Hektoen International

A Journal of Medical Humanities

A culpable culture: underlying factors in obesity among Hispanic women

Sarah Bahr
Indianapolis, Indiana, USA

 

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La maja vestida, c. 1803, Francisco Goya

The modern obesity epidemic is an extensive, and growing, problem worldwide. According to The American Journal of Clinical Nutrition, the 2012 National Health and Nutrition Examination Survey found that the obesity rate doubled among adults and the number of overweight children tripled between 1982 and 2002 (Fisler and Warden 473). And with this rising obesity rate has come increases in a variety of health problems: hypertension, type 2 diabetes, and sleep apnea, among others, all symptoms of a marked decline in the welfare of the human population (Gil Extremera et al. 133). The obesity problem is especially serious among members of the Hispanic community. In fact, a Centers for Disease Control and Prevention (CDC) report found that “Latinos had the second highest prevalence of obesity in the United States, meaning that this group is 20% more likely to be obese than non-Hispanic whites” (qtd. in “Los latinos y la obesidad”).

Some of the greatest victims of this trend are the traditional stewards of the Hispanic family: women. According to the CDC report, “78% of Mexican-American women are overweight compared with only 60.3% of non-Hispanic White women” (qtd. in “Los latinos y la obesidad”). The report leaves no doubt that Hispanic women are disproportionately affected by the obesity epidemic in comparison with their white counterparts. But why?

One proposed explanation for the Hispanic obesity epidemic in general is, in the words of Joseph McCormick, the dean of the University of Texas’ School of Public Health, “a combination of lifestyle, genetics, and socioeconomic status” (Capobres). But the results of a study conducted by Rachel Kimbro et al. with regard to the differences in the obesity rates between white, black, and Hispanic children in The American Journal of Public Health found that “White-Hispanic and Black-Hispanic differences in overweight prevalence rates were not explained by socioeconomic, health and household, or parenting characteristics” (298). Accordingly, the study suggests that future analyses of factors contributing to the obesity epidemic in the Hispanic world should primarily examine cultural factors.

After examining the contributions of a variety of cultural factors, five primary culprits of the disproportionately high rate of obesity among Hispanic women emerge: (1) the heavier ideal body of the Hispanic world, (2) a distorted and inaccurate body image, (3) food consumption patterns derived from this heavier ideal body, (4) the poor nutrition of traditional Hispanic food, and (5) the marital and social expectations of Hispanic women. These five cultural factors are the biggest issues underlying the obesity epidemic among Hispanic women, and have a greater determinant effect than either socioeconomic circumstances or household differences on weight gain among Hispanic women.

The first culprit behind the higher obesity rates among Hispanic women is their different notion of what constitutes an ideal, and healthy, body. In her 2002 study, “Flabless is Fabulous: How Latina and Anglo Women Read and Incorporate The Excessively Thin Body Ideal Into Everyday Experience,” Robyn Goodman outlines the contrast between Anglo and Latina women’s views of the ideal female body. She notes that “The women described the current ideal body shape in fashion magazines as ‘thin and tall’ (Anglo), ‘big breasts’ (Anglo), ‘anorexic’ (Latina), and ‘skinny with muscles like Jennifer Aniston’ (Latina)” (715). Goodman’s findings demonstrate that what is popularly known as ‘the curvy ideal’ for women is more common in the Hispanic world than the white one, an ideal reinforced by female Hispanic celebrities and Hispanic music. Each time a curvy celebrity appears on the cover of Latina magazine, it sends a message to Hispanic girls that the world thinks their bodies should look similar, and these young women then try to embody an ideal that is not necessarily healthy for them.

While the curvy female figure is a basic element of Hispanic culture, there are simultaneously health risks inherent in this ideal. Elma Dieppa, a Hispanic woman quoted in a 2013 CNN article on this topic, offered some insight as to the nature of the problem: “The problem within the Hispanic community . . . [is that] we love our curves, but the line between beautiful and deadly curves is blurred” (Rodriguez). Dieppa’s statement attesting to the value of a curvy figure for Hispanic women is reinforced by the conclusion reached by Emily Massara in her book ¡QuéGordita!: A Study of Weight Among Women in a Puerto Rican Community. Massara notes that in the community of Puerto Rico, “Weight gain is not viewed in a negative light as a result of the valuation on weight gain as a tangible sign of health and ‘tranquility’” (292). This positive association between health and weight gain is deeply rooted in Hispanic culture, and extends as far back as childhood.

