Using the PRECEDE-PROCEED model as a conceptual framework, this exploratory, descriptive study examined how the prevalence of obesity in African-American women is related to their body size values and perceptions of overweight, and whether these values and perceptions are culture-bound. Face-to-face interviews were conducted in health care sites, participants' homes and work sites. Using a semi-structured interview guide and a body size values tool, each participant was asked to indicate which body size she and her significant others considered to be most attractive for herself and women in general.

The 42 African-American women in this study represented a wide range of ages, incomes, educational backgrounds, and weights. Based on body mass indices, participants were assigned to one of three weight categories: normal, overweight, or severe overweight. Statistically significant differences were noted among the weight categories for income, education, and number of pregnancies. Sixty percent of the participants indicated a preference for the two smallest body sizes for themselves, and 74% of the participants considered these same body sizes as most attractive for women in general. Of the women who indicated that at least one significant other cared about their weight, 55% selected the same two smallest body sizes as what they assumed their significant others would prefer for them and as most attractive for women in general. Although 67% of the participants were either overweight or severely overweight, only 7% ever recalled a health professional discussing weight as a risk factor prior to their actually being diagnosed with a weight-related disease.

The study demonstrated that African-American women, as well as their significant others, appear to espouse biomedical standards as their own weight preferences. The study also indicated a great need for health professionals to develop culturally sensitive methods of approaching issues related to the risks and treatment of overweight.