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. 2011 Jul;70(7 suppl 1):32–36.

Race/Ethnic Differences in Desired Body Mass Index and Dieting Practices Among Young Women Attending College in Hawai‘i

Susan M Schembre 1,2,✉, Claudio R Nigg 1,2, Cheryl L Albright 1,2
PMCID: PMC3158449  PMID: 21886291

Abstract

In accordance with the sociocultural model, race/ethnicity is considered a major influence on factors associated with body image and body dissatisfaction, and eating disorders are often characterized as problems that are primarily limited to young White women from Western cultures. The purpose of this study was to determine whether there are differences that exist by race in desired body weight; the importance placed on those ideals; and dieting strategies among White, Asian American, Native Hawaiian/Pacific Islanders, and other mixed-race young women in Hawai‘i. A total of 144 female college students 18–20 years of age were surveyed about body weight as well as eating and exercise habits. Results demonstrated that all the young women wanted to lose weight. However, there were no differences in desired body weight or desired weight change by race after controlling for body mass index suggesting that current weight rather than race/ethnicity is the predominant influence on weight-related concerns. Young White women placed the greatest level of importance on achieving a lower body weight, which corresponded with a greater likelihood to be attempting weight loss (dieting) and greater endorsement of behaviors consistent with weight loss compared to their counterparts. Findings imply that, for young women, race/ethnicity may not have as significant an impact on factors associated with body weight ideals as previously believed. Rather, differences in the value placed on achieving a desired body weight, as it relates to disordered eating, should be further explored among race/ethnic groups.

Introduction

Research demonstrates that body dissatisfaction and weight-related concerns play a key role in the etiology of eating disorders1,2 and other psychological disorders including depression,3–5 particularly in young White women. In support of this, the sociocultural model of eating pathology posits that ethnic minority groups have fewer eating disturbances than Whites because there has been less cultural pressure to be thin.6,7 However, weight-related concerns and behaviors consistent with dieting, and an increased risk for eating disorders are now prevalent among adolescents from various cultural backgrounds.8–13 It is believed the drive to be “thin,” commonly referred to as the “Westernized” body ideal, has become an international issue14 due in part to globalized Western media.15,16 It is generally accepted that youth in developed countries are differentially exposed to multimedia messages that can increase the likelihood of developing problem eating and psychological disorders. However, the extent to which young women with various cultural backgrounds are dissatisfied with their bodies is not well understood.

The sociocultural model suggests that factors such as peers, parents, and media play a major role in explaining dieting, issues related to body image, and eating.7,17 In line with this model, race/ethnic identification has been considered a major influence on perceived body ideals with body dissatisfaction and eating disorders often being characterized as problems that differentially affect young White women from Western cultures more than other race/ethnicities.18–20 As a result, a majority of the research in the area has been conducted on samples of White women and girls and there have been fewer studies that have focused on potential differences in perceived body ideals or weight dissatisfaction by race/ethnicity.8 The role of ethnic differences in body ideals among young women living within the United States is of particular interest given the high exposure to thin body ideals in this country. The multicultural nature of the state of Hawai‘i offers researchers rich opportunities to investigate these issues further. Two of the larger ethnic subgroups in the state are Asian Americans and Native Hawaiian/Pacific Islanders who, in the past, have been less likely to aspire to the “Westernized” thin body ideal. Specifically, Asian Americans are consistently shown to be at a lower risk for developing eating disorders given their smaller body sizes, but are more likely to endorse “Western” beauty standards.8,21 Native Hawaiians and Pacific Islanders have typically been the heaviest of the ethnic subgroups in the United States and are more likely to value larger body sizes.22–26 With the ever-changing race/ethnic composition of the United States and the perpetuation of the thin body ideal, research exploring race/ethnic differences or similarities in body weight ideals and other factors known to increase risk for eating disorders is needed.

Guided by the sociocultural model,7,17 the purpose of this study was to determine if there are significant differences in desired body weight and weight control strategies by race among young women attending college in Hawai‘i. This study adds to the limited amount of literature on weight-related issues among young Asian American women and explores the potential shift in changing body weight ideals of Native Hawaiians/Pacific Islanders. Findings will better inform pediatricians and other health care professionals about potential issues around body weight and weight control practices in the multiethnic youth living in Hawai‘i.

