Overweight and Obesity among Women in rural Dominica: Models of body fat, attitudes, and social networks
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Globally, overweight and obesity represent major threats to public health as they put individuals at risk for the development of non-communicable diseases such as diabetes milletus and hypertension. Shifting lifestyles and cultural models of body fat may contribute to rates of overweight and obesity. Using a mixed-methods approach, this body of research investigates the state of overweight and obesity in a rural community in the Commonwealth of Dominica. Four trips between 2008 - 2013 were made to the study site. The study population includes 108 women, ages 18 - 82. First, an ethnomedical perspective was assessed to understand the local model of body fat. Following, a standardized psychometric scale, the attitudes towards obese persons scale (ATOP) was used in order to measure anti-fat attitudes. Due to the near human universal propensity to gain weight, a context-specific perspective is helpful to gain a greater understanding of rising rates of overweight and obesity. Because overweight/obesity is known to cluster in social networks, the notion of overweight/obesity acting as a social contagion was investigated via communication networks of female residents. Results indicate that rural Dominican women decipher two 'types' of body fat: hard versus soft. The former is considered a healthy type of fat representing vitality while the later is considered shoddy and unsightly. This ethnomedical model 'competes' with biomedical understandings of overweight and obesity as risk factors for the development of non-communicable diseases such as diabetes milletus and hypertension. Because residents identify 'sugar' (i.e., diabetes milletus) and 'pressure'' (i.e., hypertension) as the two top health issues, it's important to interpret local models of body fat as they do not map onto biomedical realities of elevated levels of adiposity. Regarding anti-fat attitudes, results indicate that rural Dominican women display more extreme attitudes than study populations in the U.S. and Peru. Given the relaxed view of body image in rural Caribbean communities, these results are rather surprising indicating a prevailing shift of globalizing fat-stigmatizing attitudes. Lastly, overweight and obesity appear to act as a social contagion and 'spread' via female social networks. These findings are on par with other study populations. The upshot of the results may be used in public health efforts to prevent and manage overweight and obesity among female social networks as positive behaviors may cluster in the ways that deleterious behaviors do.