Obesity and the African-American woman: a cultural tolerance of fatness or other neglected factors.

This article takes a critical look at the much-touted cultural tolerance explanation of obesity among African-American women with the hope of stimulating a re-examination of its relative merits. After reviewing evidence that runs contrary to the cultural tolerance explanation, the focus turns to an examination of some of the explanation's inherent risks and limitations. Among those discussed is that an overstated cultural tolerance explanation seems to have had a tendency of polarizing thinking in this area of public health, in that if a population group is not pre-occupied with the ideal of thinness, there has been a proclivity to assume they are indifferent about their weight. A corollary risk and limitation also discussed is that factors, which adversely affect the less extreme weight reduction behavior of African-American women but are outside the cultural realm, have tended to be neglected. The factor identified that has been most conspicuously neglected in recent years, but which can profoundly affect the weight management behavior of African-American women on many different levels, is the enduring socioeconomic disparity compared with European-American women.