• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of jnmaLink to Publisher's site
J Natl Med Assoc. Jul 2006; 98(7): 1160–1170.
PMCID: PMC2569457

What women want: understanding obesity and preferences for primary care weight reduction interventions among African-American and Caucasian women.


PURPOSE: To explore attitudes and perceptions of obesity, and identify preferences for weight-management interventions by African-American and Caucasian women who were followed in general internal medicine clinics. PROCEDURE: Surveys exploring these issues were mailed to African-American (n=240) and Caucasian (n=240) women with a BMI of > or =30. MAIN FINDINGS: Caucasian women felt past weight-loss efforts were helped by weight-loss programs significantly more than African-American women (P<0.001); African-American women were more likely to feel that their cultural background contributed to their weight gain than did Caucasian women (P=0.001). African-American women expressed a higher need for one-on-one counseling with their physician (P<0.001) as well as group meetings with the dietician, physician and other women (P=0.004) than did Caucasian women. African-American women also felt it was more important for weight-loss programs to have information on food common to their culture than did Caucasian women (P<0.001). CONCLUSIONS: Differences in cultural background and preferences about weight loss interventions have important policy implications for how the U.S. healthcare system provides care to an ever-increasing multicultural population with a national epidemic such as obesity.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Flegal Katherine M, Carroll Margaret D, Ogden Cynthia L, Johnson Clifford L. Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002 Oct 9;288(14):1723–1727. [PubMed]
  • Flegal Katherine M, Williamson David F, Pamuk Elsie R, Rosenberg Harry M. Estimating deaths attributable to obesity in the United States. Am J Public Health. 2004 Sep;94(9):1486–1489. [PMC free article] [PubMed]
  • Wee Christina C, Phillips Russell S, Legedza Anna T R, Davis Roger B, Soukup Jane R, Colditz Graham A, Hamel Mary Beth. Health care expenditures associated with overweight and obesity among US adults: importance of age and race. Am J Public Health. 2005 Jan;95(1):159–165. [PMC free article] [PubMed]
  • Allison DB, Edlen-Nezin L, Clay-Williams G. Obesity among African American women: prevalence, consequences, causes, and developing research. Womens Health. 1997 Fall-Winter;3(3-4):243–274. [PubMed]
  • Kumanyika SK. Obesity in minority populations: an epidemiologic assessment. Obes Res. 1994 Mar;2(2):166–182. [PubMed]
  • Flynn KJ, Fitzgibbon M. Body images and obesity risk among black females: a review of the literature. Ann Behav Med. 1998 Winter;20(1):13–24. [PubMed]
  • Cachelin FM, Striegel-Moore RH, Elder KA. Realistic weight perception and body size assessment in a racially diverse community sample of dieters. Obes Res. 1998 Jan;6(1):62–68. [PubMed]
  • Wilfley DE, Schreiber GB, Pike KM, Striegel-Moore RH, Wright DJ, Rodin J. Eating disturbance and body image: a comparison of a community sample of adult black and white women. Int J Eat Disord. 1996 Dec;20(4):377–387. [PubMed]
  • Burke GL, Savage PJ, Manolio TA, Sprafka JM, Wagenknecht LE, Sidney S, Perkins LL, Liu K, Jacobs DR., Jr Correlates of obesity in young black and white women: the CARDIA Study. Am J Public Health. 1992 Dec;82(12):1621–1625. [PMC free article] [PubMed]
  • Carter-Edwards L, Bynoe MJ, Svetkey LP. Knowledge of diet and blood pressure among African Americans: use of focus groups for questionnaire development. Ethn Dis. 1998;8(2):184–197. [PubMed]
  • Airhihenbuwa CO, Kumanyika S, Agurs TD, Lowe A, Saunders D, Morssink CB. Cultural aspects of African American eating patterns. Ethn Health. 1996 Sep;1(3):245–260. [PubMed]
  • Johnson Ruth W, Broadnax Pier A. A perspective on obesity. ABNF J. 2003 May-Jun;14(3):69–70. [PubMed]
  • Kahn HS, Williamson DF. Is race associated with weight change in US adults after adjustment for income, education, and marital factors? Am J Clin Nutr. 1991 Jun;53(6 Suppl):1566S–1570S. [PubMed]
  • Shepherd K, Roberts D, Golding S, Thomas BJ, Shepherd RW. Body composition in myelomeningocele. Am J Clin Nutr. 1991 Jan;53(1):1–6. [PubMed]
  • Kumanyika SK, Morssink C, Agurs T. Models for dietary and weight change in African-American women: identifying cultural components. Ethn Dis. 1992 Spring;2(2):166–175. [PubMed]
