Body Image and Obesity among Arab American Women: A Qualitative Descriptive Study of Cultural and Religious Influences

Kholoud Hardan-Khalil^1, , Jill Kardously¹, Bana Khalil² and Samantha Wee¹

¹School of Nursing, California State University, Long Beach, USA

²College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, USA

Cite this paper:
Kholoud Hardan-Khalil, Jill Kardously, Bana Khalil and Samantha Wee. Body Image and Obesity among Arab American Women: A Qualitative Descriptive Study of Cultural and Religious Influences. American Journal of Nursing Research. 2026; 14(3):54-61. doi: 10.12691/ajnr-14-3-1

Abstract

Obesity is a multifactorial chronic disease with significant physical, psychological, and economic consequences. Arab American women (AAW) remain an understudied population whose experiences of body image and obesity are shaped by the intersection of cultural traditions, religious beliefs, family expectations, and Western acculturation pressures, yet limited research addresses these unique influences. Aim: This study aimed to explore the perceived factors influencing body weight and body image among AAW, with attention to daily routines, eating behaviors, and cultural and spiritual practices. Method: A qualitative descriptive design guided by Colaizzi's phenomenological method was used. Fourteen AAW aged 20 and older, residing in Southern California, were recruited via snowball sampling. Semi-structured interviews were conducted via videoconferencing, transcribed, and analyzed through statement-by-statement coding until thematic saturation was achieved. Results: Seven themes emerged: cultural and religious influences on daily routine, eating attitudes and behaviors, healthy body image perspectives, body image concerns, influences on body image, balancing tradition with personal choice and self-care, and holistic well-being. Findings revealed that family obligations, religious practices, community expectations, and exposure to Western beauty ideals collectively shaped participants' perceptions of health, weight, and appearance, often creating tension between traditional and acculturated identities. Conclusion and Implications for Practice: Obesity and body image among AAW cannot be addressed through standardized weight-management approaches alone. Healthcare providers should adopt culturally responsive, patient-centered assessments that incorporate religious and family context, while healthcare systems and policy should promote clinician cultural competence training and improved ethnic data collection to reduce disparities in this underserved population.

Keywords:
Qualitative research Arab American women obesity body image

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References:

