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The purpose of this study was to assess the association of perceived racial discrimination with emotional eating behaviors, weight status, and stress levels among obese African-American women, who volunteered to enter a weight control study (SisterTalk) in the New England region of the United States. The sample of women was taken from the baseline data of participants in SisterTalk, a randomized, controlled trial of a cable TV-delivered weight control program. Using the Krieger instrument, telephone and in-person surveys were used to assess perceived discrimination, emotional eating behaviors, and stress. Height and weight were measured to calculate BMI in order to assess weight status. ANOVA models were constructed to assess the association of discrimination with demographics. Correlations were calculated for discrimination, stress, emotional eating, and weight variables. ANOVA models were also constructed to assess discrimination with emotional eating, after adjusting for appropriate demographic variables. Perceived discrimination was associated with education and stress levels but was not associated with weight status (BMI). The frequency of eating when depressed or sad, and eating to manage stress, were both significantly higher among women who reported higher perceived discrimination and higher stress levels. Discrimination may contribute to stress that leads to eating for reasons other than hunger among African-American women, although the causal direction of associations cannot be determined with cross sectional data. Associations of discrimination with weight status were not found, although it is likely that emotional eating behaviors related to perceived discrimination are unhealthy. Future research should examine these relationships more closely in longitudinal studies.

Overweight and obesity have reached epidemic proportions in the United States, with black women disproportionately affected. SisterTalk is a weight control program designed specifically for delivery to black women via cable TV. The theoretical and conceptual frameworks and formative research that guided the development and cultural tailoring of SisterTalk are described. Social Action Theory was applied in the development of SisterTalk along with a detailed behavioral analysis of the way that black women view weight and weight loss within the context of their cultural and social realities. The entire intervention development process was framed using this information, rather than by changing only superficial aspects of program delivery. Community networking and both qualitative and quantitative interview techniques from the fields of social marketing and cultural anthropology were used to involve black women from Boston in the design and implementation of a program that would be practical, appealing, and culturally sensitive. Also discussed are strategies for evaluating the program, and lessons learned that might have broader applicability are highlighted. The development of the SisterTalk program could provide a useful starting point for development of successful weight control programs for black women in other parts of the United States as well as for other ethnic and racial groups.