Methods

Data Collection

This paper reports findings from a secondary data analysis of previously collected data used to explore the weight history and eating and exercise habits of university students in Hawai‘i. Questionnaire items were collected via an on-line survey supported by SurveyMonkey.com during the Spring semester of 2010 at the University of Hawai‘i at Manoa in the following order: demographics (including race/ethnicity) and data on body height and weight, desired body weight, weight control status, patterns of energy intake (fruit/vegetable intake and dietary fat intake), and physical activity participation. In the original study design, male and female college students of all ages were recruited from two large general education classes comprised predominantly of freshman and sophomore level students. All students were invited to participate in the study for class credit. Data for individuals reporting a prior eating disorder diagnosis, who were possibly pregnant, or reported having medically related dietary restrictions (eg, diabetes) were considered ineligible. A resulting sample of 281 students met eligibility criteria. In the current study the dataset was further limited to include only young women up to age 20 years in accordance with the definition of a child as established by the National Institutes of Health.27 Analyses were not conducted for the young men due to small sample sizes by race/ethnicity, which limited statistical power to detect differences. The final sample included in the following analysis is 144 young women. Protocols were approved by the University's Institutional Review Board.

Measures

Race/ethnicity was assessed by asking, “What is your ethnic or racial background?” and “Do you consider yourself to be Hispanic or Latino?” Eight categories were provided as response options for race based on the race/ethnic composition of Hawai‘i and previously developed surveys.28 Black/African American, White, Chinese, Filipino, Hawaiian, Japanese, Korean, and Mexican or other Hispanic. Students could select multiple race categories and/or write in a category that was not listed as a response option. Approximately 56% of the sample identified themselves as single-race and a maximum of seven race categories were selected by one participant. Only 12% of the sample identified themselves as Hispanic. The race variable coded for this study reflects four main groups: White; Asian (single-race)/Asian mix, including single-race and mixed-race Filipino (Hispanic and non-Hispanic), Chinese, Japanese, Korean, other Asian (eg, Thai and Vietnamese); Native Hawaiian/Pacific Islanders, including all individuals who selected Hawaiian or identified themselves as Pacific Islander (in the “other” category); and all “other mixed races,” which included all other individuals.

Data on body weight status and desired body weight was collected by asking the following questions, “To the best of your knowledge, what do you currently weigh (in pounds)?” and, “How much would you like to weigh (in pounds)?” Students were also asked to report their height with the following question: “To the best of your knowledge, what is your height (in feet and inches)?” To standardize reported body weight for individuals' heights, body mass index scores (BMI; kg/m2) were calculated. Desired weight was similarly converted into a standardized BMI score and will be referred to as desired BMI from this point. Desired weight change was calculated as the difference between reported weight and desired weight. Negative values represent the desire to lose weight. The importance of achieving desired body weight was assessed using a single question (“How important is it for you to achieve the weight you'd like to be?”) with a 5-point Likert-scale with the following response format: 1=not at all important; 2=somewhat important; 3=moderately important; 4=pretty important; 5=very important.

Weight control status was assessed by asking, “Are you currently trying to achieve the weight you would like to be?” Three response options were offered: (a) Yes, I'm purposely trying to lose weight; (b) Yes, I'm purposely trying to gain weight; and (c) No, I'm not purposely trying to lose or gain weight.

Eating and exercise habits traditionally associated with weight control were assessed with multiple, validated instruments. Dietary restraint was assessed using the 16-item Weight-Related Eating Questionnaire29 to address the cognitive strategies for weight control. Dietary restraint (6-items) can be broken down into two subscales addressing strategies for weight control on a routine basis (eg, counting calories and portion control) and compensatory strategies used to balance periods of (perceived) overeating. Calories from dietary fat (%) was calculated using the National Cancer Institute (NCI) Dietary Fat Scan,30,31 which is a 17-item questionnaire that assesses the frequency at which high fat foods are consumed and provides an algorithm that estimates percent calories from dietary fat. Fruit and vegetable intake (cups) was assessed using the NCI All-Day Fruit and Vegetable Screener,32,33 which is a 19-item questionnaire that assesses frequency and portion size of servings of fruits and vegetables and provides an algorithm that estimates the frequency of cups of fruits and vegetables eaten daily. Physical activity was assessed using the International Physical Activity Questionnaire — Short Form,34,35 which is a 7-item questionnaire that assesses the frequency and duration of physical activity during an average week. Established scoring protocols were used to compute hours per week spent walking and doing moderate- and vigorous-intensity activities.

Data Analysis

Analyses were conducted to examine if there were differences in body weight status, desired weight/BMI change, and weight control strategies by pre-defined race categories using analysis of variance and analysis of covariance in which BMI was included in the model where appropriate. Computed fruit and vegetable intake and physical activity values were non-normally distributed; therefore, square root transformation was utilized to normalize the data prior to conducting further analyses. Tukey post-hoc pairwise comparisons were used to identify significant differences between the subgroups. Person chi-square difference testing was used to determine if weight control status varied by race. Significance was set at P<0.05. All analyses were conducted with SPSS (version 16.0).

