Battle For Minimum Weight

Caught up in the frenetic grind of her fashion industry job, Allison Ferrell, 41, paid little attention to what she ate. As director of production, logistics, and operations for Abaeté, a New York-based women’s dress collection, lunch was a luxury she couldn’t afford. “I was crazed and I couldn’t spare the time. So if I didn’t eat by 1 p.m., that was it for the rest of the day.” After a 2005 surgery to remove fibroids left her with a delicate stomach, Ferrell avoided a litany of foods and routinely skipped meals.

Her erratic eating habits kicked her body into pre-starvation mode. Not knowing when it would receive the necessary nutrients, her body stopped burning calories and began to store food reserves, causing an increase in body fat. According to the American Council on Exercise, the average body fat range for women is 25% to 31%; 32% and above is obese. Ferrell measured almost 39%. Accustomed all her life to being thin, she was now flummoxed by having gained 15 pounds. “I’d had a good run, but my negative habits were catching up with me and it was time to take care of myself,” she says.

Ferrell is hardly alone in her struggle to manage her weight. The American Obesity Association estimates that approximately 127 million adults are overweight. The escalating phenomenon of obesity has become a national crisis, and nowhere is it more evident than in African American communities. Recent statistics from the Centers for Disease Control and Prevention show nearly 52% of black women are obese–the highest of all ethnic groups–and about 30% of black men are obese.

THE PRICE OF OBESITY
America’s burgeoning waistlines are also having an impact on the business world. According to a study by Duke University Medical Center, obese workers filed double the number of workers’ compensation claims, had almost seven times higher medical costs from such claims, anbe,be,d lost about 13 times more days of work from job injury or illness than did non-obese workers. Obese workers also have up to 21% higher healthcare costs than those who are at a healthy weight.

The study, titled Obesity and Workers’ Compensation, concludes that there’s a direct connection between Body Mass Index (BMI) and the rate of health insurance claims. Dr. Truls Østbye of the Department of Community and Family Medicine at Duke University Medical Center points out that some of the more common insurance claims among overweight employees involved shoulder, wrist, lower back, hip, ankle, and knee injuries. “What surprised us was not the fact that there was a relationship between obesity and workers’ comp claims and time off work for work-related injuries, but that the effect was so strong,” says Østbye, the study’s lead author.

BMI is a widely used formula that uses weight and height measurements to assess total body fat and provides healthy weight ranges for all ethnicities. BMI is also an indicator of heightened risk for developing diabetes, heart disease, and other obesity-related illnesses. A BMI of 18.5 to 24.9 is considered normal. However, a BMI of 25 to 29.9 is overweight, and 30 and higher is obese. The waist circumference measurement is used to determine obesity-related health risks specific to abdominal fat.

CHANGING CULTURE
Despite glaring evidence, many African Americans have a poor perception of what is considered to be a healthy weight and fail to recognize their weight as problematic. Dr. Ian Smith, medical and diet expert for VH1’s Celebrity Fit Club and author of Extreme Fat Smash Diet, explains, “This speaks to the core concept of self-definition and what we think we look like.” To change the tide, Smith insists, the imperative is to change the cultural mind-set that promotes and sustains the behavioral habits that cause obesity. The curvaceous, full-figured body is the feminine ideal in black culture, which is why many black women are resistant to weight loss; they equate maintaining a healthy weight with losing their curves and by extension their attractiveness. “There is a tendency to sexualize weight,” Smith notes. “You can be full-figured and still be healthy. We shouldn’t be defined by a condition that is damaging to our health, but instead by our courage, inner and outer beauty, and our vigor for life.”

While a variety of factors contribute to obesity and being overweight, the root causes remain the same: lack of exercise and poor nutritional choices. The consequences of obesity present a smorgasbord of debilitating illnesses, including diabetes, heart disease, stroke, hypertension, and certain cancers, which have a domino effect on the body’s physiology. What has been commonly considered “a little sugar” has now morphed into a runaway epidemic affecting an estimated 18 million Americans, with blacks at a 1.6 greater risk of developing diabetes than whites.

Obesity leads to diabetic complications which can include stroke, kidney failure, amputation, and blindness. “Obesity is one of the primary causes of type 2 diabetes, which increases the occurrence of cardiovascular disease, resulting in an 80% death rate from heart attacks,” says Dr. Christopher J.W. B. Leggett, director of cardiology for Medical Associates of North Georgia in Canton, Georgia. Excess abdominal fat is highly problematic. It expands, releasing chemicals that ensure its continued existence. This in turn creates a resistance to the hormone insulin, which controls blood sugar. Increased insulin-resistance exhausts the pancreatic gland, resulting in high blood-sugar levels, which sets the stage for diabetes.

