Research Round-Up: "Fat Talk," Early Puberty and Breast Cancer

By Christine Cupaiuolo — March 8, 2007

‘- When a group of young women get together, sooner or later the conversation turns to their dissatisfaction with their bodies. Anthropologist Mimi Nichter, who looked at the behavior in girls in middle and high school, calls it “fat talk.” Researchers from Appalachian State University are now looking at the behavior among college-age women.

“Our research showed that college students — males and females — know that when women are in a group of other women who are fat talking, that they are supposed to join in to say negative things about their bodies. And, there is pressure to do so,” said psychology professor Denise Martz.

The practice happens most frequently among Caucasian women, added Martz.

In a related study, psychology graduate student Katheryn Tucker found that when a student talks negatively about her body in front of another female student, the second student also express dissatisfaction with her body. Conversely, when the student talked positively, the second student was more likely to verbalize a positive body image. Tucker’s research, coauthored with Martz and two other professors, will appear in the June 2007 issue of Body Image: An International Journal of Research and will be published online at

“We believe that many American women succumb to a vicious cycle of private/public body image dissatisfaction,” the researchers wrote. “If there is a social pressure to fat talk, and this is what females routinely hear in social circles, ordinary social interactions may reinforce their own personal body image discontent.”

Increasing rates of childhood obesity in the United States may be contributing to an earlier onset of puberty in girls, according to researchers at the University of Michigan C.S. Mott Children’s Hospital. The study was published in the journal Pediatrics.

From the journal Cancer, a study exploring the impact of pharmaceutical-company involvement on breast cancer clinical trial design and outcome found that industry-funded studies of breast cancer therapies are more likely to report positive results than non-pharmaceutical funded studies, and there are significant differences in the design and nature of clinical trials supported by the pharmaceutical industry.

“The significance of our study is not to say that the drug industry does anything wrong — they are excellent at developing new therapies, and there are many recent examples in breast cancer research. But if more and more research is funded by drug companies, then the limited amount of funding coming from other sources may need to be directed to address other questions,” said Dr. Jeffrey Peppercorn, assistant professor of medicine at University of North Carolina and one of the study’s authors.

Why are African American women 1.5 to 2.2 times more likely than white women to die from breast cancer, despite their lower incidence of the disease? An analysis in the International Journal of Surgery proposes that the reason may in part be due to the timing of the onset of the disease: black women are more likely than white women to develop breast cancer before menopause, when surgery to remove the tumor may pose a higher risk of stimulating cancer growth. The analysis offers some scientific basis for long-held concerns in some black communities that diagnosis and surgery can itself be deadly.

Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society and a prolific blogger, writes about the potential for this theory to be misinterpreted:

The authors go on to say that the reason for the prevalence of the “when the air hits it” myth in the African American community may in fact be based on historical experience of the African American community. In their opinion, this experience of bad outcomes is in part the result of the theory described above.

The researchers conclude that, since mammography was primarily investigated in Caucasian women in the United States, Europe and Scandinavia, therefore these “early detection protocols may be suboptimal in African American women.”

They reiterate that their original theory may explain why the outcome of breast cancer treatment of women in Africa is poor, especially since, as they write, most breast cancer in Africa occurs in pre-menopausal women.

What they ignore is that the reason for the increasing survival gap between African American women and Caucasian women in this country may be due to the fact that African American women are not receiving the same screening and treatment opportunities as others.

They also ignore, in this comparison, that the lifespan of women in many African countries is short, and many women don’t live long enough to develop post-menopausal breast cancer. Cancer registries in Africa and elsewhere in the world are not particularly well developed, so it is difficult to get such information on large populations. […]

In my opinion what they should be saying is that we need to do everything in our power to reduce the real disparities in health care. We need to be certain that every woman in this country has access to state of the art cancer screening and cancer treatment in this country. That is the most “curable” way to close the survival gap for breast cancer between African American and white women in this country. […]

My fear is that there are women who will read the news and say, “I don’t need to be screened. It will increase my chances of dying from my breast cancer.”

My fear is that we could take another giant step backwards.

I meant to post this during February, National Heart Month, but it’s never too late top point out the differences in how men and women may experience a heart attack. “Men often experience the traditional symptoms of heart attacks such as squeezing chest pain or pressure, while more subtle symptoms such as shortness of breath, dizziness, fatigue, nausea or vomiting and back and jaw pain are more likely in women,” notes Dr. C. Noel Bairey Merz, medical director of both the Women’s Health Program and the Preventive and Rehabilitative Cardiac Center at Cedars-Sinai Medical Center.

Bairey Merz is also chair of the National Institutes of Health (NIH)-sponsored multi-center study, Women’s Ischemic Syndrome Evaluation (WISE), which is investigating the potential for more effective diagnostic and evaluation methods of coronary artery disease in women. NPR did a story on Bairey Merz’s research last July.

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