Results

Table 1 summarizes the characteristics of the study sample (n=144). All of the participants in this study were between 18–20 years old. A majority of the sample subjects were at either a freshman or sophomore level in college, and had a BMI reflecting underweight (8.8%; BMI<18.5 kg/m2) or normal weight (80.8%; BMI<24.9 kg/m2) as defined by the World Health Organization.36 A large portion of the sample reported their ethnicity as single-race Asian or mixed-Asian descent with relatively equal distributions of Whites, Hawaiians/Pacific Islanders, and other mixed race (excluding Hawaiian). Compared to available University demographics,37 the sample had a greater proportion of Asian/Asian mixed students and students of other mixed races, and a comparatively smaller proportion of Hawaiians/Pacific Islanders. Noted differences in the race demographics may be the result of variations in the question and/or response options on the surveys.

Table 1.

Participant characteristics (n=144 young women)

Characteristic %
Race White 20.8
Asian/Asian mix (including Filipino) 39.6
Native Hawaiian/Pacific Islander 19.4
Other mixed races 20.1
Year in College Freshman 53.8
Sophomore 31.5
Junior 14.0
BMI Underweight/normal weight 89.6
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Mean age: 18.8±0.8 (Range: 18–20 years). Underweight/normal weight: BMI < 25 kg/m2.

Table 2 summarizes differences by race in BMI, % with a BMI≥25, desired weight and BMI, desired weight and BMI change, and the importance of achieving body weight ideals. There were noted differences by race in BMI, desired weight, desired BMI, and importance of achieving their desired body weight among the young women. The mean BMI for each race group was within normal range (BMI=18.5–24.9 mg/kg2) with young White women demonstrating a greater mean BMI compared to young women of Other mixed race. After adjusting for differences in BMI by incorporating the variable as a covariate in the model, only the importance of achieving desired weight remained significant. However, both the unadjusted and adjusted models indicated that young White women placed the greatest level of importance on achieving a lower BMI relative to all other race groups.

Table 2.

Race/ethnic differences in body weight status and body weight ideals of young women1

White n=30 Asian/ Asian mix n=57 Native Hawaiian/Pacific Islander n=28 Other mixed races n=29 P-value BMI adjusted P-value
BMI 21.9±3.4a 21.0±3.1ab 21.8±3.5ab 19.8±2.5b 0.039 —
BMI≥252 (Percent) 10.0 10.5 17.9 3.4 0.365 —
Desired weight (Pounds) 126.2±14.2a 116.6±12.8b 124.9±17.9ab 114.8±13.3b 0.002 —
Desired BMI 20.1±2.0ab 19.6±1.9ab 20.5±2.2a 19.0±1.8b 0.030 0.227
Desired weight Change −11.9±12.9 −8.5±11.7 −8.1±11.2 −5.0±7.2 0.132 0.186
Desired BMI change −1.9±2.0 −1.4±1.9 −1.3±1.8 −0.8±1.2 0.148 0.227
Importance of achieving desired weight3 3.6±1.1a 2.7±1.0b 2.8±1.1b 2.9±1.1b 0.002 0.004
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1

Values with different superscripts varied significantly by analysis of variance and Tukey post-hoc tests with homogeneous subsets (p<0.05).

2

Chi-square tests used to examine categorical differences in % BMI≥25.

3

Importance of achieving body weight ideals: 5-point Likert-scale of importance (1=not at all; 2=somewhat; 3=moderately; 4=pretty; 5=very).

In line with findings in Table 2, Table 3 shows that young White women are also most likely trying to lose weight (dieting) despite being of under or normal weight (mean BMI<25). Similarly, of those young women who were dieting (Table 4), young White women reported lower dietary fat intake, more hours of walking during the week, and greater dietary restraint consistent with eating less following episodes of overeating (compensatory restraint). Race/ethnic differences in other behaviors, including hours of moderate and vigorous activity were not significant.

Table 3.

Race/ethnic differences in weight control status

White n=29 Asian/Asian mix n=57 Native Hawaiian/Pacific Islander n=29 Other mixed races n=28 P-value
% trying to lose weight (dieting) 75.9 35.1 50.0 37.9 0.026
% trying to gain weight 3.4 5.3 3.6 3.5
% neither trying to lose nor gain 20.7 59.6 46.4 58.6
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Analyses conducted with chi-square difference testing.