Additionally, the cardio vasculature of the body is impacted by elevated cholesterol and lipids in the blood. A buildup of low-density lipoprotein (LDL or “bad” cholesterol) and other food slush form plaque within the coronary arteries, the vessels that supply blood to the heart. This deposit eventually narrows the opening of the blood vessels that supply organs with oxygen and nutrients. A rupture in the coronary artery causes a heart attack; ruptures in the carotid arteries can cause stroke or thrombosis, the formation of a blood clot within a blood vessel. Blockages in the lower extremities often lead to poor circulation, joint pain, and even amputation.

An American Cancer Society study shows that up to 90,000 cancer deaths annually can be attributed to obesity and being overweight. Researchers speculate that increased production of insulin and estrogen stimulates the growth of cancer cells. In women, obesity is related to elevated risk of uterine, breast, cervical, ovarian, renal cell, and endometrial cancers; in men, prostate cancer. The high incidence and virulence of obesity-related diseases are exacerbated by lack of preventive care and appropriate health screenings. Smith explains: “Blacks tend to visit the doctor later, and by then these illnesses are less treatable and less curable, and the body is weakened. That’s why whether it’s talking to your physician or going to a free clinic, we must become more proactive about our own health.”

An unspoken consequence of obesity is the double jeopardy of weight discrimination within the healthcare industry. Doctors’ subjective opinions and prejudices can negatively impact medical treatment, care, and outcome. A physician may, for example, withhold treatment or a procedure based on latent feelings that the obese patient is lazy or lacks discipline, self-respect, or willpower.

A PRESCRIPTION FOR HEALTH
Is it possible to halt the upward trend of obesity? Healthcare experts agree that education and moderation are keys to incorporating healthy habits into daily living. Despite the promises of diet-pill pushers and the growing popularity of bariatric and gastric bypass surgeries, the surest solution to weight loss remains diet and lifestyle changes. Lisa Jubilee, nutritionist and cofounder of Living Proof, a nutrition and fitness center in New York City, requires clients to keep
a food journal and formulates eating plans tailor-made for the lifestyle and needs of the individual. She suggests walking 10 blocks a day if squeezing in 30 minutes of daily exercise seems like too much at first. And eating whole foods–whole grains, fruits and vegetables, fresh lean meat and fish–as much as possible.
For employers looking to lower the number of employee health insurance claims, Østbye recommends the following:

Stocking healthy food in cafeterias and snack machines
Creating walking trails around the workplace
Having annual health and lifestyle checkups and offering follow-up programs for those who are obese
Working to make the environment safer for everyone and training all workers to recognize situations likely to lead to injury

For people like Ferrell, Jubilee suggests different ways to prepare old favorites, such as baking instead of frying foods, and minimizing the amount of batter used to make treats such as biscuits. Small steps are necessary to make the big changes that will sustain weight loss. Ultimately, African Americans have the means and opportunity to overcome the tide of obesity and being overweight by setting new, grander examples of healthy living for this generation and the next.

Gender
Age
Race
Rates of workers’ compensation claims, lost days, and claims costs
Per 100 full-time employees *for referrals to outside providers Source: obesity and workers’ compensation: results from the duke health and safety surveillance system

Dr. Ian Smith has thrown down the gauntlet. In what is gearing up to be the most historic health initiative ever undertaken for African Americans, the popular medical and diet expert for VH1’s Celebrity Fit Club, recently launched the 50 Million Pound Challenge, a program to educate and empower individuals by providing the tools and resources to make weight loss work. “We’re creating a groundswell within our communities about the need to lose weight so we can live longer, healthier lives and improve quality of life. With African Americans leading statistics for obesity and being overweight and the high prevalence of weight-influenced diseases within the community, the challenge is the perfect catalyst for change,” Smith says. “We are a strong, proud people and we can come together to help each other to reverse these trends.”

The Challenge isn’t only about the pounds on the scale; it’s a communal effort that addresses the entire spectrum of weight loss. Smith and his champions have enlisted the help of community organizations and health professionals, including the National Medical Association, American Diabetes Association, National Urban League, and the Congressional Black Caucus. “We’re encouraging conversations about weight loss and about what healthy looks like,” Smith adds. One imperative is removing psychological impediments to weight loss which are often warped by perceptions of beauty. “We’d also like healthcare professionals to discuss with their patients why this is a critical health issue and provide information to help make lifestyle changes that would prevent their premature death.” Another key component is helping individuals understand how they can make small, wholesome food substitutions without sacrificing taste and enjoyment.

Individuals can visit or contact any one of sponsor State Farm’s more than 11,000 participating offices throughout the country for a free Challenge kit, which includes a CD and nutritional booklet on dieting, exercise, and healthy living, and a pedometer. Website visitors can sign up for a free account to track weight loss, receive nutrition and exercise information, and calculate BMI. Smith says, “The Challenge is my contribution toward getting people inspired and encouraged to make changes to protect their health.”

Average number of lost days, medical costs, and indemnity costs per claim by BMI group
Source: obesity and workers’ compensation: results from the duke health and safety surveillance system