All ETDs from UAB

Advisory Committee Chair

Olivia Affuso

Advisory Committee Members

Jamy D Ard

Mark Beasley

Jose R Fernandez

Virginia Howard

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Public Health


Obesity not only increases risk for morbidity/mortality, but also impacts the quality of life of obese individuals. In the United States, black women have the highest prevalence of obesity of any other group with approximately 80% of black women over age 20 having a body mass index (BMI) ≥ 25 kg/m2. We aimed to examine the association between weight and quality of life in this high risk population and compare it to weight-related quality of life in white women using the Impact of Weight on Quality of Life (IWQOL)-Lite questionnaire. Data for 343 women were analyzed (172 black, 171 white). The mean age and BMI of participants was 40 years and 35.6 kg/m2, respectively. The mean IWQOL-Lite total score was 74.3; black and white women had IWQOL-Lite scores of 81.6 and 66.9, respectively. Hierarchical linear regression models revealed a significant BMI-by-race interaction indicating that the relationship between BMI and IWQOL-Lite score was modified by race. Subgroup analyses were conducted on 150 black women to examine the role of body image in the relationship between BMI and IWQOL-Lite scores. Using the Pulvers Figure Rating Scale, participants were shown a series of nine body figures (1=smallest) and asked to select which figure most closely resembled her current body size (BIcurrent) and which figure reflected her ideal body size (BIideal). Body discrepancy (BD), a surrogate measure of body image dissatisfaction, was calculated from BI responses (BD = BIcurrent-BIideal). Participants' current perception of body image was larger than their ideal body image (BIcurrent= 6.0 ±€ 1.4 vs. BIideal= 3.7 ±€ 0.9). Tests for mediation indicated that BD partially mediated the relationship between BMI and IWQOL-Lite scores in this sample. This study supports the hypothesis that obesity is associated with reduced quality of life in women. Our findings also suggest notable psychological differences regarding weight in black and white women. Differences in the mentality of black women regarding weight suggest the need for different approaches to promote seeking and maintaining a healthy body size. Additional research is needed to understand how to incorporate the weight perspectives of black women into weight management messages and interventions.

Included in

Public Health Commons



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.