However, a heavier ideal body is not the only perception problem contributing to the obesity epidemic among Hispanic women. Numerous studies have demonstrated that many Hispanic women also possess distorted and inaccurate body images, and consequently have difficulty perceiving their own true weights. In a 2013 study conducted by Elsa-Grace Giardina et al. in the Journal of Women’s Health, researchers found that Hispanic women were less likely than white women to correctly estimate their own weights (69.4% to 82.9%, respectively), and that 48.5% of overweight Hispanic women compared to 12.7% of non-Hispanic women underestimated their weights (if the woman was obese this gap grew to 17.2% for Hispanic women compared to 0% for non-Hispanic women) (1009). The problem is a circular one for Hispanic women: their ideal body is unhealthy, and as a result of their adherence to this cultural ideal they become overweight, leading to a higher incidence of overweight women in the Hispanic world, a circumstance which only further reinforces the same ideal.

Another reason for the disproportionately high rate of obesity among Hispanic women is the “clean-your-plate,” generous pattern of consumption that is characteristic of traditional Hispanic culture. This lifelong dietary pattern has its roots in infancy, as Hispanic culture considers a well-fed child to be a sign of prosperity, as well as a signal to others that the child’s parents are able to afford enough food for him or her (Martinez et al. 230). Along these lines, since Hispanic culture considers mothers who provide a large quantity of food for their children to be good parents, mealtimes may even become a social competition of sorts among mothers (Martinez et al. 234).

Massara’s findings in ¡QuéGordita! reinforce the centrality of food to Hispanic social life, and Massara further extends the classification of a “good parent” to a “good wife.” In Puerto Rican society, Massara notes that mothers profess to express their love for their husbands and children by doling out generous portions of food, and expressing concern with the quantities of food consumed by family members (171). Because of this social expectation, many of Hispanic women’s efforts to institute measures to combat their own excess weights, or those of their families, would be derided as socially unacceptable by Hispanic culture, that is, if a mother were even brave enough to attempt these efforts in the first place.

Massara’s ideal Hispanic woman, eager to prove that she is a good wife, may also cook traditional Hispanic foods that leave her and her family feeling full, but are high in carbohydrates and fat (294). Poor nutrition is a common problem with the traditional Hispanic diet, and while individual foods are not necessarily excessively unhealthy, according to Dion Begay of the University of Arizona, “while most Latinos have high fiber diets, they also have high fat diets, and what they lack is many fruits and vegetables to balance out the calorie intake.” The American Diabetes Association (ADA) reports that many Latin American foods also incorporate beans, rice, or tortillas as bases, all of which are very high in carbohydrates. However, according to the ADA, Hispanic foods are less to blame for the obesity epidemic than the methods used to prepare them. The ADA reports that often the methods used to prepare Latin American foods add unhealthy amounts of fat and salt to dishes (“Do Latino Foods and Diabetes Mix?”). This combination of an unbalanced diet and the consumption of foods rich in carbohydrates and fats makes it very difficult for Hispanic women to maintain a healthy weight.

Finally, the biggest obstacle to maintaining a healthy weight for a Hispanic woman may be the person who loves her the most: her husband. In her study of Puerto Rican women, Massara observed a 47.3% increase in female obesity among women aged 26 to 39 compared to women above or below this age bracket. Massara describes the time between ages 26 and 39 as a time when weight gain has “many positive connotations” in Puerto Rican society (293). She found that it was customary for husbands to encourage their wives to gain weight after marriage as a signal, particularly to the bride’s family, that he was adequately providing for her (200). She discovered that the wives she studied complied with the wishes of their husbands “because of a strong wish to please . . . and thereby demonstrate [their] respect for [their husbands]” (200).

Many Hispanic women are similarly trapped in difficult situations that force them to choose between complying with cultural norms and prioritizing their own physical health. And for many of these women, putting their health first is out of the question. Massara summarizes this sentiment when she says that for Latinas, “concerns about weight for its effect on [their] appearance are incompatible with the important self-concept of the ‘good wife’ and mother whose primary concern is the nurturance and care of her family” (295). The efforts of Hispanic women to maintain a healthy weight are thwarted by cultural expectations that require them to comply with this family-first attitude, and also as a result of their desire to simultaneously be both good mothers and loving wives.

