THE good news: For the most part big beautiful Black women are self-confident, content with their lives and are not on a destructive mission to transform themselves into living Barbie dolls. The bad news: Obesity experts say that too many Black women are caring themselves to death.
The National Center for Health Statistics' reports that more than one-half (54.3 percent) of Americans are obese, with Black women comprising the most overweight segment of the U.S. population, followed by Hispanic women. Rubbing salt into the wounds of overweight Black women is the latest University of Pennsylvania Medical Center study that indicates that Black women have "a biological disadvantage" that makes it more difficult to lose the extra weight. Researchers have found that even at rest, overweight Black women burn nearly 100 fewer calories daily than their overweight White peers.
Dr. Otelio Randall, director of the General Clinical Research Center at Howard University, disputes the assumption that Black women are biologically disadvantaged when compared to Whites. He says some people are just simply more active than others.
"There are some people who are very active, or hyperkinetic, and they constantly burn calories, even if they are not playing tennis," Dr. Randall says. "People who sit watching television and who do nothing will burn very few calories, whereas the hyperkinetic people are sitting but are constantly moving and burning energy. Some people just burn a lot of calories and it has nothing to do with being Black or White."
Although obesity contributes to heart disease, certain forms of cancer, hypertension, high blood pressure and diabetes, Black women (like those,in other ethnic groups) are continuing to pack on the pounds, says Chicago obesity specialist Soundrea Hickman, M.D., founder of the Association for Improving and Maintaining Black Health.
"In 1998, the average clothes size for Black women was 18; today it is a size 20," Dr. Hickman asserts. "I think the mistake that is happening is this `full-figured woman' title--she's no longer considered obese, she's just full-figured--it's a death sentence for the Black woman. I'd like to choke the person who came up with that title because it's killing us, and I'm sick and tired of going to funerals of Black women in their 50s."
The question remains, in a society bursting with fat-free foods, exercise videos and health clubs, why are so many Black women steadily gaining weight? Some experts believe that Black women don't view their weight problem as a health problem. "I really believe that weight is a health issue, and if Black women don't see it as a health issue, then we need to educate them," says Shiriki Kumanyika, a University of Pennsylvania nutritional epidemiologist and an expert on race and obesity. "The long-term effects of weight on health for many heavy people are harmful, and it creates problems; once you get them, you can't turn back the clock."
Strengthening the belief that obesity is not a major health issue is a recent study conducted by the American Cancer Society (ACS) that has caused confusion and outrage among some obesity specialists.
The ACS study indicates that overweight Black women were not more likely to suffer premature deaths when compared to their normal-weight peers. And while health and nutritional experts are scratching their heads in disbelief, many fat-acceptance organizations are touting the ACS' findings as the scientific validation of obesity that they've been searching for.
But Dr. Kumanyika warns that although the study was "well-done, people should not ignore a pertinent fact--excess fat is fatal. "To use the ACS study to say that Black women don't have to worry about weight would be a huge disservice," Dr. Kumanyika asserts. "Death was the outcome of that study, not disease, and the study's death rate included all kinds of things that people die from; some are obesity-related, some are not. Obesity contributes to health problems in a variety of ways, and you may not be able to sort it out as a specific factor because other things are in the equation as well."
What's interesting about today's heftier Black women is that contrary to popular belief, many are not just sitting in front of the tube and letting themselves go. They dress to impress, love to exercise, have prominent jobs and lead active social lives.
At 6 feet tall, and wearing a size 26, Omaha native Davina Brown says she loves her body, works out often and is not at all swayed by the skinny women she sees on television and in the movies.
"I don't idealize or relate to those media images of European-American women who are very unrealistic and actually look as if they could use a good hamburger," says Brown, a customer service manager. "Those women are not real; they are only characters, and I don't relate to them."
Many larger women--with healthy egos, healthy role models and the support of obesity groups--consider themselves to be physically fit, and they get regular exercise to feel good rather than to transform themselves into the elusive size 6. And ironically, most consider themselves to be in better shape than their thinner counterparts.
"The only time I had a health problem was during my pregnancy when I had high blood pressure," says Dee Dee Underwood, a Washington, D.C., administrative assistant at a television network. "Today my blood sugar and cholesterol levels are great. I love to walk and I'm healthier than many people who are smaller than I am."
Susan Lowe, an Atlanta salon owner who walks constantly while at work, says that skinny women have just as much to worry about health-wise as overweight women. "I often think about other people who are in good shape but who have health problems," says Lowe, who wears a size 22. "My uncle works out every day, but he's a diabetic; I know of several small-framed people who have had heart attacks. Just because you're skinny doesn't mean that you're healthy."
Dr. Fred L. Daniels, an internist in Chicago, agrees that some overweight women are in good shape. "Every obese person is not unhealthy. You have to make distinctions between a healthy, obese patient and a poorly conditioned obese patient," Dr. Daniels explains. "Conditioned obese patients are those who exercise very frequently but because of genetic structure are not going to lose 100 pounds. In many cases they are in much better shape than thin, unconditioned patients."
Chicago native Viola Norwood, an IBM project network manager, says she is quite healthy. "I ride a bike and I'm an active member at my health club. I'm pretty healthy and I look good, and I wouldn't change a thing about myself," she says.
Positive self-image is undoubtedly a plus for overweight women, but many make the sometimes fatal mistake of equating good looks with being healthy.
Dr. Hickman recalls that during a health seminar, this woman who was well over 300 pounds said: "My hair looks good when I walk out the door in the morning. My makeup is always perfect, and my shoes match my outfit. Therefore I'm healthy." At that point, she realized that there had been no emphasis on weight as being a health problem.
Dr. Hickman's unconventional weight-loss techniques has yielded positive results for her clients. Her program fuses beauty and sensuality classes (she teaches everything from make-up application to exotic dancing) with nutrition education and exercise routines. The health/beauty combination is' working; her clients are slimming down. "Black women respond to beauty and relationships, but they don't respond to health, so I'm trying to bring the two together," she says.
The bottom line is that having a healthy self-image and actually living a healthy lifestyle are two separate entities, and one should not be mistaken or forsaken for the other. Any overweight person (or underweight person for that matter) should not be fooled into believing that looking good is equivalent to her overall health status. And for the most part, many overweight women do not make the important connection between obesity and its associated health effects, says Dr. Kumanyika.
"Some people accept the knee problem or the high blood pressure as a natural part of aging, and they are not making the connection to obesity," Dr. Kumanyika explains. "I want women to understand that after a certain level, carrying the excess weight can cause metabolic changes that are likely to reduce their quality of life."
To that end, a four-year study of 40,000 female nurses published in The Journal of the American Medical Association recently reported that overweight women who had lost as little as five pounds handled everyday activities with more ease and reported fewer aches and pains, whereas women who gained as little as five pounds experienced the reverse effect.
