Is There A Better Way To Talk About Obesity?

A recent study projects that more than 40 percent of Americans will be obese by the year 2030. Host Michel Martin delves into the cultural factors that might be preventing African-Americans and Latinos from losing weight. Martin speaks with Jane Delgado of the National Alliance for Hispanic Health, and Jenee Desmond-Harris of The Root.

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MICHEL MARTIN, HOST:

I'm Michel Martin and this is TELL ME MORE from NPR News. Now, we want to go behind closed doors. That's the part of the program where we talk about issues that many people often talk about only in private.

Today, though, we want to swing open the door on weight. Now, who hasn't said, I shouldn't have eaten that cupcake or I should go to the gym more? But there's also a lot about controlling weight that people are ashamed to talk about, and now there's a new study that's caught a lot of attention. Forty-two percent of Americans are now projected to be obese by the year 2030, that according to the American Journal of Preventative Medicine.

And that sounds like a shocking number, but African-Americans have already passed that mark. Forty-four percent are obese, according to the Centers for Disease Control and obesity rates are high among Latinos, as well.

And we wanted to talk more about this, so we've called Jenee Desmond-Harris. She is a staff writer for The Root. That's a news and commentary site with an African-American perspective. They've just launched a yearlong series on blacks and obesity.

Also with us is Jane Delgado. She is the CEO of the National Alliance for Hispanic Health. She's the author of a number of books, including the "Latina Guide to Health." She's a trained psychotherapist and she's also with us often to talk about health issues.

I welcome you both. Thank you so much for speaking with us.

JANE DELGADO: I am thrilled, as always, to be with you, Michel.

JENEE DESMOND-HARRIS: Thank you so much for having us.

MARTIN: Jenee, let me start with you. Why did The Root decide to launch this series? What do you hope to accomplish with it?

DESMOND-HARRIS: Well, in light of some of the statistics that you mentioned of obesity among all Americans and African-Americans, as well as the first lady's focus on combating childhood obesity, we really wanted to get this conversation going in a way that went beyond - oh, my God, black people are so fat and they're getting fatter. It's terrible. What are we going to do? We wanted to add a little more perspective and nuance as far as the nature of the problem and the solutions.

MARTIN: What are some of the kinds of things you want to explore?

DESMOND-HARRIS: Well, we even want to take a step all the way back and say, is there really a problem? And if it is, we want to know what's causing it on an individual level, but also on a systemic level and we want to look at solutions that can be implemented in both ways.

MARTIN: Jane Delgado, I should mention that we've spoken with you about this issue before. You don't even like the term obesity. You prefer the term, excess weight. Could you talk a little bit about why that is?

DELGADO: Well, one of the things that is happening in the sciences is that we're learning that excess weight may be a consequence of illness, of an endocrine system that's not working so that the fact that someone tends to gain weight may be because their endocrine system is out of balance and there's more and more evidence to this effect.

Additionally, different kinds of people have different kinds of body frames, which means what's BMI good for one person may not be good for another person.

MARTIN: BMI being body mass index.

DELGADO: Right. And, you know, in the NIH tables, for example, it very clearly says that, for African-America, it overstates what is obese, so that people should not be considered obese, but they still have the tables and everybody uses them.

MARTIN: What is your take on the numbers that we are citing that suggest that 44 percent of African-Americans have excess weight, that something like 30 percent - is it - of Latinos have excess weight and that, overall, the numbers seem to be inching higher for Americans, in general? What, in your view, is driving this?

DELGADO: Well, first of all, remember that Hispanics and African-Americans have always had more excess weight, but Hispanics live longer than non-Hispanic whites and have less heart disease, so the very things that people are concerned about that causes excess weight is not true in our community.

The question is, why do people have excess weight? When does it become a problem and how to fix it? And the thing which is most discouraging to me is this view in America that, if you are overweight, it's 'cause you're lazy. You're not trying and you really don't have the will to do it, when in fact, sometimes, it's very hard to change.

