As researchers categorize issues facing Black women's health, obesity and physical exercise continue to be significant topics of debate. General interventions targeted toward Black women to address obesity and increase physical exercise have been largely ineffective. In this article, I situate the current public health discourse on obesity and related interventions within a sociocultural context of body appearance, with a specific focus on hair. Why do some African American women feel such strong ties to their hair that they will avoid exercise? What can be done to understand this phenomenon and address alternatives that may make both hair maintenance and regular exercise feasible? I map a theoretical argument for why hair matters for some women, and discuss how physical activity intervention strategies might be improved by considering such complexities.