As obesity persists in the United States, many public health interventions have been conceived to encourage people to change their diets. These interventions are based on encouraging people to prioritize healthier alternatives in food choice. However a consideration of the existing but limited literature on food choice for diverse populations renders such an assumption problematic. This qualitative study examined the food choices of a population most at risk for obesity - low-income African American women - by considering psychological factors, social and cultural meanings of foods, and structural conditions that shape how women decide what to eat. Interviews revealed the complexity of their food choices, illustrating the extent to which multiple influences operate simultaneously on food choice decisions. Implications for obesity prevention are discussed, in particular highlighting the problem that some types of public health interventions do not correspond to the lived experiences of the populations they intend to target. (C) 2012 Elsevier Ltd. All rights reserved.