Stress, Spirituality, & Self-Care: Exploring the Relationship Obese & Overweight African-American Women Have with Food

Background and Purpose: Obesity rates among African-American women continue to startle researchers. Current estimates indicate that approximately 80% of all African-American women are considered overweight or obese in the U.S. To date, no intervention has shown an appreciable reduction in weight loss for African-American women. Consequently, African-American women are at an increased risk for heart disease, diabetes, breast cancer, and hypertension. These health problems are unequivocally objectionable, and are further compounded by the complex relationships African-American women have with food.  This study sought to explore the relationship African-American women have with food, and examine cultural coping skills and barriers that impact their continued challenges with weight.

Methods: The following ethnographic study documents the experiences of obese and overweight African American women in their experiences to lose weight. Over a 14 month period, the researcher observed African-American women participating in support/educational group offering a non-diet and spiritual weight loss approach. The setting for observation was an African-American church located in southwestern Pennsylvania and the sample consisted of 25 African-American women. Data collection included use of field notes, interviewing, and historical data documenting previous trends in order to gather key themes and refine previous theories. In order to adhere to the standards set by inductive qualitative research practice, data was continuously analyzed during the study duration so as to identify pertinent themes and patterns.

Results: The results of this study indicated there were several themes that arose to describe the difficulty the women had losing weight: (1) emotion, (2) family ties & learned behaviors, (3) "Superwoman" pressures, and 4) Cultural Barriers. Women found difficulty losing weight because the relationship was a source of comfort and a source that inflicts punishment. Participants also connected their eating experiences to past behaviors inherited from parents. Participants reported carrying pressure to be "strong," and were experiencing stress that made it difficult to make choices to positively impact their health. The palliative use of food was a source of "self-care" the women accepted and felt was reinforced by their African-American culture. In the teaching of the intervention, women appeared to receive hope from their spirituality, and demonstrated comprehension of their faith  as a coping skill that would allow them to make changes in their relationship with food.

Implications and Conclusions: The results of this study indicate obesity rates among African-American women may not be connected to lack of knowledge, but rather, the absence of cultural permission to make necessary changes. Social workers play a vital role in facilitating therapeutic treatments that would serve to increase self-efficacy, stress management, and encourage use of alternative forms of coping. The results from this study suggest that spirituality may buffer these maladaptive food coping strategies and help offset the high obesity rates among African-American women.  Future research should focus on examining the cultural and emotional correlates that impact the obesity epidemic in African-American women, while searching for factors that could mediate or offset negative outcomes.