Body image and socio-cultural context among underserved women enrolled in a weight loss controlled trial

Background: Women from lower socioeconomic backgrounds and African-American women are disproportionately affected by obesity, associated comorbidities and mortality. Body image may be a contributing factor in obesity prevention. Purpose: The purpose of this report is to describe body image perception and body image discrepancy that may impact obesity and weight control among high-risk women. Methods: Women (n=91) enrolled in a community-based randomized controlled trial for weight loss among underserved women were administered a culturally tailored random ordered body image instrument. Participants chose from among nine silhouettes (extremely thin to extremely obese) that matched their current figure, desired figure and significant others' desired figure, as well as a silhouette perceived to represent a health problem. Participants were mostly African American (89%) with ≥ high school education (92%). Mean age was 39.56; Mean BMI was 41.8, range=27.9 -70.4. Results: Silhouette 6, was the modal (25%) choice for current figure, whereas silhouettes 4 and 5 together were the most commonly selected desired figures (68%). Discrepancy scores, the difference between current body figure and desired figure is a measure of dissatisfaction that can range from 0-5; lower scores represent lower discrepancy. 54% scored > 3. Most (67%) identified silhouette 9, the largest, as a health problem. Discussion: African-American women are more likely to be obese and suffer worse health outcomes. Understanding socio-cultural influences of body image perceptions impact on obesity-related behavior change and intervention outcomes represent an important formative step in developing effective tailored strategies especially among some high-risk racial/ethnic minorities.