Background  

African-American (AA) women have higher rates of obesity and obesity-related diseases but are less likely than other women to undergo bariatric surgery or have success with conventional weight loss methods.

Objective  

To explore obese AA women’s perceptions regarding barriers to weight loss and bariatric surgery.

Design  

Focus groups to stimulate interactive dialogue about beliefs and attitudes concerning weight management.

Participants and Approach  

We partnered with a community organization to recruit women who were AA, were ≥18 years old, and had a body mass index (BMI) of ≥30 kg/m². We audiotaped the 90-minute focus groups and used content analysis for generating and coding recurring themes.

Results  

In our sample of 41 participants, the mean age was 48.8 years and mean BMI was 36.3. Most participants were unmarried, had some postsecondary education, and reported good or fair health. About 85% knew someone who had undergone bariatric surgery. Qualitative analysis of 6 focus group sessions revealed that the most common barriers to weight loss were lack of time and access to resources; issues regarding self-control and extrinsic control; and identification with a larger body size. Common barriers to bariatric surgery were fears and concerns about treatment effects and perceptions that surgery was too extreme or was a method of last resort.

Conclusions  

Only through the elimination of barriers can AA women receive the care needed to eliminate excess weight and prevent obesity-related morbidity and mortality.