1. Que Gordita Emily Massara

2. Average overall obesity of Puerto Rican woman is 19.4% higher than Puerto Rican Males Woman under 25 have a 13.3% rate of obesity Women 26 to 39 have a 60.6% rate of obesity Why the increase? - cultural factors related to marriage -cultural factors related to perception -cultural factors which decided how stress is channeled -Migration -attitudes of how physical appearance reflects health -Self preservation

3. Cultural Factors Related to Marriage  1. weight gain reflects the husbands ability as a breadwinner  2.Gaining 15 to 20 lbs is seen as increasing shapeliness (good thing) and reflects vitality and health  3. Excelling in the role of a good wife will lead to increased exposure to food  4. Expanding Family: food represents nuturing and care of family, increased food preparation, weight gain can result from skipping breakfast  5. Pregnancy: restraint in eating seen as something that will harm the child

4. Cutural Factors Related to Perception Heaviness is of little negative social consequence Heaviness = Tranquility Study on perceptions of women weighing 45% more than medical ideals 10.5 % classify women as too heavy 15.3% classify women as regular 35.9% classify women as plump Conforming to medical ideals creates appearance which is incompatible with the Puerto Rican ideal wife and mother

5. Cultural norms contribute to how individuals channel stress  Cope with stress by overeating  Often attribute weight gain to use of tranquilizers (heaviness = tranquility)  Eating is one of the least strict areas of life for older Puerto Rican woman  This can lead to severe obesity!

6. Migration  Given the association of heaviness with health, women may gain weight as an antidote to illness associated with colder climates  The association of heaviness with tranquility might encourage woman to aspire to gain weight in new country

7. Body Image: What is Healthy?  All the heavy women in the study conducted by Massara suffered from diseases such as diabetes and hypertension  Relationship between food and health not recognized or ignored because: Disease kept under control by meds Cultural idea that heaviness and zest for life are indicators of good health and conversely that weight loss indicates poor health

8. Self Preservation  Culturally defined obesity may help to neutralize power that men have over women Obesity leads to perception of woman as assexual  Results in vibrant social life without suspicions of sexual infidelity

9. How to treat obesity among Puerto Rican women  Family must be involved with doctor and weight loss process  Behavior modification rather than alter food choices  Exercise will encourage weight loss and provide outlet for stress

10. Method  Use western measurements (etic) to quantify cultural norms and ideals (emic)  Massara feels this is a good strategy to deal with health problems in ethnic communities