The author of this study conducted focus groups with African American women to explore their perspectives on obesity, disease causation, and their ideas on the functionality of cultural, social, historical, environmental, and psychological forces in altering healthy eating habits. Reoccurring themes centered on four areas: (a) the definition of health as a mind, body, and spiritual construct; (b) conceptualizations of cultural norms regarding healthy foods versus unhealthy foods; (c) the importance of eating and social rituals on food choices; and (d) the impact of the environment in sustaining healthy initiatives. Structural constraints that uphold legacies of disenfranchisement, environmental injustice, and segregation influence the food choices available in low-wealth communities. These factors continue to operate and are vital issues to consider when designing culturally relevant wellness programs.