Models for dietary and weight change in African-American women: identifying cultural components.

This paper explores cultural factors that potentially influence the effectiveness of weight-control programs for African-American women and attempts to challenge the perception that such programs operate in a culture-free context. The prevalence of obesity and related chronic conditions is notably higher among African-American than among white women. A larger net weight gain during adulthood among African-American women is associated at least in part with a lesser likelihood of losing weight. Evidence from clinical trials also suggests that African-American women have difficulty in losing weight. Cultural variables are thought to limit the intensity of weight-loss motivations among African-American women, but it is also possible that unrecognized cultural variables within behavioral weight-control programs limit their applicability to persons who do not fit a typical middle-class white American prototype. Many perspectives that differ between African-American and American cultures are directly relevant to the tasks and expectations involved in conventional behavioral therapy. Thus, efforts to make programs culturally appropriate for African-American women may need to go beyond superficial adaptations (eg, logistical accommodations) toward a behavioral analysis of weight control as it is likely to be approached by African-American women within their cultural context.