Table 4.

Race/ethic differences in weight loss strategies of young women

Weight loss strategy Dieting young women1
All non-dieting young women2 n=75 White n=22 Asian/Asian mix n=19 Native Hawaiian/Pacific Islander n=14 Other mixed races n=11 P-value
Mean±SD
Dietary Restraint3 1.9±0.6 3.0±0.7a_ 2.7±0.6ab_ 2.3±0.6b 3.1±0.9a_ 0.017
Compensatory Restraint 2.3±0.8 3.4±0.9a_ 3.1±0.8ab_ 2.4±0.9b 3.5±0.9a_ 0.010
Routine Restraint 1.6±0.6 2.5±0.6_ 2.4±0.8_ 2.1±0.7 2.7±1.0_ 0.294
% calories dietary fat 31.2±4.6 29.2±3.8a 30.6±4.0ab 34.8±6.4b 30.9±5.8ab 0.023
Median (Range)
Cups of fruit/vegetable4 1.7 (0.2–7.8) 2.6 (0.3–7.0) 1.5 (0.3–5.0) 1.5 (0.8–4.9) 3.1 (0.6–5.4) 0.093
Walking (hr/week)4 3.5 (0.0–25.0) 7.0 (1.3–39.3)a 2.0 (0.0–15.0)b 1.8 (0.5–20.0)ab 3.8 (0.8–10.5)ab 0.014
Moderate-intensity activity (hr/week)4 0.0 (0.0–8.0) 1.7 (0.0–23.3) 0.0 (0.0–3.0) 0.5 (0.0–2.3) 0.8 (0.0–4.0) 0.055
Vigorous-intensity activity (hr/week)4 0.0 (0.0–17.5) 2.0 (0.0–16.7) 0.3 (0.0–4.5) 0.5 (0.0–6.7) 2.0 (0.0–6.0) 0.093
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1

Values with different superscripts varied significantly for dieting young women using analysis of variance and Tukey tests with homogeneous subsets (p<0.05).

2

Race-specific values for dieting young women varying significantly from non-dieting young women are denoted with _.

3

Dietary restraint and subscales of dietary restraint measured on a 5-point Likert scale with greater values denoting higher levels of endorsement for eat behaviors reflecting dietary intake regulation for weight control (Scores range from 1 to 5).

4

Fruit/vegetable and activity data analysis performed with square-root transformed variables, but is presented as untransformed for interpretative purposes.

Discussion

Contrary to the sociocultural model,7,17 which purports race/ethnicity has a major influence on weight-related issues, the current study indicated there are no differences in desired BMI by race after controlling for BMI status. This suggests that current weight rather than race/ethnicity explains variations in personal body size preference. Most young women regardless of race desire a body weight that is less than their current weight, but the amount of weight they desire to lose appears to be more proportional to their current BMI rather than an “ethnically-specific” ideal. However, the importance placed on reaching a desired body weight was significantly greater among the young White women compared to Asian Americans, Native Hawaiians/Pacific Islanders, and those of other mixed races, which was reflected in the use of weight control strategies. Though body dissatisfaction was not specifically assessed, the findings of this study are consistent with the literature on the higher prevalence of body dissatisfaction and dieting in young White women, but they do not support the notion that Native Hawaiians/Pacific Islanders have a culturally-specific desire for a larger body size.

These findings call into question the robustness of race/ethnic differences in body weight ideals,3,38 in particular those studies that have indicated that Native Hawaiian/Pacific Islanders desire a larger body size.26 Of the ethnic/race groups more commonly shown to prefer a larger body size, the most robust differences have been demonstrated between Black and White young women such that Black women are consistently shown to have a more positive body image compared to White women.39 Based on literature that similarly suggests that Native Hawaiian and Pacific Islanders traditionally value a larger body size, it would have been expected that this subgroup of women would more closely identify with Black women's positive attitudes towards a larger body size. However, this was not observed in this sample of Native Hawaiian/Pacific Islanders. On the contrary, the young Native Hawaiian/Pacific Islander in this sample did not vary from any other race groups on BMI or percent overweight/obese nor did they vary on desired BMI or desired weight change (after controlling for BMI). These findings imply that race/ethnicity may not have as significant an impact on desire for a “thin” body ideal18 and may further suggest that the socio-cultural pressures to achieve thinness are so pervasive that they have reached all race/ethnic groups in Hawai‘i.

