Research roundup: Obesity
by Practice Research & Policy Staff
May 31, 2010 — With at least 400 million obese individuals worldwide, obesity is a critical health problem. (World Health Organization & International Obesity task force, 2005). According to 2006 data summarized by the World Health Organization, 35 percent of the U.S. population is considered obese, while another 32 percent is overweight. Black Americans and Mexican Americans have disproportionately higher rates of obesity than white Americans. Obesity is defined medically as a body mass index (BMI) of 30 or greater.
Depression, anxiety, cardiovascular disease, diabetes, hypertension, various cancers, and other health conditions are associated with obesity. Direct care to reduce obesity combined with health care to treat conditions caused by or compounded by obesity may cost as much as $147 billion annually in the United States (Centers for Disease Control and Prevention, 2009).
The Healthy People 2010 report (U.S. Department of Health and Human Services, 2001) identifies obesity as a major public health problem and advocates a healthy diet as the key solution. The report calls for activities and interventions in five settings: families and communities; schools; health care; media and communications; and work sites (U.S. Department of Health and Human Services, 2001). Psychologists can play a key role in the reduction of obesity by facilitating needed behavior changes across settings.
The articles below examine some of the main psychosocial factors associated with obesity, with particular attention on African Americans due to their increased risk: the influence of race/ethnicity, parental food choices, stress, the influence of peer relationships and individuals’ perception of body size.
Sealy, Y. M. (2010). Parents' food choices: Obesity among minority parents and children. Journal of Community Health Nursing, 27, 1-11.Summary
Focus groups were conducted with parents of African American, Caribbean and Latino heritage to examine their perceptions, attitudes, food choices and eating behaviors and how each factor influences the food they provide for their children. The ethnicity and culture of respondents had a significant influence on the foods chosen for their children and those choices reflected, to some extent, respondents’ sense of cultural identity.
Parents from all three cultural backgrounds indicated that multiple demands limited their time to prepare meals resulting in food choices of convenience rather than the healthiest food choices. Some parents were limited by cost and availability in their food choices; for instance, fresh produce is more expensive than processed food and often less readily available in urban neighborhoods.
African American and Latino parents were more likely to prepare foods high in sodium, sugar, starch and/or fats, and to cook by frying in oil, as opposed to baking, broiling or boiling. These less healthy food preparation methods and food choices directly increase the likelihood of obesity both in the parents and their children.Practical considerations
Obese and overweight individuals may not present specifically for problems related to weight but psychologists, in the course of addressing various mental health concerns, may be in the unique position to help individuals change weight-related behaviors. Understanding the factors that influence food choices and attitudes, including the unique role of culture and the limitations of modern life, may enable psychologists to develop more effective strategies for their minority clients who may be dealing with multifaceted issues including depression, anxiety and obesity.
Chandler-Laney, P.C., Hunter, G.R., Ard, J.D., Roy, J.L., Brock, D. W., & Gower, B.A. (2009). Perception of others’ body size influences weight loss and regain for European American but not African American women. Health Psychology, 28, 414-418.Summary
Moderately obese African American and European American women participated in a weight loss intervention program. Measures taken prior to the intervention, as well as at follow up, were aimed at determining whether women’s perceptions of the body size of others were related to their own weight loss and maintenance. Finally, after a year, follow up measures were collected to determine the percentage of body fat and rate of weight loss of each participant.
No significant differences in BMI (body mass index) or weight existed between the European American and African American women at the beginning of the study.
The overweight African American women saw their own bodies as smaller compared with the overweight European American women’s self-perceptions of their bodies. At the same time, the European American women saw the average US woman as smaller than how African American women perceived the average US woman. Consequently, the European American women had a greater discrepancy between their perceived self size and perceived size of others than the African American women.
But only European American women’s self-reported perceptions of other women’s size appeared to be related to their weight loss and maintenance suggesting that body size perceptions are a less important motivator for African American women who are attempting to lose weight.Practical consideration
Psychologists assisting women with weight loss are likely to be more successful if they can capitalize on the impact of women’s perceptions of peers’ weight on the individual’s own attitudes and behaviors related to modifying eating and exercise behaviors. Recognizing the possibility of differential impact of social influences on these behaviors for African American and European American women will allow psychologists to more carefully tailor interventions.
Kim, K.H., Bursac, Z., DiLillo, V., White, D.B., & West, D.S. (2009). Stress, race, and body weight. Health Psychology, 28, 131-135.Summary
A diverse group of overweight and obese women participated in a comprehensive behavioral weight loss program focusing on diet and physical activity. Some women received a motivational interviewing component as well. Additionally, measures examining the relationship between stress, race and body weight were collected. While there were no differences in weight between the African American and White women at baseline, African American women lost less weight over the course of the intervention. Self reported pre-intervention stress levels were significantly associated with weight loss (but not baseline weight). African American women’s self reported stress was higher (the difference almost met significance) than White women’s self reported stress, which may have contributed to African American women losing less weight over the course of treatment.Practical considerations
It appears that perceived stress influences weight loss for all women attempting to lose weight via behavioral methods. Behavioral weight loss interventions that include attention to reduction of stress may facilitate greater weight loss. Given that African American women’s perceived stress was higher (approaching significance), psychologists working with overweight and obese African American women may particularly want to include stress reduction strategies with their weight loss interventions. Even when working with women not explicitly trying to lose weight, psychologists may wish to attend to perceived stress in order to positively impact the potential for healthier behavior.
U.S. Department of Health and Human Services. (2001). The surgeon general’s call to action to prevent and decrease overweight and obesity. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General.
White House Task Force on Childhood Obesity. (2010). Solving the problem of childhood obesity within a generation.