Cultural approach is key to tackling obesity

New Haven, Conn. -- Culture plays a significant role in how women perceive obesity in terms of both appearance and health, according to a study by Yale School of Nursing researchers in the Journal of Advanced Nursing.

Maryanne Davidson, Yale University School of Nursing, and Kathleen Knafl, Oregon Health and Sciences University, reviewed 20 papers published over 10 years on descriptions of the concept of obesity by health professionals, Black Americans, Latino Americans and Caucasian Americans. Davidson and Knafl found women in general base their ideal weight on cultural criteria.

"Black American study participants defined obesity in positive terms, relating it to attractiveness, sexual desirability, body image, strength or goodness, self esteem and social acceptability," said Davidson. "They didn't view obesity as cause for concern when it came to their health."

White women, on the other hand, defined obesity in negative terms, describing it as unattractive and socially undesirable and associated obesity with negative body image and decreased self-esteem. Davidson said some of these women saw weight as a health issue, while others did not.

"Key health issues related to obesity include diabetes, high blood pressure and cholesterol, asthma and some cancers," Davidson said. "That's why it's imperative that researchers and healthcare providers understand how people from different cultures view obesity. This will help them to promote key messages about the health risks associated with excess weight in a culturally sensitive way."

Davidson also found variation in how health professionals define obesity.

Although most use the BMI to measure obesity, there were different views on what BMI constitutes normal weight or obesity.

"I'm glad to say there is a move towards standardized measurement of what is obese and what is overweight," Davidson said. "For example, the International Obesity Task Force is helping to address the need for a global objective measurement based on BMI."

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The World Health Organization estimates that there are at least 300 million obese people worldwide and another one billion who are overweight. Davidson said rates of obesity range from below five per cent in China, Japan and some African nations to more than 75 per cent in urban Samoa. Recent data suggests that 54 percent of adult Americans are overweight. Women of all cultures are particularly affected.

Journal of Advanced Nursing Vol. xx: pp-pp (date published)


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