Knowing is power: obesity among African Americans

Obesity is a gradual epidemic; severe weight gain does not happen overnight. Obesity results from years worth of eating habits related to poor socioeconomic status, depression, genes, or sedentary lifestyle.

Obesity is a word that can be “easily” thrown about in conversations or outings to describe an overweight person without knowing the actual context of the word.

The staff at Mayo Clinic defines obesity as a complex disorder involving an excessive amount of body fat that increases a person’s risk for diseases or health problems, such as heart disease, diabetes and high blood pressure.

The determining factor of obesity is found in an individual’s body mass index, or BMI, which estimates his or her body fat. When an individual’s body mass index becomes thirty or higher, the person’s weight status is considered obese or, at forty, extremely obese. However, because BMI does not directly measure body fat, it is important to add that the issue of high BMI is significantly different in the case of muscular athletes.

Maudene Nelson, RD, certified diabetes educator at Naomi Barry Diabetes Center at Columbia University, notes that Blacks have more serious diabetic complications than Whites, regarding vision loss, loss of limbs, and kidney failure.

About 13 years ago, American Psychological Association (APA) Past-President Suzanne Bennet Johnson, PhD, learned that many Black children were developing type 2 diabetes, a largely obesity-related disease that occurs mainly in adults. Then, Johnson discovered that 50 percent of African-American women develop type 2 diabetes in their lifetime.

“Over the past 20 years, the United States has become an overweight nation,” said Johnson. “America’s skyrocketing body mass index is the result of a host of factors that have made junk food and fast food inexpensive while making fresh fruits and vegetables comparatively more expensive.”

In addition, as more women work outside of the home, families become dependent on eating at restaurants because of the convenient lack of meal planning and cooking. As a result, 42 percent of today’s family food budget goes toward eating out, as compared with 21 percent in the 1960s. In this decade, almost 60 percent of Black women are obese, compared with 32 percent of White women and 41 percent of Hispanic women.

The Office on Women’s Health observes that African-American women, specifically, are more prone to disease and disability due to the lack of health care, than other minority groups. Without proper care and early identification of potential problems, chronic disease is often too late to treat or prevent. This can be considered a seriously missed opportunity in the fight between life and death. Granted, the lack of health care is not the only reason for this health gap, as racism, poverty, cultural differences and a lack of knowledge have also played a decisive role in the matter.

Moreover, a postdoctoral fellow who studies the social determinants of health at the University of Texas M.D. Anderson Cancer Center in Houston says that, people with diabetes cannot always triumph in self-empowerment while living within Black neighborhoods.

“I go to this Black neighborhood 20 minutes from my house (in a white neighborhood) and the health education they get in school is much worse than the health education my kids get,” says Carlson. “It is not just formal education, but everyday things. It’s being afraid to go out and exercise because you live in a high-crime neighborhood. It’s not having transportation to your health care provider. It’s not having decent fresh fruits and vegetables in the local grocery.”

Evidently, the social components of living in a poor inner-urban city impact its inhabitants, who depend on themselves as well as their surroundings. Therefore, a person’s socioeconomic status has a relationship with the quality and quantity of food that the individual consumes.

In a 2005 study by the American Society for Clinical Nutrition, researchers found that the highest rates of obesity and diabetes in the United States are found among the lower-income groups. The study focused on the low and high income groups’ decisions to choose certain foods.

“Food choices are made on the basis of taste, cost, convenience and, to a lesser extent, health and variety,” states one of the researchers.

“The cheapest foods contain high levels of refined grains and added sugars and fat, and tend to include processed ingredients and high-fructose corn syrup, proven to cause obesity.”

Notably, refined grains, added sugars, and added fats are the least inexpensive sources of dietary energy that is convenient and “tastes good.” In contrast, the more nutrient-dense foods, such as lean meats, fish, fresh vegetables and fruit, cost more.

As a casual solution, researchers believe that “food policy interventions at the national and international level may be the most promising approach to making healthy foods affordable and accessible to all.”

More recently, in a 2011 sample study concerning mid-life African-American women residing within Washington, D.C., the majority (64.4%) of women were either obese or extremely obese based on their body mass index. However, most (61.8%) of the sample deemed that they were healthier than other African-American women. Furthermore, one-half of the women were “somewhat to very satisfied with their health knowledge, attitudes, behaviors and their physical, emotional, and spiritual health.”

According to this study, the relationship between obesity level and socioeconomic status is null, documenting the paradox of obesity in mid-life African-American women. Though, from these results, the possibility of obtaining the “ideal image” has not changed, as most of these obese women are not completely satisfied with their body weight and shape.

Despite the overall data and setbacks of obesity-related diseases, present food choices and lifestyle can still be managed to help regulate the person’s body mass. Often times, patients give away too much of their power to health care providers and doctors.

Organizations will continue to educate Black communities about the causes of obesity, and this will be “an important first step in helping communities fight back,” says Emerson College health communication and behavioral science professor Angela Cooke-Jackson, PhD, MPH.

“So often, as Black people, we are talked about but not talked to,” says Cooke-Jackson. “We need to give Black women a voice and give them agency. Tell them how stress is affecting them, and tell their communities what they are up against.”