1383-P: In the 21st Century, African Immigrants to the United States Do Not Value Obesity—The Africans in America Study

With acculturation superimposed on nutritional transitions, urbanization and globalization, 21^st century attitudes of African immigrants towards optimal body size are unknown. To gain perspective on body image, we assessed in 412 Africans living in America: 1) ideal body size 2) body size dissatisfaction and 3) cardiometabolic health by body size category. Participants chose 2 silhouettes from the Stunkard Figure Rating Scale, one for their wish body size and one for their perceived body size. The scale has 9 silhouettes corresponding to body size categories: Underweight: 1-2; Normal-Weight: 3-4; Overweight: 5-7; Obesity: 8-9. Body size dissatisfaction was calculated as the difference between perceived and wish body size. Cardiometabolic health was determined by BP, glucose and lipids. Enrollees lived in the Washington, DC area (BMI 27.9±4.6 (mean±SD), range 19.5-47.3 kg/m², female: 42% (174/412); age 39±11y, range 20-69y). As their wish body size, no one (0/412) chose silhouettes in the obese category. In fact, the body size silhouettes most preferred were in the normal-weight category. Dissatisfaction because perceived body size was too large occurred in 63% (260/412). Whereas dissatisfaction because body size was too small occurred in 12% (49/412). However, body size dissatisfaction was higher in women than men (84% (146/174) vs. 69% (164/238), P<0.001). BMI of women who thought they were too large was 30.3±4.6 kg/m². Their wish body size silhouettes were: 1 to 6. BMI of women who thought they were too small was 23.4±3.3 kg/m². Their wish body size silhouettes were: 3 to 6. BMI of men who thought they were too large was 29.2±3.9 kg/m² and they chose for their wish body size: 1 to 5. BMI of men who thought they were too small was 23.0±2.7 kg/m². Their wish silhouettes were: 4 to 6. Cardiometabolic health was most optimal for women and men with normal-weight BMI. Overall, Africans living in America did not value obesity and preferred a healthier normal-weight body size.