Racial and Socio-economic Differences in Weight Control and Weight Concern

Racial and socio-economic differences have been identified in a large number of studies of adolescent weight concern. Researchers from the United Kingdom and North America have found that black girls are less likely to perceive themselves as ‘overweight’ or ‘fat’ and to report that they are trying to lose weight than white girls (Story et al 1995; Wardle and Marsland 1990; Serdula et al 1993; Neff et al 1997). There are racial differences in BMI and levels of obesity in adult populations, such that black women are consistently found to be fatter than white women (Kumanyika 1987), and similar weight differences have also been identified in children and adolescents in recent studies (Park et al 2001, Strauss and Pollack 2001).

With regard to socio-economic differences, a number o f studies have reported that weight concern and weight control attempts are associated with higher socio-economic status in adolescent girls using a range of approaches to measuring SES, including household income, parental education and school-level measures (Drewnowski et al 1994; Dombusch et al 1984; Wardle and Marsland 1990; Ogden and Thomas 1999). Not all studies have reported such effects, however (Davies and Fumham 1986, Patton et al 1990), and differences in weight concern may well be emerging during the adolescent years since associations are much stronger in adult women. A study of a representative sample of British adults (Wardle and Griffith 2000) found that women of high SES were significantly more likely to feel overweight, more likely to be trying to lose weight and used a wider range of restrictive dietary practices. Similar results were found in a sample of working adults in the United States (Jeffery et al 1991), where those of higher social status reported a higher prevalence of dieting and a lower dietary fat intake than those of lower status.

Controlling for BMI when looking at weight concern and weight control behaviours generally brings these socio-economic differences into sharper relief, as adult women

Chapter 3: Factors associated with weight concern and weight control

o f higher socio-economic status have a lower mean BMI, and a lower prevalence of overweight and obesity than those of lower SES both in the UK and throughout most developed societies (Prescott-Clarke and Primatesta 1996; Sobal and Stunkard 1989). An inverse association between SES and weight-for-height in adolescents has been reported in some studies (e.g. De Spiegelaere et al 1998; Drewnowski et al 1994; Wardle and Marsland 1990; Buddeberg-Fischer et al 1996) but many others, including most of those using data from the UK, do not report any consistent SES differences in BMI in adolescents (Prescott-Clarke and Primatesta 1997; White et al 1995; West et al 1990; Booth et al 2001). These socio-economic differences in body shape and size seem to be emerging in adolescence and are less pronounced than they are in adult female populations.

A number of possible explanations for the social gradient in weight concern and weight control have been examined in the literature, working on the assumption that demographic differences in behaviours are likely to be mediated (at least in part) by demographic differences in attitudes. Variation in the weight control activities of women of high and low social status does not appear to be due to any SES differences in perceptions o f the ideal weight, since weight ideals do not differ by social class in adults or children (Wardle and Griffith 2000; Ogden and Thomas 1999). Instead it seems probable that high status adult women have less tolerance of deviation from their desired weight. Certainly high status women seem to monitor their weight more closely with more frequent weighing (Wardle and Griffith 2000). Meanwhile a study of weight attitudes in US women found that higher status women would tolerate less weight gain than those of lower status before they initiate weight control (Jeffery and French 1996).

The small body o f research which has been carried out into the associations between SES and the weight attitudes of children or adolescents has been less conclusive. One study o f British primary school pupils reported that children from higher SES backgrounds stigmatise obesity to a greater extent than those from a lower SES background (Wardle et al 1995) whilst another British study (Ogden and Thomas 1999) which used adolescent participants reported the reverse: that the lower status girls were more likely to stigmatise obesity. The latter of these two studies also examined the

Chapter 3: Factors associated with weight concern and weight control

extent to which family weight attitudes and values mediate the association between SES and weight concerns, and suggested that while attitudinal variation accounts for some o f the association between SES and weight concern, there is also an independent effect. Both of these studies, however, had the disadvantages of using school type as a proxy measure of social class, and using only a small number of individual schools. This results in a lack of variation in the measure of social class, and also means that some of the differences attributed to social class could be produced by other, unmeasured, inter­ school differences, since school contexts may have an effect over and above those of social class. Whilst many issues surrounding the mechanisms by which social class influences weight concerns and behaviour are unresolved, it seems likely that high status women and girls inhabit a subculture that places a particularly high value on female attractiveness, and which encourages them to take pains to present an attractive body to the world (Bourdieu 1984). This may leave them vulnerable to excessive body dissatisfaction, and it may also have a role to play in suppressing age-related weight gain in this population in comparison to lower status women, through encouraging higher levels of weight control.