Wednesday, April 1, 2009

Fat or PHAT? Cultural Perspectives of Obesity within the African American Community

There are of a number of health concerns plaguing the public health community. Of these concerns, the issue of obesity within society, specifically within communities of color, is taking on an alarming trend that is arguably characterized as an epidemic among public health professionals. Obesity is a label for the range of weight greater than what is widely considered as healthy for a given height. Obesity ranges are determined by using weight and height to calculate the “body mass index” or BMI. For most people, BMI is used because it correlates with the amount of body fat a person has. An adult who has a BMI of 30 or higher is considered obese. Obesity may also refer to the range of weight corresponding to increased likelihood of certain diseases, including a variety of other health problems. Obesity affects all races and ethnic groups in the United States. According to the Food and Drug Administration (FDA), approximately two-thirds (64%) of all Americans are overweight; and about 30% are obese. An estimated 400,000 deaths are attributed to obesity, annually. According to a study conducted by the Robert Wood Johnson Foundation (RWJF), the childhood obesity rate has more than doubled between 1980 and 2004, with 14% of 2-to-5 year olds and 19% of 6-to-11 year olds classified as obese by 2004. Obesity increases the risk of several types of chronic disease (i.e. diabetes, heart disease); therefore, obesity at all ages is of concern. Studies have demonstrated that children who are obese are most likely to remain obese during adulthood. As a result of this, it is important to take pro-active measures to alleviate pediatric and adult obesity. One effort that is often undermined is the study of cultural perceptions attributed to obesity. African American communities have higher incidence of overweight and obesity compared to the Caucasian population. Efforts need to be focused on perceptions of obesity within the African American community and educational methods of preventing obesity. Prevention strategies should focus on basic lifestyle changes such as eating behaviors and activity patterns, including programs that specifically focus on preventive pediatric obesity.

Evidence suggests that there are racial differences in weight and body image perceptions. A recent study released by the Journal of Advanced Nursing compared perceptions of body image and weight between Black and White women. Results suggested that “Black American participants defined obesity in positive terms, relating it to attractiveness, sexual desirability, body image, strength or goodness, self-esteem and social acceptability.” White Americans expressed an opposing view, defining obesity in negative terms, such as unattractive, socially unacceptable, further associating obesity with a negative body image and decreased self-esteem. Study findings affirm that ideal weight is often based on cultural criteria—an important factor in resolving obesity within the African American community. In a study entitled, Attitudes toward Body Size and Dieting: Differences between Elderly Black and White Women, researchers found that Adult African-Americans are less likely to perceive overweight is a problem. Furthermore, National data presents evidence that dieting/weight loss attempts are less common among African Americans than Whites.

An in-depth look into the African American culture exemplifies the attitudes toward obesity among members of this community. One example is the use of the term “phat” among members of the African American community to describe body images that would otherwise be considered overweight or obese. Phat is an alteration of the word fat, dating as far back as the 80s, when its slang use became popular as an adjective for positive elements within hip hop culture. The word phat has positive connotations for members of the African American community. In other words, “phat” is an adjective used among members of the African American community to suggest one’s approval of something. On the subject of body size/image, phat contains a dual meaning: (1) an acronym meaning: Pretty, Hot, and Tempting (2) Pretty, Hot, and Thick, referring to “the sexiness in a woman,” in reference to her body silhouette. The term is common among the teenage population within the African American community, an important cultural aspect for targeting pediatric obesity. When evaluating a program that addresses the cultural perspective of obesity among the African American population, it is important that the program addresses the issue in a way that appears attractive to the current pop culture so that there is affinity toward the program.

Insight into the possible nature of cultural attitudes towards obesity and research, regarding nutritional anthropology, within the African American community are significant factors. The factors assist in deciding the necessary mechanisms to alleviate the epidemic obesity across a variety of cultural activities. Overweight and obesity place a significant impact on the overall health of one’s community. Cultural perspectives have huge implications for public health; therefore, this issue should be addressed as such. As aforementioned, African Americans, when compared to Whites, are less likely to participate in exercise or weight loss communities. As a result of this, it is important that programs that focus on healthy lifestyles and promote healthy body images, as opposed to BMI, to achieve the ideal weight and health status for this community. Furthermore, programs should address the socio norms of obesity within the Black community as they pertain to adult and childhood perceptions of body size and image.

As incidence rates of obesity continue to rise among members of the African American community, there have been a number of programs that attempt to challenge the acceptance of bigger body images by promoting a healthy living program which incorporates the pop culture and cultural perception of obesity among members of the Black community.

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