Black Women & Obesity: What Are We Missing? Part I- BMI & Body Composition

Updated: Aug 5


We hear the statistics often, "Two-thirds of Black women are overweight or have obesity."

But too often, the discussion stops at this statistic.

It's time to stop quoting statistics. Instead, let's create personalized solutions. For example, I wrote "The Obesity Disparity in Black Women: How to Be More Inclusive" for on behalf of Physician Weekly. The Obesity Medicine Association released this article in preparation for the upcoming Spring Summitt in Atlanta, GA, April 27-May 1st, 2022. I will be presenting "Obesity and Black Women: What Are We Missing?"

Here are a few thoughts on the topic in preparation for the conference.


Obesity Isn't A Lifestyle Choice.


The latest scientific evidence shows that obesity is a complex disease. Many biopsychosocial factors disrupt the body's metabolism. Outdated science on obesity overlooks the importance of psychological stress, sleep hygiene, socioeconomic status, psychological trauma, weight bias, and racial discrimination in diagnosing and treating obesity. Each factor uniquely impacts Black women and obesity.





BMI Is Biased


The BMI, or Body Mass Index, is the most commonly used clinical tool to assess weight-related health. But it wasn't designed to check individual weight-related health.


For one thing, BMI doesn't tell your body composition. Specifically, it's essential to know if your "extra weight" is due to extra fat. You indeed need a specific amount of body fat for optimal health. But, on the other hand, too much body fat or "adipose tissue" increases your metabolic disease risk.

Also, where the fat is matters. For example, visceral fat, such as abdominal fat, is more associated with disease risk.



Body Composition Differences & Adjusted BMI

Studies have found that Black people have more muscle. So the standard BMI tends to overestimate "overweight/ obesity" in Black women. To address this discrepancy, Dr. Fatima Cody-Stanford & her team have proposed adjusted BMI charts. The new chart adjusts target BMI levels based on race/ethnicity, biological sex, and obesity-related conditions.

For example, using Stanford's adjusted BMI chart, a Black woman with diabetes and a BMI of 30 kg/m2 would not have obesity. However, her new obesity range BMI would be greater than 32kg/m2.


There is still ongoing research into the widespread clinical use of the adjusted BMI charts. But it highlights that BMI should only be the starting point for evaluating your individualized healthy weight. I discuss

"Your Healthy Weight" in-depth in Chapter 2: Embrace You: Your Guide to Transforming Weight Loss Misconception Into Lifelong Wellness, Healthy Weight of Healthline's Best Overall Weight Loss Book of 2022.


It's important to evaluate body composition, waist circumference, and metabolic health to assess healthy weight for Black women and all people individually,



Wellness Can't Wait

In conclusion, surviving the COVID-19 pandemic has taught us that Black women's wellness can not wait. In 2020 we witnessed the collision of two pandemics, the obesity pandemic, and the COVID-19. People of color and people with obesity were disproportionately affected by COVID-19. The pandemic was a tragic reminder obesity has to be addressed with practical, individualized solutions, especially for Black women. Addressing obesity goes beyond weight loss. It's about gain wellness and creating generational health.


Fortunately, many researchers and stakeholders have been exploring solutions to the obesity epidemic in Black women. I'm grateful to stand on the shoulders of phenomenal researchers who have extensively studied the complexity of obesity in Black women. Researchers such as Dr. Fatima Cody-Stanford, Dr. Tiffany Powell-Wiley, Dr. Sabrina Strings, and Dr. Tiffani Bell-Washington are some of the many champions.


More to Come

In Part II of "Obesity & Black Women: What Are We Missing," we'll discuss the role of racial discrimination, weight bias, and cultural expectations in obesity rates among Black women.


Your Turn:

What are your thoughts on Black women's weight & wellness? What is the healthcare community missing?


Join me at the Obesity Medicine Association Spring Submit for "Obesity and Black Women: What Are Missing?". Register here.


Related Resources featuring Dr. Sylvia Gonsahn-Bollie, MD

The Obesity Disparity in Black Women: How to Be More Inclusive, Physician Weekly


Black Health Learning Academy: Obesity is A Disease


How to Unlearn Weight Bias , Livestrong.Com

Why BMI Can Be Problematic the BIPOC Community? , Everyday Health


Why the Body Mass Index Is So Often Misleading According to Doctors, Prevention Magazine


Scientific American, Readers Respond to July 2020 Issue for Fighting the Racist Roots of Obesity


References

Byrd, A. S., Toth, A. T., & Stanford, F. C. (2018). Racial Disparities in Obesity Treatment. Current obesity reports, 7(2), 130–138. https://doi.org/10.1007/s13679-018-0301-3


Stanford, et al (2019). “Race, Ethnicity, Sex, and Obesity: Is It Time to Personalize the Scale?” Mayo Clin Proc. 94(2):362-369. https://www.mayoclinicproceedings.org/action/showPdf?pii=S0025-6196%2818%2930807-3 on 10/30/2020


Agyemang, P., & Powell-Wiley, T. M. (2013). Obesity and Black Women: Special Considerations Related to Genesis and Therapeutic Approaches. Current cardiovascular risk reports, 7(5), 378–386. https://doi.org/10.1007/s12170-013-0328-7

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