Describing the Cultural Perceptions of Weight and Perceived Body Size with Obese African American Women: A Descriptive Focused Ethnography

African American women (AAW) have the highest incidence and prevalence of obesity among all cultural groups in the United States. Understanding cultural factors which influence perception of body size and ultimately impact decisions by obese AAW to lose or manage their weight is essential in ultimately designing culturally appropriate interventions. Gaining insight into the core cultural perceptions and factors that influence acceptable body size is imperative to furthering scientific knowledge with obese AAW. Larger body sizes for women are often culturally accepted and perceived as attractive and desirable within the African American community. Self-definition and self-worth, concepts found in Black Feminist Theory, play a pivotal role in the perceptions that obese AAW have about weight loss and weight management. The interconnectedness of the two concepts provided a strong basis for this qualitative research design to examine how these concepts may influence perceptions of acceptable body size among AAW. The purpose of this study was to describe the cultural perceptions of weight and ideal body size with obese AAW from an emic or insider's perspective. A focused ethnographic perspective was used to describe obese AAW's cultural norms about perceived body size and describe obese AAW's self-definition and self-worth that relate to perceived body size. A sample of eight obese AAW was recruited for the study. Data collection included: (a) individual interviews; (b) participant observation; and (c) field notes. The overarching theme derived from the data was "I'm Ok with Me." There were four subthemes that supported the overarching theme. They included: (a) acceptance of heavier body size by others; (b) acceptance of heavier body size by self; (c) cultural foods that impact heavier body size; and (d) sedentary lifestyles that impact heavier body size. The overarching theme lays a foundation for nursing towards cultural competency with obese AAW. Future studies are needed to further evaluate perception of body size and how obese AAW culturally define themselves and define their self-worth in relation to perception of body size