It is not easy for Hispanic women to combat the obesity epidemic when their own culture reinforces it so strongly. Since childhood, Hispanic women learn that they should eat plenty of food in order to grow strong and healthy and prove that their parents are taking good care of them. Then, in adulthood, these same women are encouraged by Hispanic society to gain weight as evidence that their husbands are adequately providing for them. In their daily lives, Hispanic women have to overcome five primary culture-specific obstacles with regard to obesity: the Hispanic curvy ideal, inaccurate and distorted perceptions of their own weights, food consumption patterns that prize a clean plate, the high amount of saturated fat and carbohydrates present in traditional Hispanic food, and the marital and social expectations of Hispanic culture.

In light of the fact that the obesity epidemic among Hispanic women has a cultural origin and a childhood basis, it is important to begin intervention efforts early in life, and to employ intervention strategies specific to Hispanic culture. One such strategy is to teach Hispanic parents that it is more important for their children to be “healthy and strong” than “big and strong.” According to a 2013 CNN article, the ADA recently launched a campaign called “Portufamilia” with the goal of combating the family-first mentality of many Hispanic women by telling these women that they need to be healthy if they want to be there for their families (Rodriguez). Efforts such as this one are small, but nevertheless important, steps forward, because unless a massive change occurs in Hispanic culture in the near future, the obesity problem does not look as though it will be going away any time soon. In light of this tremendous challenge, it is encouraging to remember that, while old habits die hard, it may be easier to bring about significant change if, in the famous words of an unknown sage, people “take it one step at a time.”

 

References

  1. Bayles, Bryan. “Perceptions of Childhood Obesity on the Texas-Mexico Border.” Public Health Nursing 27.4 (2010): 320-28. Web.
  2. Begay, Dion. “Why Should Latinos Be Concerned?” Arizona State University. Arizona State University, 2005. Web. 17 Nov. 2014.
  3. Capobres, Kacy. “Combating Diabetes and Obesity in the Latino Community in Texas.” FOX News Latino. FOX News, 17 Jan. 2013. Web. 17 Nov. 2014.
  4. Fisler, Janis, and Warden, Craig. “Genetics of obesity in Hispanic children.” The American Journal of Clinical Nutrition84.3 (2006): 473-74. Web.
  5. Giardina, EG, et al. “Cardiovascular disease knowledge and weight perception among Hispanic and non-Hispanic white women.” Journal of Women’sHealth 22.12 (2013): 1009-15. Web.
  6. Gil Extremera, B., Gómez Jiménez, F.J., and Soto Más, J.A. “Hipertensión refractaria: Obesidad y síndrome de apnea del sueño.” Hipertensión22.3 (2005): 133-38. Web.
  7. Goodman, Robyn J. “Flabless is Fabulous: How Latina And Anglo Women Read and Incorporate The Excessively Thin Ideal Into Everyday Experience.” Journalism & Mass Communication Quarterly 79.3 (2002): 712-27. Web.
  8. Kimbro, Rachel Tolbert, Brooks-Gunn, Jeanne, and McLanahan, Sara. “Racial and Ethnic Differentials in Overweight and Obesity Among 3-Year-Old Children.” The American Journal of Public Health 97.2 (2007): 298-305. Web.
  9. Martinez, Suzanna, et al. “Maternal Attitudes and Behaviors Regarding Feeding Practices in Elementary School-Aged Latino Children: A Pilot Qualitative Study on the Impact of the Cultural Role of Mothers in the US-Mexican Border Region of San Diego, California.” Journal of the Academy of Nutrition and Dietetics 114.2 (2014): 230-37. Web.
  10. Massara, Emily Bradley. ¡QuéGordita!: A Study of Weight Among Women in a Puerto Rican Community. New York: AMS Press, 1989. Print.
  11. Rodriguez, Cindy. “Beautiful but deadly: Latinos’ curves put them at risk.” CNN Health. Cable News Network, 17 Oct. 2013. Web. 17 Nov. 2014.
  12. “Do Latino Foods and Diabetes Mix?” My Food Advisor. American Diabetes Association, n.d. Web. 17 Nov. 2014.
  13. “Los latinos y la obesidad: Consejos para una vida saludable.” PR Newswire. PR Newswire Association, 9 Sept. 2014. Web. 17 Nov. 2014.

 


 

SARAH BAHR an IUPUI sophomore pursuing majors in English Writing and Literacy, Journalism, and Spanish with minors in English Literature and Women’s Studies.

 

Highlighted in Frontispiece Volume 9, Issue 4 – Fall 2017

Spring 2016  |  Sections  |  Food

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