Weight-related Beliefs, Behaviors, and Social Networks of Obese, Young Adult African- American Women: Implications for Healthy Weight Interventions

Obesity is a public health concern that affects over 30% of Americans. Approximately 78% of African-American women are overweight/obese, as compared to 46% of Caucasian women. Obese African-American women are at higher risk for associated morbidities (e.g., hypertension, type II diabetes, select cancers, and early mortality) as compared to non-Hispanic whites. Weight gain after young adulthood (ages 20-35) is associated with an increased risk of cardiovascular disease and other health problems later in life. Research that seeks to explain, predict, or control obesity among African-American women has focused on individual behavior change. Few studies have addressed the social contexts within which these behaviors occur. The purpose of this exploratory study was to examine the weight-related beliefs, behaviors, and social network characteristics of obese, young adult African-American women. A conceptual framework based on social support and social network theory guided the design of the study. Ten African-American women between the ages of 20 and 35, self-described as “plus-size” or “full-figured,” completed initial informal conversations about weight-related issues and concerns and semi-structured, in-depth face-to-face interviews. Five participants were randomly selected to complete social network profiles to identify potential social influences on weight-related beliefs and behaviors. Results of the initial conversations revealed approximately half of the participants were class III obesity (BMI > 40), reported overall good health, and 70% participated in physical activity at least one day a week. Semi-structured interviews results disclosed two primary reasons for unsuccessful long-term weight loss: (a) inconsistent weight loss behaviors and (b) lack of accountability. Weight-related beliefs and behaviors of study participants were similar to those reported for older adult African-American women. Similarities included (a) mixed levels of body satisfaction; (b) the belief that health is not determined by weight; (c) sedentary lifestyles and; (d) social support from family and friends impacts long-term weight loss success. The five social network profiles indicated participants’ networks are small, comprised of at least two overweight/obese females, and exhibited positive social support behaviors. Social networks included positive, negative, and non-positive relationships. Social support for weight loss is shared among network members through face-to-face interactions, phone conversations, and use of social media tools such as Facebook, Twitter, and text messaging. Future healthy weight studies would benefit from comprehensive analyses of the social networks of obese, young adult African-American women, inclusive of interviews with social network members. Culture-based healthier weight interventions that organize social support networks through social media tools are promising strategies for promoting healthy weight management among obese, young adult African-American women