1. ^*Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
2. ^†Department of Social Medicine, Harvard Medical School, Boston, Massachusetts
3. ^‡Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts
4. ^§Centers for Behavioral and Preventive Medicine, Brown Medical School, Providence, Rhode Island
5. ^¶Department of Psychology, University of Denver, Denver, Colorado

Correspondence: Anne E. Becker, Director, Adult Eating and Weight Disorders Program, Massachusetts General Hospital, WAC 816, 15 Parkman Street, Boston, MA 02114. E-mail: abecker@partners.org

^**The costs of publication of this article were defrayed, in part, by the payment of page charges. This article must, therefore, be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

Received 12 February 2004; Accepted 10 November 2004.

Abstract

Objective: To investigate changes in prevalence of overweight and obesity and in body image among ethnic Fijian women in Fiji during a period of rapid social change and the relationship between changes in body image and BMI.

Research Methods and Procedures: The study design was a multiwave cohort study of BMI in a traditional Fijian village over a 9.5-year period from 1989 to 1998. Cohorts were identified in 1989 (n = 53) and in 1998 (n = 50). Selection criteria included Fijian ethnicity, female gender, age of at least 18 years, and residence in a specific coastal Fijian village in 1989 and 1998, respectively. Assessments consisted of measurement of height and weight, collection of demographic data by written survey, and administration of the Nadroga Language Body Image Questionnaire.

Results: The prevalence of overweight and obesity was significantly different between the cohorts, increasing from 60% in 1989 to 84% in 1998 (p = 0.014). In addition, the age-adjusted mean BMI was significantly higher in 1998 compared with 1989 (p = 0.011). Finally, there were significant between-cohort differences in multiple measures of body image, which were mostly independent of BMI.

Discussion: At 84%, the prevalence of overweight and obesity in this community sample of Fijian women is among the highest in the world. The dramatically increased prevalence over the 9.5-year period studied corresponds with rapid social change in Fiji and significant shifts in prevailing traditional attitudes toward body shape.