  • Young DR, Gittelsohn J, Charleston J, Felix-Aaron K, Appel LJ. Motivations for exercise and weight loss among African-American women: focus group results and their contribution towards program development. Ethn Health. 2001 Aug-Nov;6(3-4):227–245. [PubMed]
  • Dietz W. Focus group data pertinent to the prevention of obesity in African Americans. Am J Med Sci. 2001 Nov;322(5):286–289. [PubMed]
  • Karanja Njeri, Stevens Victor J, Hollis Jack F, Kumanyika Shiriki K. Steps to soulful living (steps): a weight loss program for African-American women. Ethn Dis. 2002 Summer;12(3):363–371. [PubMed]
  • Shavers Vickie L, Lynch Charles F, Burmeister Leon F. Racial differences in factors that influence the willingness to participate in medical research studies. Ann Epidemiol. 2002 May;12(4):248–256. [PubMed]
  • Matthews KA, Abrams B, Crawford S, Miles T, Neer R, Powell LH, Wesley D. Body mass index in mid-life women: relative influence of menopause, hormone use, and ethnicity. Int J Obes Relat Metab Disord. 2001 Jun;25(6):863–873. [PubMed]
  • Winkleby MA, Kraemer HC, Ahn DK, Varady AN. Ethnic and socioeconomic differences in cardiovascular disease risk factors: findings for women from the Third National Health and Nutrition Examination Survey, 1988-1994. JAMA. 1998 Jul 22;280(4):356–362. [PubMed]
  • Gordon-Larsen Penny, Adair Linda S, Popkin Barry M. The relationship of ethnicity, socioeconomic factors, and overweight in US adolescents. Obes Res. 2003 Jan;11(1):121–129. [PubMed]
  • Kimm SY, Obarzanek E, Barton BA, Aston CE, Similo SL, Morrison JA, Sabry ZI, Schreiber GB, McMahon RP. Race, socioeconomic status, and obesity in 9- to 10-year-old girls: the NHLBI Growth and Health Study. Ann Epidemiol. 1996 Jul;6(4):266–275. [PubMed]
  • Sobal J. Obesity and socioeconomic status: a framework for examining relationships between physical and social variables. Med Anthropol. 1991 Sep;13(3):231–247. [PubMed]
  • Klesges RC, Klem ML, Hanson CL, Eck LH, Ernst J, O'Laughlin D, Garrott A, Rife R. The effects of applicant's health status and qualifications on simulated hiring decisions. Int J Obes. 1990 Jun;14(6):527–535. [PubMed]
  • Stevens J, Kumanyika SK, Keil JE. Attitudes toward body size and dieting: differences between elderly black and white women. Am J Public Health. 1994 Aug;84(8):1322–1325. [PMC free article] [PubMed]
  • Wilson DB, Sargent R, Dias J. Racial differences in selection of ideal body size by adolescent females. Obes Res. 1994 Jan;2(1):38–43. [PubMed]
  • Kumanyika S, Wilson JF, Guilford-Davenport M. Weight-related attitudes and behaviors of black women. J Am Diet Assoc. 1993 Apr;93(4):416–422. [PubMed]
  • Becker DM, Yanek LR, Koffman DM, Bronner YC. Body image preferences among urban African Americans and whites from low income communities. Ethn Dis. 1999 Autumn;9(3):377–386. [PubMed]
  • Sowers JR, Epstein M, Frohlich ED. Diabetes, hypertension, and cardiovascular disease: an update. Hypertension. 2001 Apr;37(4):1053–1059. [PubMed]
  • Zhang AY, Snowden LR. Ethnic characteristics of mental disorders in five U.S. communities. Cultur Divers Ethnic Minor Psychol. 1999 May;5(2):134–146. [PubMed]
  • Syme SL. Strategies for health promotion. Prev Med. 1986 Sep;15(5):492–507. [PubMed]
  • Sullivan J, Carter JP. A nutrition-physical fitness intervention program for low-income black parents. J Natl Med Assoc. 1985 Jan;77(1):39–43. [PMC free article] [PubMed]
  • Bronner Yvonne, Boyington Josephine E A. Developing weight loss interventions for African-American women: elements of successful models. J Natl Med Assoc. 2002 Apr;94(4):224–235. [PMC free article] [PubMed]
  • Bronson David L, Maxwell Richard A. Shared medical appointments: increasing patient access without increasing physician hours. Cleve Clin J Med. 2004 May;71(5):369–passim. [PubMed]
  • Cohen S. Psychosocial models of the role of social support in the etiology of physical disease. Health Psychol. 1988;7(3):269–297. [PubMed]
  • Wagner EH, Grothaus LC, Sandhu N, Galvin MS, McGregor M, Artz K, Coleman EA. Chronic care clinics for diabetes in primary care: a system-wide randomized trial. Diabetes Care. 2001 Apr;24(4):695–700. [PubMed]
  • Trento M, Passera P, Bajardi M, Tomalino M, Grassi G, Borgo E, Donnola C, Cavallo F, Bondonio P, Porta M. Lifestyle intervention by group care prevents deterioration of Type II diabetes: a 4-year randomized controlled clinical trial. Diabetologia. 2002 Sep;45(9):1231–1239. [PubMed]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...