Comparisons of Body Image Perceptions of a Sample of Black and White Women with Rheumatoid Arthritis and Fibromyalgia in the US

Josephine E.A Boyington*, 1, Britta Schoster 2, Leigh F Callahan 2, 3, 4, 5
1 National Institutes of Health, National Heart Lung and Blood Institute, Bethesda, MD, USA
2 Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
3 Division of Rheumatology
4 Department of Medicine, UNC, Chapel Hill, NC, USA
5 Department of Social Medicine, UNC, Chapel Hill, NC, USA

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© Boyington et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Division of Cardiovascular Sciences/Clinical Applications and Prevention Branch, National Heart Lung and Blood Institute 6701 Rockledge Drive, Suite 10024, Rockledge II, Bethesda, MD 20892, USA; Tel: 301-435-0446; E-mail:


Objective :

To explore the disease-related, body image (BI) perceptions of women diagnosed with, rheumatoid arthritis (RA) and fibromyalgia (FM).

Methods :

A purposive sample of twenty-seven females participated in individual semi-structured phone interviews to elicit BI perceptions relative to pain, activity limitations and coping measures. Sessions were digitally recorded, transcribed verbatim, and content analyzed.

Results :

Body image perceptions relative to 5 major themes emerged in the analysis. They focused on Pain, Disease Impact on Physical and Mental Function, Weight, Diseased-Induced Fears and, Coping measures. Pain was a common experience of all participants. Other troubling factors verbalized by participants included dislike and shame of visibly affected body parts, and disease-induced social, psychological and physical limitations. RA participants thought that manifested joint changes, such as swelling and redness, undergirded their prompt diagnosis and receipt of health care. Contrarily, women with fibromyalgia perceived that the lack of visible, disease-related, physical signs led to a discounting of their disease, which led to delayed health care and subsequent frustrations and anger. All but one participant used prayer and meditation as a coping measure.

Conclusion :

The body image perceptions evidenced by the majority of participants were generally negative and included specific focus on their disease-affected body parts (e.g. joints), mental function, self-identity, health care experiences, activity limitations and overall quality of life. Given the global effect of RA and FM, assessment and integration of findings about the BI perceptions of individuals with FM and RA may help define suitable interdisciplinary strategies for managing these conditions and improving participants’ quality of life.

Keywords: Black women, body image, fibromyalgia, perceptions, rheumatoid arthritis, white women..