MARTIN: As a person - as a health care provider yourself, are you encouraged or discouraged by the renewed focus that we seem to be placing on weight?

DELGADO: When Surgeon General Satcher was the surgeon general, he's the one who started this whole issue in looking at excess weight. Way back then, I told him - I said, David, women have always been concerned about their weight. We've got to do something to build people's self-esteem and self-image so that they feel good about themselves and do the kinds of things they need to do. So it's been a long history of following this as a trend.

And now, unfortunately, obesity has become a funding source in the health area. If you're doing something at obesity foundations, you know, corporations, all sorts of people want to jump at your door to say, oh, yes. Let me help you. But it's not necessarily the right people.

MARTIN: But isn't it the case, though, that there are more deaths associated with illnesses that are associated with excess weight than there are deaths associated with smoking? I mean, isn't that the case now?

DELGADO: No. Because the difference is, with smoking, we know that smoking causes a carcinogen to go into your body. With excess weight, people are very careful because we don't know whether the excess weight is a cause of the illness or a consequence of it. And that's the big science question that people are looking at now.

MARTIN: If you're just joining us, you're listening to TELL ME MORE from NPR News. We're going behind closed doors to talk about weight. I'm speaking with Jane Delgado. She is the CEO of the National Alliance for Hispanic Health and the author of a number of books about health. Also with us, Jenee Desmond-Harris, staff writer for The Root. She's launching a year-long series on African-Americans and obesity.

Jenee Desmond-Harris, a recent op-ed by Alice Randall, who's an African-American writer, has been getting a lot of buzz. She wrote in The New York Times that, quote, "many black women are fat because we want to be," unquote. And she argues that there are a lot of cultural issues at work. One of them is that there's a cultural preference for women to be larger size in the African-American community. This has set off a lot of discussion. What are you hearing about that argument?

DESMOND-HARRIS: Yeah, we have sort of participated in and helped to curate(ph) a conversation on that particular piece, which I think is about some bigger issues. There's a lot of frustration with what Ms. Randall said, I think because of the perception that she was speaking about her own anecdotal experience, which may be true. You know, she mentioned that in her view being overweight was a source of political resistance against the image of the fit slave. Those things were brand new to a lot of people.

Like a lot of black women had not heard those before and they didn't sound familiar, so there was a lot of pushback. But I think in a bigger sense the upside about it was about this real frustration we have as African-Americans, and particularly as African-American women, as being portrayed as a monolith. We're all of the same. If there's something wrong there is one cause and there's one solution. And people are sick and tired of that when it comes to relationships, when it comes to other issues, and increasingly so when it comes to this issue of weight and obesity.

MARTIN: Where are you going to try to take this conversation in a way that hopefully will not irritate people and make them feel once again that they are reduced to one dimension?

DESMOND-HARRIS: We're talking to people from a variety of different perspectives - from health professionals to personal trainers to, you know, sociologists who all have different ideas about what's causing the high rates of obesity to(ph) excess weight among African-Americans. And ultimately our goal is for people to listen to the solutions and hopefully have a healthier community.

MARTIN: Jane Galgano, you know, one of the things that's interesting, though, that the survey shows that African-Americans and Latinos as a whole are statistically carrying more weight - women are caring more weight - but like their bodies more.

DELGADO: Isn't that wonderful?

MARTIN: Well, is it?

DELGADO: It is. You know, one of the things that produces like body fat like in your belly for women is stress. When you are under stress, your brain produces more cortisol, it gives you more belly fat.

I think, though, for women, Hispanic women and African-American women to have a good self image, that's a good thing, we should be happy about that. The problem I feel bad is for a lot of non-Hispanic white women who suffer with anorexia and all sorts of body image dysfunctions because they don't have those images. But the thing is, each woman, regardless of her size, has to be as healthy and fit as she can be. That's a different thing for every person. Regardless of race, ethnicity, she's got to find that spot where she can be happy - whatever that is - and that's where the work is.