[1]	Safaei, M., Sundararajan, E. A., Driss, M., Boulila, W., & Shapi'i, A. (2021). A systematic literature review on obesity: Understanding the causes & consequences of obesity and reviewing various machine learning approaches used to predict obesity. Computers in biology and medicine, 136, 104754.
[2]	Horesh, A., Tsur, A. M., Bardugo, A., & Twig, G. (2021). Adolescent and Childhood Obesity and Excess Morbidity and Mortality in Young Adulthood—a Systematic Review. Current Obesity Reports, 10(3), 301–310.
[3]	Chang Chusan, Y. A., Eneli, I., Hennessy, E., Pronk, N. P., & Economos, C. D. (2025). Next Steps in Efforts to Address the Obesity Epidemic. Annual review of public health, 46(1), 171–191.
[4]	NCD-RisC (NCD Risk Factor Collab.). (2024). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet 403: 1027–50.
[5]	Bays, H. E., Golden, A., & Tondt, J. (2022). Thirty Obesity Myths, Misunderstandings, and/or Oversimplifications: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. Obesity Pillars (Online), 3, Article 100034.
[6]	Ward, Z. J., Bleich, S. N., Long, M. W., & Gortmaker, S. L. (2021). Association of body mass index with health care expenditures in the United States by age and sex. PLOS ONE, 16(3), e0247307.
[7]	Okunogbe, A., Nugent, R., Spencer, G., Powis, J., Ralston, J., & Wilding, J. (2022). Economic impacts of overweight and obesity: current and future estimates for 161 countries. BMJ Global Health, 7(9), e009773.
[8]	Fan, K., Lv, F., Li, H., Meng, F., Wang, T., & Zhou, Y. (2023). Trends in obesity and severe obesity prevalence in the United States from 1999 to 2018. American journal of human biology: the official journal of the Human Biology Council, 35(5), e23855.
[9]	Kendrick, K. N., Bode Padron, K. J., Bomani, N. Z., German, J. C., Nyanyo, D. D., Varriano, B., Tu, L., & Stanford, F. C. (2023). Equity in Obesity Review. Endocrinology and Metabolism Clinics of North America, 52(4), 617–627.
[10]	Narain, K., & Scannell, C. (2026). Exploring Racial and Ethnic Differences in Utilization of Medications for Obesity Management in a Nationally Representative Survey. Journal of Racial and Ethnic Health Disparities., 13(1), 329–339.
[11]	Oyetunji, I. O., Tinsley, M. R., Battalio, S. L., & Pfammatter, A. F. (2026). Perceived barriers and facilitators to engagement and behavioral enactment in weight management interventions among racial and ethnic minorities. Discover Public Health, 23(1), Article 123.
[12]	Koceva, A., Herman, R., Janez, A., Rakusa, M., & Jensterle, M. (2024). Sex- and Gender-Related Differences in Obesity: From Pathophysiological Mechanisms to Clinical Implications. International journal of molecular sciences, 25(13), 7342.
[13]	Ayesh, H., Nasser, S. A., Ferdinand, K. C., & Carranza Leon, B. G. (2025). Sex-Specific Factors Influencing Obesity in Women: Bridging the Gap Between Science and Clinical Practice. Circulation research, 136(6), 594–605.
[14]	Abdoli, M., Schiechtl, E., Rosato, M. S., Mangweth-Matzek, B., Cotrufo, P., & Hüfner, K. (2025). Body image, self-esteem, emotion regulation, and eating disorders in adults: a systematic review. Neuropsychiatrie, 39(3), 118–132.
[15]	Abuelezam, N. N., El-Sayed, A. M. & Galea, S. (2018). The Health of Arab Americans in the United States: An Updated Comprehensive Literature Review. Front. Public Health 6: 262.
[16]	Abouhala, S., Abdulle, A., Zanial, N., Aziz, G., Hussein, A., Stiffler, M. J., Hawa, R., Tariq, M., Ady, G., Shalabi, I., Awad, G. H., & Abuelezam, N. N. (2025). Facilitators and Barriers to Health Research Knowledge and Participation among Arab/Middle Eastern and North African (MENA) Patients in the US. Journal of Community Health, 50(2), 358–368.
[17]	Al-Faham, H. (2021). Researching American Muslims: A Case Study of Surveillance and Racialized State Control. Perspectives on Politics, 19(4), 1131-1146.
[18]	Fleischer, N. J., & Sadek, K. (2025). Arab, Middle Eastern, and North African Health Disparities Research: A Scoping Review. Journal of Racial and Ethnic Health Disparities, 12(3), 1397–1415.
[19]	Awad, G. H., Abuelezam, N. N., Ajrouch, K. J., & Stiffler, M. J. (2022). Lack of Arab or Middle Eastern and North African Health Data Undermines Assessment of Health Disparities. American Journal of Public Health, 112(2), 209–212.
[20]	Abuelezam, N. N., El-Sayed, A. M. & Galea, S. (2019). Differences in health behaviors and health outcomes among non-Hispanic Whites and Arab Americans in a population-based survey in California. BMC Public Health 19, 892.
