Cultural notions contribute to African-American obesity, medical anthropologist says
Book seeks to guide Blacks to healthful eating
Mary Beth Faller
The Arizona Republic
Jun. 14, 2006 12:00 AM
It's a sensitive topic, and Eric J. Bailey has heard about it.
"I've already received some subtle remarks saying, 'Why are you doing this?' " he says.
Bailey, a medical anthropologist, has written a new book, Food Choice and Obesity in Black America: Creating a New Cultural Diet (Praeger Publishers, 2006, $39.95, hardcover).
"The African-American community is conservative," says Bailey, who is Black. "So many things just are not talked about. Weight is just one of those things.
"But we need to bring theses issues to the forefront because we're losing too many people needlessly and the quality of life has declined dramatically."
Not only is obesity more prevalent among Black Americans than other ethnic groups, Blacks also are more likely to be diagnosed with diabetes, according to the Centers for Disease Control and Prevention. And they are more likely to experience higher rates of serious complications from the disease, such as blindness, amputation and end-stage renal disease.
There are many cultural reasons for the higher rates of obesity, as Bailey cites in his book, having to do not only with food but also with physical activity, including:
• Food is a major focus of social and church gatherings for Black people, and the type of food served is often fried or otherwise laden with fat.
• Cost is an issue with food. For example, it's cheaper to buy three boxes of macaroni and cheese than a pound of boneless chicken breasts.
• Physical activity is often hindered by time constraints, cost and unsafe neighborhoods.
Bailey admits those factors can affect many subsets of the population, but other factors are deeply cultural.
"If you're an African-American trying to make it in society and you're not able to make it, food is one way to console yourself," he says. "If you're not able to achieve that professional success, you can still purchase food, and it's one way to achieve success in your family and community."
There are also complex emotions having to do with exercise.
"A lot of African-Americans think that if this person is out jogging or doing other certain kinds of physical activity, they see it as moving toward mainstream society, and they'll recoil from it," he says.
A major barrier to reversing the overweight trend, Bailey says, is Blacks' perception of it. In the African-American community, a full physique is considered an ideal body type, whereas extreme thinness is not. Bailey cites studies indicating that Black people don't consider being overweight a health problem.
"They don't see it as overweight, they see it as being a little heavy" or "big-boned," he says.
"It's extremely difficult to address, yet it has to be challenged," he says. "Food is the instrument that is causing us poor health."
Bailey is not a physician; he's a medical anthropologist, looking at health and disease from a biological, psychological and social perspective. He's an associate professor of anthropology and family medicine at East Carolina University.
"I look at all the factors that come into play about why people adhere to a specific regimen or how they perceive disease or illness a certain way," he says.
Language is a key factor in his studies.
"You hear it all the time: 'That girl is going to be the same size as her mama,' or 'That boy is just thick,' " he says.
"Those are cultural messages, and it's setting up the younger generation to be overweight."
The topic of weight also had personal relevance. Bailey realized a few years ago that he had gained more than 20 pounds.
"It sneaks up on you," he says.
He studied popular literature, such as diet books and cookbooks, as well as academic research. He started eating healthfully and exercising and eventually lost the weight. He and his family brought baked, skinless chicken and pita chips to family events. Relatives were skeptical.
"They were hesitant at first, but we tried it again and again, and they realized the food still has flavor," he says.
Several pilot programs that integrated cultural attitudes have been successful over the years. For example, many mainstream exercise programs emphasize weight loss to look better. But exercise programs geared toward Black women work better when they emphasize recreation and social interaction. The Black American Lifestyle Intervention project of 1991 used a Black nutritionist to lead interactive nutrition sessions, and menus, recipes and educational materials were culturally appropriate. Another program was offered through churches and included aerobics done to gospel music and nutrition training for pastors.
Bailey is optimistic that the African-American community will respond to the challenge, especially the younger generation: "They're not buying into that language."
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