Incongruence in body image and body mass index: a surrogate risk marker in Black women for type 2 diabetes mellitus/Incongruence l'image corporelle et l'indice de masse corporelle: un marqueur de risque de substitution chez les femmes noires de diabete de type 2

Background: Excess weight contributes to the development and progression of Type 2 diabetes mellitus (T2DM). Distorted body image amongst urban Black women and the perception that thinness is linked with HIV, may however be compounding the problem, particularly in areas with a high HIV burden. Objectives: This study aimed to compare the perception of body image in urban Black women with and without T2DM. Methods: A cross-sectional comparative study was conducted on 328 Black women systematically sampled into two groups (with and without T2DM). Body mass index (BMI) (weight [kg]/height [[m.sup.2]]) was determined and the adapted Stunkard Body Image Silhouettes for Black women was used to determine perceived body image (PBI). Results: Seventy-two per cent had T2DM and in this group 89% were obese, with a mean BMI of 39.5 kg/[m.sup.2] (s.d. [+ or -] 8.5). In the non-diabetes group (NDG) 44% were obese, with a mean BMI of 31.3 kg/[m.sup.2] (s.d. [+ or -] 9.0) Black women underestimated their body image across all weight categories (p < 0.05). Both groups (99% of the study group) also perceived thinness as being associated with HIV. Conclusions: This study identified an incongruence between PBI and actual BMI amongst urban Black women. This, combined with their belief that thinness is associated with HIV, places those with T2DM at risk of secondary complications arising from diabetes mellitus, and those without diabetes mellitus at a higher risk of developing T2DM. A discrepancy between PBI and BMI may therefore serve as a risk marker to alert clinicians to use a more ethno-cultural specific approach in engaging with urban Black women regarding weight loss strategies in the future. Contexte: La surcharge ponderale contribue au developpement et a la progression du diabete non insulo-dependant de type 2. La perception deformee du corps de la femme chez les femmes noires et la perception que la minceur est associee au VIH pourraient encore aggraver ce probleme, notamment dans les zones affectees par une forte prevalence d'infection par le VIH. Objectif: L'objectif de cette etude etait de comparer la perception de l'image du corps de la femme chez les femmes noires vivant en milieu urbain et ne souffrant pas de diabete non insulo-dependant de type 2. Methode: Une etude comparative transversale a ete realisee aupres de 328 femmes noires echantillonnees de maniere systematique dans deux groupes (avec et sans diabete non insulodependant de type 2). L'indice de masse c