Ending the Obesity Epidemic

Rampaging obesity and related illnesses in the African-American community have triggered calls for urgent action to halt their deadly advance.??

One Wednesday evening last November, a standing-room-only audience of journalists, medical specialists, fitness practitioners and other health experts showed up for a forum in New York City titled ?The U.S. Obesity Epidemic: African-Americans at Risk.?

The forum was hosted by the New York Association of Black Journalists and The New York Times Co.?s African Heritage Network. Presenters not only recited frightening obesity statistics for the African-American community and reasons for those statistics, but they also stressed the urgency of ending what clearly is an epidemic in the community and offered ways to do so.
All agreed that access to quality care, a sedentary lifestyle and cultural influences ? such as food choices, perceptions of weight and a stigma associated with getting treatment ? are major culprits. ?By the time we think we?re overweight, we?re obese,? said Virgie Bright Ellington, M.D., a board-certified internal medicine physician, television medical analyst and author of What Your Doctor Wants You to Know But Doesn?t Have Time to Tell You. Ellington moderated the panel.

According to the Centers for Disease Control and Prevention, 36 percent of African-Americans are obese, 51 percent higher than the general population. African-Americans suffer disproportionately from obesity-related diseases such as type 2 diabetes, hypertension, cancer and heart disease, which are also the leading causes of death among people of color. Childhood obesity among African-Americans is especially worrying, with 22 percent of Black children six to 19 years old likely to be overweight compares to 15.5 percent of non-Hispanic whites, the CDC reports.

Why the explosion of childhood obesity?

?We live in a supersize society. What was ?large? years ago is ?medium? today. We?re more sedentary. Carbs are cheaper,? said William Gibbs, M.D., medical director, Department of Rehabilitation Medicine and founder of Pediatric Healthy Lifestyle Program at New York Hospital in Queens.

Obesity among Blacks is ?correlated to economics,? he argued, and used the real-life case of a 10-year-old ?latchkey kid? to illustrate. ?Her mom gives her money for food and she buys all the KFC and McDonald?s. She blew up. We had to admit her. She had low self-esteem. When we admitted her she started losing weight,? he recounted. Emphasizing the ?psychological health risks,? he called for ?lifestyle modification? to combat the epidemic.

In addition to cultural influences, ?there?s genetic predisposition that affects all of us. But being big-boned is not cool anymore,? said Jamie Dukes a former National Football League lineman who currently is an NFL Network commentator and analyst. Dukes revealed that he underwent gastric banding surgery to lose weight. ?We have to take a wholehearted approach to this. Diet and exercise are great, but we have to take advantage of the technology that?s out there,? he said.?

Collin Braithwaite, M.D., bariatric surgeon at Winthrop Bariatric Surgery Center in Long Island, N.Y., said a medical procedure sometimes is the only treatment option. ?Most people will be treated first with diet, exercise [and]?? lifestyle modification. But there are benefits of surgical intervention for some in the morbidly obese category,? he said. ?Once you get to that category, the patient has to make a life-and-death decision. If they don?t do surgery, they?re condemning themselves to death.?

Roy S. Johnson, vice president and editor-in-chief of Men?s Fitness magazine and MensFitness.com, urged individual and collective responsibility in addressing the problem. ?We have a lot of control over our bodies more than anything else. Like any other challenge, it is one step at a time if you make a decision that this is important to you,? he said. ?It?s a matter of each one of us helping somebody to take that first step. Our job is to empower our people with education.?

Education for empowerment requires a proactive, grassroots effort that involves churches and even barbershops and nail salons, all agreed. ?It starts in the community. No national program is going to come in and fix that situation,? Dukes declared.

That may be so, but reigniting the President?s Council on Physical Fitness and Sports (www.fitness.gov) would help, Johnson said. Established in 1956 and housed in the Department of Health and Human Services, the council develops programs and partnerships with the public, private and nonprofit sectors to promote health, physical activity and fitness for all Americans through programs and partnerships with the public, private and nonprofit sectors. The ?fittest? states have adopted fitness as a community mandate, where activities such as walk-to-school day and open-house day at gyms are organized, Johnson added. ?Colorado is the only state with twenty percent or less obesity and has the fittest cities,? he said.

Any solution comes back to the individual, insisted Lynya Floyd, health and fitness senior editor at Essence magazine. ?If you?ve made the choice, the decision that you don?t want to be this weight, you?ll figure it out,? she said.

Exercise should be a part of whatever you figure out, said Carol V.R. De Costa, M.D., medical director at Rehabilitation Medicine and Sports Services P.C., in Brooklyn, N.Y. She spoke to The Network Journal via e-mail after the forum.

?As a physician who takes care of athletes, nonathletes, the young and the elderly, I impress upon my patients that exercise is medicine. Exercise is the best tool for prevention of diseases including diabetes, hypertension, certain cancers, heart disease, obesity, depression and osteoarthritis,? she says.

That may be easier said than done, she concedes. ?Whether I am working with athletes, weekend warriors or inactive patients, time is the biggest factor needed to exercise. My recommendation is to build activity into your day every day. Literally start with walking. You can get off of the bus one stop before your destination,? she says. ?In addition, you should take time to participate in stress-relieving activities, such as going to a spa and playing a sport, says De Costa, who also is the founder of Aria Spa and Wellness Center and co-founder of Capacity Building Through Access to Wellness, both in Brooklyn.