of eight silhouettes (from thinnest to heaviest) for boys (55%) and girls (49%). Overweight and obese girls selected larger ideal body figures than the others (trend test: P < 0.001). Compared with those with middle ideal body figures, girls who selected smaller ones were twice as likely to have an unhealthy diet as indicated by less fruit and milk consumption; the odds ratios (ORs) and 95% confidence intervals (95% CIs) were 2.40 (1.15-5.02) for fruits intake (<once/week) and 2.13 (1.06-4.29) for milk consumption (<once/day), respectively. Boys with larger IBI were less likely to eat snack often [≥once/day; OR = 0.11 (0.02-0.50)]. Girls with larger IBI were less likely to spend more screen time [OR = 0.12 (0.02-0.70)] and reported better food choice intentions (P < 0.05). Overweight and obese boys and girls appeared to have better food choice intentions and food self-efficacy than their non-overweight peers (trend test: both P < 0.01).

CONCLUSIONS

Ideal body image is associated with weight status, food self-efficacy and lifestyle behaviours among low-income African American adolescents.

Associations among body size dissatisfaction, perceived dietary control, and diet history in African American and European American women

European American (EA) women report greater body dissatisfaction and less dietary control than do African American (AA) women. This study investigated whether ethnic differences in dieting history contributed to differences in body dissatisfaction and dietary control, or to differential changes that may occur during weight loss and regain. Eighty-nine EA and AA women underwent dual-energy X-ray absorptiometry to measure body composition and completed questionnaires to assess body dissatisfaction and dietary control before, after, and one year following, a controlled weight-loss intervention. While EA women reported a more extensive dieting history than AA women, this difference did not contribute to ethnic differences in body dissatisfaction and perceived dietary control. During weight loss, body satisfaction improved more for AA women, and during weight regain, dietary self-efficacy worsened to a greater degree for EA women. Ethnic differences in dieting history did not contribute significantly to these differential changes. Although ethnic differences in body image and dietary control are evident prior to weight loss, and some change differentially by ethnic group during weight loss and regain, differences in dieting history do not contribute significantly to ethnic differences in body image and dietary control.