Living Large: Doctors Tackle Obesity in Black Women

Thursday, 04 August 2011
By Chris Levister –

Obesity is a nationwide epidemic across the racial spectrum and it's a big problem for African-American women, more than half of whom are considered overweight. The prevalence, causes, and consequences surrounding obesity were the focus of intense discussion, debate and concern at the National Medical Association (NMA) 2011 Annual Convention and Scientific Assembly, July 23-27. The prevalence is clear, 77 percent of African American women are overweight. 50 percent of Black women are obese.

Marilyn Hughes Gaston, M.D. and Gayle K. Porter, PsyD, founders of the Gaston & Porter Health Improvement Center in Potomac, Maryland told a standing room only audience, the root causes, misconceptions, paradoxes and consequences are as clear as mud.

Recently 351 Black women 40-75 years of age signed up for a 12-week intervention called Prime Time Sister Circles. Less than 10% of the women in the program reported being of normal weight by prevailing standards – the rest were overweight, obese or extremely obese. More than half of participants reported health concerns such as diabetes and heart disease. Nearly 70% reported high blood pressure.

Dr. Gaston said the survey “exploded with misconceptions” about the root causes of obesity in the Black community. “This is not a diagnosis of poor people with poor eating habits,” she explained.

The survey found a tsunami of contributing factors including depression, yoyo dieting, cravings, poor self esteem, sexual abuse, emotional eating and a perception, reinforced by celebrities such as Queen Latifah and Mo’Nique that African American women are satisfied with their weights.

The survey also found that only 10% of obese women expressed satisfaction with their weight which might play a role in the high rates of depression, stress and morbidity seen in Black women.

Denia Tapscott, M.D. program director of the Center for Wellness and Weight Loss Surgery at Howard University in Washington D.C. told the audience sexual abuse in young Black women is an important factor contributing to the obesity epidemic.

Research shows about 1 in 4 young women have experienced physical or verbal abuse in dating situations with Black and other minority women showing the highest risk.

“If you look at recurring patterns in teenagers, many girls have been sexually or physically abused and have never talked about it . Instead they eat,” explained Janet Taylor, M.D. , a psychiatrist at Harlem Hospital in New York City.

“Internalized racism, “weathering” is postulated to be responsible for increased psychosocial stress and blood pressure in Blacks said,” said Richard Kotomori M.D. , a Riverside, California, Adolescent and Adult Psychiatrist.

He explained measures of chronic stress (eg, anger, hostility, depression, and anxiety) are also associated with increased hypertension, high levels of diabetes, elevated cholesterol, low infant birth weight and weight gain.
Other physicians lamented the perception that many Black women are overweight because brothers like it that way. “That is to say that the culture rewards women for a little extra padding,” said a member of the audience.

I think there's probably some class issues there, said a physician from Atlanta. “As kids many of us were told that brothers prefer women who have junk in the trunk – put plainly – big butts.”

Others pointed to media influenced perceptions eg, “Norbit,” the 2007 romantic comedy film starring Eddie Murphy and Thandie Newton where obese Black women are held up as objects of ridicule.

Members of the panel agreed movies aimed at Black audiences, music videos and a slew of new urban magazines that feature women with humongous rear ends are finding increasing success particularly with Black males.

Add to the obesity mix: poor nutrition reinforced by a lack of healthy choices in underserved communities, said Dr. Tapscott. “It’s not unusual to walk into Black and brown communities and find that there is not one single healthy restaurant. There's only one sit-down restaurant. Everything else is fast food.”

“How many times have we gone to grandmother’s house and sat at a table full of fried chicken, Mac and cheese and greens smothered in fatback,” added Dr. Porter.

“We are led to believe as Black folks that somehow that food is good for us because that's the food that we were raised on.” The panel noted in this era, led by “bootstrap mentality” in which Black women are collectively carving a place in the society that enslaved them exercise over constant work is not an option.

“Bally Fitness’ and 24-Hour Fitness’ aren’t in our communities. Then there’s the other issue of Black women unwilling to take the time to exercise and sweat for fear of messing up their hair,” said a physician in the audience.
“As Black women in particular, we take care of everybody and nobody takes care of us and we don't take care of ourselves,” said Dr. Taylor.

“The numbers speak for themselves in terms of diabetes and hypertension and how much sooner we die than other people. When we get those conditions, we get them much more severely.”

Dr. Gaston explained some physicians are reluctant to address obesity in the Black community because they don’t want to offend Black women.
“We have to come face to face with the facts on how we ourselves play a role in this epidemic as well.”

“We're on dangerous territory here, but we’ve got to take the veil off this issue,” said Dr. Porter.

She said African American doctors are in a pivotal position to lead the charge with individual education, healthcare education and community education.

“Obesi ty is a significant health threat. Obesity should be viewed as a chronic condition. Effective treatment requires a multidisciplinary approach. We have to help people change the way they think!”

“Most doctors ask patients, are you having unprotect sex,” said Dr. Porter. “It’s now time to ask what’s on your plate – literally and figuratively.”

The NMA represents more than 30,000 African-American physicians. Founded in 1895 it is the largest organization representing African-American physicians and the patients they service.