This paper analyzes obesity as a socioeconomic and cultural phenomenon rather than solely an individual health failure. It argues that disparities in obesity rates among African Americans stem from unequal access to resources, neighborhood conditions, and the imposition of Western health standards that do not account for cultural variations in body image and wellness. The paper examines obesity through individual, cultural, and institutional lenses, drawing on research by Mary Davidson and others to show how different cultures define and perceive obesity differently. It concludes that addressing obesity requires systemic changes—including food access, safe environments, and culturally competent healthcare—rather than relying on personal responsibility narratives that blame individuals for circumstances shaped by structural inequality.
According to the Centers for Disease Control and Prevention, being overweight and obese are both labels for ranges of weight that are greater than what is generally considered healthy for a given height. Obesity can cause other health problems as well. The CDC reported in 2014 that obesity remains more prevalent among African American adults compared to adults from any other social group. This paper analyzes the social foundations of obesity, recognizing that eating habits alone are not the main reason for being overweight. There are numerous reasons why African Americans have higher rates of obesity, including genetic predisposition, environment, and psychological factors such as motivation to address weight gain. This analysis discusses socioeconomic influences on obesity at the individual, cultural, and institutional levels, providing background on mainstream theory and examining cultural pluralism and conflict theory.
Black individuals are more likely to be identified as obese regardless of economic status. However, in poor neighborhoods, socioeconomic factors play a significant role in obesity rates. Poor communities typically have higher rates of fast food advertisements and greater availability of unhealthy substances such as alcohol and drugs. Possible outcomes of obesity include heart disease, diabetes, and other weight-related health problems. The individual is influenced by the society they live in. In contemporary society, being overweight is often associated with uncleanliness, immorality, laziness, and self-hatred. Blame is frequently placed on individuals, with claims that overweight people lack self-control or do not exercise enough. However, what a person eats and their activity level do not always correlate directly to body size.
In poor Black communities, higher obesity rates reflect structural barriers rather than individual failings. There is often a lack of variety in fresh produce and access to whole food stores. Healthy foods are more readily available in wealthier communities, while fast-food restaurants concentrate their advertising in lower-income areas. Eating unhealthy food is cheaper than purchasing nutritious alternatives. Additionally, there are fewer safe places to walk and play or exercise for both children and adults in poorer communities. When individuals face pressure from their circumstances, they may accept their situation and lack the motivation or opportunity to strive for better nutrition, becoming malnourished in the process.
When examining obesity in individuals, multiple factors must be considered: finances, neighborhood conditions, genetics, daily activity levels, occupation, and more. The mainstream theory suggests that obese people prefer to eat and are lazy. However, looking across multiple cultures reveals different views of obesity, which will be discussed further. There is a conflict between the common perception that obese people simply eat too much and the reality that most obese individuals are poor and lack access to healthy food options.
A cultural approach may hold the key to understanding and addressing obesity. Certain cultures view being obese very differently than Western societies do. According to a paper in the British-based Journal of Advanced Nursing, "Health professionals need to use more than tape measures and scales to define and tackle obesity." A research review by Mary Davidson from Yale University discovered that many women do not associate high weight with poor health, and that culture plays a significant role in how they perceive themselves.
Davidson reviewed published papers to examine how health professionals and Black and White American women define obesity and to identify differences in attitudes. Health professionals typically used quantitative methods such as Body Mass Index measurements based on height-to-weight ratios, whereas women were more likely to base their ideal weight on cultural criteria.
Davidson stated: "My review revealed that Black American participants defined obesity in positive terms, relating it to attractiveness, sexual desirability, body image, strength or goodness, self-esteem and social acceptability. In addition, they did not view obesity as cause for concern when it came to their health." White Americans, by contrast, expressed the opposite view. They defined obesity in negative terms, describing it as unattractive, not socially desirable, and associated with negative body image, decreased self-esteem, and social unacceptability.
Fat studies scholar Kwan elaborates on this point: "I am trying to get students and audiences to understand that there are competing cultural meanings about the fat body. Fat does not, in itself, signify unhealthy and unattractive. These are cultural constructions. We as a society say what it means to be fat, and right now cultural discourses say it's ugly and unhealthy to be fat. It's also assumed that the body is a reflection of the psyche, including one's moral fiber." This observation underscores that obesity standards are not universal truths but rather products of specific cultural and historical contexts.
Healthcare systems are dominated by views not centered on the ideals and practices of non-white groups. Most health professionals use the Body Mass Index to measure obesity, yet there are differing views about what level of BMI constitutes normal weight and what level indicates obesity. The media saturates society with images of thin bodies in magazines and television. Thousands of pharmaceutical advertisements claim to help people lose weight and promise improved health. However, this ideal is primarily promoted in first-world countries, especially America. Other groups, such as Africans and Samoans, view larger body sizes as beautiful or normal.
Historically, White populations controlled definitions of what was viewed as good, true, and beautiful. As a result, the term "obese" may be misapplied because it does not align with the health perspectives of all groups. It is important for women in particular to maintain a certain amount of weight on their hips and thighs to prevent certain health issues. Institutional standards fail to account for these biological and cultural realities.
The prevalence of being overweight among African Americans is undeniable. Fast food consumption and limited access to whole food stores in lower socioeconomic areas have contributed to higher concentrations of overweight people in these communities. But is this inherently bad? Not necessarily. As stated earlier, different groups of people view obesity in various ways. In Jamaica, for example, there is a higher chance of overweight people developing diabetes. However, their culture dictates that women must be larger to be viewed as beautiful.
Davidson also discusses the historical origins of obesity definitions, revealing: "The concept of obesity in the United States appears to date back to the insurance industry, which published tables in 1912 defining average and acceptable weights for American adults. The standards were updated in 1959 with average weight being replaced by ideal weight and obesity being defined as 20 percent above this figure. That change put 40 percent of American women in the seriously overweight category." This historical shift demonstrates that obesity categories are constructed, not discovered.
A case study illustrates this cultural conflict: A family physician presented the case of an overweight woman with diabetes. After starting her on metformin, she returned considerably distressed about having lost weight. Despite the physician's explanation that her diabetes was now under control and her blood pressure had improved, she remained unconvinced about the treatment's benefits. To her, losing weight equated directly with being unhealthy and "less sexy" to her husband. This example reveals the disconnect between medical definitions and patients' lived experiences and cultural values.
Is this an inequality and an inequity? Yes, both. There is a disparity in available resources to poorer communities—more processed foods and fewer fresh foods. Income dictates what people can afford to eat. Some families must balance the dilemma of quantity versus quality when feeding their families. Not all families have access to the same resources. There is a difference in availability of food and wellness resources, and many things cost money. The inequity emerges because of the negative health effects on individuals. The World Health Organization recognizes obesity as both a health condition and a social issue shaped by unequal access to resources.
"Systemic change and healthcare competence matter more than individual willpower"
If everyone had a healthy lifestyle, all or almost all of us would be within the weight range the government currently defines as healthy or normal. This is perhaps the most pervasive and scientifically unsupported myth of all. In fact, we have every reason to believe that a very large proportion of the population cannot and indeed should not try to maintain anything like what is defined as normal weight.
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