[21]	Abuelezam, N. N., El-Sayed, A. M., Galea, S., & Gordon, N. P. (2021). Health Risks and Chronic Health Conditions among Arab American and White Adults in Northern California. Ethnicity & Disease, 31(2), 235–242.
[22]	Ajrouch, K. J., & Antonucci, T. C. (2018). Social Relations and Health: Comparing "Invisible" Arab Americans to Blacks and Whites. Society and mental health, 8(1), 84–92.
[23]	Pampati, S., Alattar, Z., Cordoba, E., Tariq, M., de Leon, C.M. (2018) Mental health outcomes among Arab refugees, immigrants, and U.S. born Arab Americans in Southeast Michigan: a cross-sectional study. BMC Psychiatry 18, 379.
[24]	Mansuri, S., Daniel, M. N., Westrick, J. C., & Buchholz, S. W. (2023). Physical Activity Behavior and Measurement in Arab American Women: An Integrative Review. Journal of Prevention 44, 749–776.
[25]	Althubyani, A. N., Gupta, S., Tang, C. Y., Batra, M., Puvvada, R. K., Higgs, P., Joisa, M., & Thomas, J. (2024). Barriers and Enablers of Diabetes Self-Management Strategies Among Arabic-Speaking Immigrants Living with Type 2 Diabetes in High-Income Western countries- A Systematic Review. Journal of Immigrant & Minority Health, 26(4), 761–774.
[26]	Kulwicki, A., & Ballout, S. (2015). Post traumatic stress disorder (PTSD) in Arab American refugee and recent immigrant women. Journal of Cultural Diversity, 22(1), 9.
[27]	Mansour, L., Rothschild-Yakar, L., Sweid, R., & Kurman, J. (2024). Understanding body dissatisfaction and preferences among Palestinian- Arab Women in Israel: Westernization and culturally bound factor. International Journal of Intercultural Relations: IJIR., 103, 102094.
[28]	Sabbah-Karkabi, M. (2024). The diverging gender inequality across households: The case of Palestinian- Arab families in Israel. Current Sociology, 72(3), 519–540.
[29]	Sidi, Y., Geller, S., Abu Sinni, A., Levy, S., & Handelzalts, J. E. (2020). Body image among Muslim women in Israel: exploring religion and sociocultural pressures. Women & Health, 60(10), 1095–1108.
[30]	Deek, M. R., Kemps, E., & Prichard, I. (2025). The role of female family members in relation to body image and eating behaviour: A cross-national comparison between Western and Middle-Eastern cultures. Body Image, 53, Article 101882.
[31]	Melisse, B., de Beurs, E., & van Furth, E. F. (2020). Eating disorders in the Arab world: a literature review. Journal of Eating Disorders, 8(1), Article 59.
[32]	Swami, V., Adebayo, S. O., Ahmed, O., Aimé, A., Halbusi, H. A., Alexias, G., Alp-Dal, N., Alsalhani, A. B., Andrianto, S., Aspden, T., Aruta, J. J. B. R., Ayandele, O., Bahbouh, R., Bellard, A., Bozogáňová, M., Browning, M. H. E. M., Brytek-Matera, A., Camacho, P., Camilleri, V. E., … Yeung, V. W. L. (2023). Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age. Body Image, 46, 449–466.
[33]	Berry, J. W. (2003). Conceptual approaches to acculturation. In P. Balls Organista, G. Marín, & K. M. Chun (Eds.), Acculturation: Advances in theory, measurement, and applied research (pp. 17–37). American Psychological Association.
[34]	Jadalla, A., Hattar, M., & Schubert, C. (2015). Acculturation as a predictor of health promoting and lifestyle practices of Arab Americans: A descriptive study. Journal of Cultural Diversity, 22(1), 15–22.
[35]	Moradi, M., Mozaffari, H., Askari, M., & Azadbakht, L. (2022). Association between overweight/obesity with depression, anxiety, low self-esteem, and body dissatisfaction in children and adolescents: a systematic review and meta-analysis of observational studies. Critical reviews in food science and nutrition, 62(2), 555–570.
[36]	Essayli, J. H., Murakami, J. M., Wilson, R. E., & Latner, J. D. (2017). The Impact of Weight Labels on Body Image, Internalized Weight Stigma, Affect, Perceived Health, and Intended Weight Loss Behaviors in Normal-Weight and Overweight College Women. American Journal of Health Promotion, 31(6), 484–490.
[37]	Farhangi, M. A., Emam-Alizadeh, M., Hamedi, F., & Jahangiry, L. (2017). Weight self-stigma and its association with quality of life and psychological distress among overweight and obese women. Eating and Weight Disorders, 22(3), 451–456.
[38]	Hardan-Khalil, K. (2019). Factors Affecting Health-Promoting Lifestyle Behaviors Among Arab American Women. Journal of Transcultural Nursing, 31(3), 267-275.
[39]	Tong, A., Sainsbury, P., & Craig, J. (2007). Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International journal for quality in health care, 19(6), 349-357.
[40]	Archibald, M. M., Ambagtsheer, R. C., Casey, M. G., & Lawless, M. (2019). Using Zoom Videoconferencing for Qualitative Data Collection: Perceptions and Experiences of Researchers and Participants. International Journal of Qualitative Methods, 18.