MARTIN: But there are those who argue, though, that on the whole, despite the fact that excess weight has become such a part of the conversation, the national part of the conversation, Americans on the whole and ethnic minorities particularly, blacks and Latinos, are in denial about it because our entire sort of culture has not kind of embraced to promote more healthy living. You know, more exercise, healthier diet, and so forth. There are those who argue that we think we can kind of pray it away or we can, but not...

DELGADO: No.

MARTIN: No?

DELGADO: I don't think so, Michel, because for example, it is rare the woman I speak to who tells me she's OK with her weight and size. So I think that across-the-board as women in America we're in a society that tells us one thing. Look, if you look at Hispanic women on television, there is not one that has excess weight. They're all like sexy, voluptuous - and our Secret Service scandal did not help us at all.

You know, that's the reality. It just fit into that kind of awful image that we as Latinos don't like to have. But, you know, it's these stereotypes...

MARTIN: But if you look at a lot of the TV stars, and African-American TV stars now are stars even - you know, it's got to be - Jenee, I don't know how you feel about this, but often it's got to be the kind of the sassy big girl...

DESMOND-HARRIS: Right.

DELGADO: Of course. Of course.

MARTIN: ...who's voracious and can sing, of course. I mean...

DESMOND-HARRIS: Right.

DELGADO: Right.

DESMOND-HARRIS: I also want to point out that...

DELGADO: She has to sing.

MARTIN: Everybody's not in love with that, so...

DESMOND-HARRIS: ...you know, when it comes to this sort of - the sort of assumed thing that we talk about, that black women and Latina women are more accepting of larger bodies, I think we should take a step back and realize that there's a lot of gray area between celebrating being curvy, like Beyonce, and you know, being totally OK with a body that's caring so much extra weight that it may or may not be causing you serious health issues and affecting your ability to live your life. And I think those two things get lumped in together. People say, you know, women of color are fine with their bodies, they love extra weight. No wonder they're dying of diabetes. And I think there's really a lot more detail there that needs to be looked at, and that's a real source of frustration when we talk about this, is that all gets sorted of like lumped together.

MARTIN: Well, why don't you tell us where you're going to go next. And then Jane Delgado, I'll give you the last word about where you'd like us to go next.

DESMOND-HARRIS: Actually, I have an interview coming up that I think Jane would actually appreciate. It's an African-American woman who is a blogger who is part of the fat acceptance movement. And so she's really resisting any notion that we should try to control or comment on each other's bodies, and she absolutely believes that you can be fit and healthy while being a size that society would consider overweight. So that's something that will probably round out our series of bit.

MARTIN: OK. Jane Delgado, where would you like this conversation to go?

DELGADO: In two ways. Well(ph), first, I want women to be more accepting of their bodies and be healthy and fit. You know, people talk about skinny fat being a problem. We also want people to know that it's OK to be healthy fat. But the most important thing is I'd like people to seriously look at environmental factors like endocrine disruptors and what they're doing to us, not just in terms of obesity and excess weight and whatever you want to call it, but also how come African-American and Hispanic girls are reaching puberty younger. I think it's all connected and we really have to look at the bigger picture of what's happening to our lives. How has our environment changed so much in the last 30 years that our bodies are now responding?

MARTIN: What about food supply and the quality and availability of food? Is that also an issue?

DELGADO: That's a separate issue because obviously the food we eat is very important, also the selection of food. There are many, many factors to this. You know, when we talk about excess weight, we talk about 10 things that you can do to be healthy. One of them is your food selection. There are a lot of other things you have to do too.

MARTIN: Jane Delgado is the CEO of the National Alliance for Hispanic Health. She's the author of a number of books, including "The Latina Guide to Health." She's a trained psychotherapist and a frequent guest on this program to talk about health issues. Jenee Desmond-Harris is a staff writer for The Root. That's an African-American news and commentary site. And they were kind enough to join us in our Washington, D.C. studios.

Ladies, thank you so much for joining us.

DESMOND-HARRIS: Thank you.

DELGADO: Thank you.

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