Abstract
Background: Both health and health behavior are highly influenced by cultural attitudes towards body size. However, the body size of preference and the degree to which body size dissatisfaction occurs in African-born Blacks living in the United States is unknown. Methods: To address this data gap, height and weight were measured, and BMI calculated in 412 African-born Blacks living in the Washington, DC area (female: 42% (174/412), age 39±11y (mean±SD), range 20-69y, range, BMI 27.9±4.6kg/m 2 , range 19.5-47.3kg/m 2 ). The Stunkard Figure Rating Scale was used to assess both body size preference and body size dissatisfaction. The Stunkard scale has 9 silhouettes which correspond to four BMI categories: Underweight: 1-2; Normal-Weight: 3-4; Overweight: 5-7; Obesity: 8-9. Participants chose the silhouettes which corresponded to their perceived BMI and to their ideal BMI. Body size dissatisfaction was calculated as the difference between perceived and ideal BMI. Results: Women had a higher BMI than men (29.1±5.0 vs. 27.0±4.2, P <0.001). As their ideal body size, 75% (131/174) of women and 60% (143/238) of men chose the two silhouettes in the normal weight BMI category, specifically 3 or 4. However, silhouette 4 was chosen more often than silhouette 3 (61% vs. 39%, P <0.001). In addition, and very importantly, as their body size of preference, no participant chose silhouettes in the obese BMI category. Overall, body size dissatisfaction occurred in 75% (309/412) of participants with women being more dissatisfied than men (84% (146/174) vs. 69% (164/238), P <0.001). Dissatisfaction due to feeling too large occurred in 63% (260/412); whereas dissatisfaction due to feeling too small occurred in 12% (49/412). Mean BMI in participants who were dissatisfied because they were too large was: 29.8±4.3 kg/m 2 . Whereas mean BMI in participants who were dissatisfied because they felt too small was: 23.1±2.8 kg/m 2 . Silhouettes of preference in 74% (36/49) of the participants who thought they were too small were 4 and 5. Conclusion: Neither high nor low BMI categories were valued by the participants. Overall, the majority of African-born Blacks living in the United States preferred a body size in the normal-weight BMI range.
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