A review of the literature in the area resulted in identifying four studies, published within the past 10 years, that explored race/ethnic differences in body dissatisfaction and other weight-related concerns in White, Asian, and/or Native Hawaiian/Pacific Island young women (<25 years).12,24,40,41 Similar to the current study, no significant race/ethnicity differences in body ideals or body dissatisfaction were observed. Findings have also remained consistent when differences among specific subgroups of young Asian American women, including Japanese-, Chinese-, and Filipino-Americans, were examined.24 In this study, the only race/ethnic differences that were observed were related to the importance placed on achieving a lower body weight (BMI) and the behavioral practices consistent with dieting. It was here that White young women varied most significantly from their counterparts showing that they were more likely to be dieting and practicing weight-control behaviors despite having a normal mean BMI (21.9±3.4 kg/m2). Only one of the reviewed studies included a measure that addressed the extent to which the participants valued a thin ideal.41 However, on this measure, Asian American and Whites did not significantly differ. Given that the use of weight-control behaviors so closely corresponded to the importance placed on achieving a lower body weight, it is suggested that future studies incorporate this construct.

Strengths/Limitations

This study is strengthened by the inclusion of young women of multiple ethnic backgrounds including Asians and Native Hawaiian/Pacific Islanders, who are typically underrepresented in research exploring the race/ethnic differences in body image and body dissatisfaction literature. Furthermore, findings support literature demonstrating body weight ideals of Hawaiians/Pacific Islanders are transitioning from larger body sizes to the thinner, “Westernized” body weight ideals.15,23,42 Additionally, the inclusion of a variable reflecting the importance of achieving a desired body weight significantly enriches the findings in this study. This evaluative approach (importance) has merit in areas of behavior change related to decisional balance.43,44 However, to our knowledge, this is only one of two studies that has sought to assess the value placed on achieving a thinner body ideal. Based on the findings in this study, it is possible that one's perceived importance of achieving a desired body weight could contribute significantly to predicting risk for eating disorders. This study provides support for future research to confirm this hypothesis.

The study is limited primarily by the secondary nature of the data analysis and limited sample size. First, a question regarding the student's unique (ie, strongest) racial/ethnic affiliation or identity was not asked (eg, “What racial/ethnic background do you most identify with?”). Among multiethnic individuals, aligning one's identity with one race more than another could help explain a lack of race/ethnic differences in factors related to body image and weight control, particularly within the sample of Native Hawaiian/Part-Native Hawaiians who are likely of mixed-race. Secondly, psychometric instruments often used in body dissatisfaction and eating disorder research such as the Pictorial Body Image Scale45 or the Eating Disorders Inventory46 were not incorporated into the data collection survey. Though one may desire to lose weight, this may not suggest body dissatisfaction. However, the findings were consistent with research that assesses body dissatisfaction. Similarly, participants were not asked about “unhealthy” weight control practices (eg, self-induced vomiting, diet pill, laxatives, and diuretics). Future research will be needed to address these constructs more comprehensively. Also, due to sample size limitations there were some observations that may have reached significance with a larger sample. We also had insufficient power to detect differences among Asian subgroups. There have been other published studies that suggest Chinese young women are more likely to be satisfied with their small body size whereas Japanese young women were highly dissatisfied with their body size though it was similar to the Chinese young women.24 Lastly, there is limited generalizability of the findings given that the age of the sample was limited to 18–20 years, attending a local University. This sample was also leaner than a similarly aged sample of Hawai‘i residents with 84.5% considered underweight or normal-weight compared to 54.4% reported for young adults age 18–24 years old surveyed by the 2009 Hawai‘i Behavioral Risk Factor Surveillance System.47

Conclusion/Implications

Among young women, current weight (BMI) appears to play a larger role in the desire for a lower body weight than does race/ethnicity suggesting a desired BMI may be more personal than cultural. All of the young women were found to desire a body weight consistent with a normal BMI, including the Hawaiians/Pacific Islanders, who traditionally have been reported to value a larger body size. This possible shift in preference could potentially lead to an increase in the prevalence of eating disorders in this population, of which local pediatricians, college physicians, and other health care workers need to be aware. The observation that the importance placed on achieving a desired weight corresponded with the use of weight control behaviors consistent with dieting among White young women may suggest that the construct of importance may have a potential role in identifying those at risk for eating disorders. Future research exploring the role of importance placed on achieving a desired weight will be needed to test this hypothesis.

Conflicts of Interest

This study and author SMS were supported by the Nutritional and Behavioral Cancer Prevention in a Multiethnic Population postdoctoral fellowship (R25 CA 90956). There are no conflicts of interest to report.

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