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Black girls look at being overweight with different eyes

The current epidemic of childhood overweight is a special problem for black girls in their teens. For example, 23.6 percent of black girls aged 12 to 19 years are overweight in contrast to 12.7 percent of white girls and 19.9 percent of Mexican American girls the same age (according to data for the years 1999 through 2002).

To understand why, researchers conducted a pilot study of 12 overweight black girls from 12 to 18 years of age. The girls were in a hospital-based program to screen for diabetes among children and intervene to prevent the disease's development. The researchers asked the girls about their attitudes towards weight, diet, and physical activity in five group interviews.

According to the researchers, the girls were "conditioned" against the impact of hurtful, weight-related comments and such comments did not motivate them to change their eating or physical activity habits. The girls used culturally based terms (such as "big," "medium," "thick," "fat," or "skinny") to describe body size, rather than an objective measure such as weight. Rather than visualizing an ideal weight or body size, the girls preferred a range of acceptable sizes—self-satisfaction with size was more important than actual size. The teenage girls consistently described large body size as preferable, and stated that large breasts and buttocks made one physically attractive.

As to food choice, the girls knew which foods were considered "healthy," but healthy foods were not seen as filling as the foods—frequently fried—that they were used to from their home life and culture. The texture, taste, and appearance of food were more important than food's nutritional value to these teens.

When asked about participation in physical activity, the girls brought up a range of barriers. They mentioned the unavailability of preferred activities at their school, exclusion from desired sports due to their weight and blood pressure, and the "beauty cost" of vigorous activity—getting sweaty or messing up their hair. The girls also noted time spent on schoolwork and the need to stay home in an unsafe neighborhood.

These findings can help design future context-sensitive interventions aimed at reducing obesity in black teenage girls, conclude the researchers. The study was funded in part by the Agency for Healthcare Research and Quality (HS13353).

More details are in "Cultural attitudes toward weight, diet, and physical activity among overweight African American girls," by Josephine E. A. Boyington, Ph.D., M.P.H., R.N., Lori Carter-Edwards, Ph.D., M.P.H., Mark Piehl, M.D., M.P.H., and others, in the April 2008 Preventing Chronic Disease 5(2), [Web only.]

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