Blacks less likely to get weight loss surgery: Is it cultural?

Opinion

Obesity and surgery

Obesity and surgery. © michaeljung - Fotolia.com

Blacks are reportedly less likely to get bariatric surgery for weight loss than whites, although more blacks qualify, according to new numbers.

Bariatric surgeries can include a range of procedures, ranging from having a portion of the stomach removed, to reducing the size of the stomach with a gastric sleeve, that result in effective weight loss.

A study co-authored by Arch G. Mainous, III, PhD, published in the August issue of the American Journal of Gastroenterology, shows that, “Although blacks have a higher prevalence of obesity, it is unclear whether bariatric surgery has been appropriately utilized among this vulnerable population.”

The study measured numbers gathered between 1999 and 2010.

“Twenty-two per cent of black women and 11 per cent of black men were eligible for bariatric surgery, compared with 12 per cent of white women and eight per cent of white men,” states a report on the findings. “But twice as many eligible white women and men than black women and men received bariatric surgery.”

Why don’t blacks get bariatric surgery?

Roughly 50 percent of blacks and 30 percent of whites in America are classified as obese.

Study co-authors theorize that whites receive the surgery more often in part because of discrepancies in health insurance coverage. Approximately 70 percent of white men and women studied possessed insurance, versus 50 percent of black women and men. About 70 percent of the black men and women who had received the procedure used insurance to pay for it.

Still, access to health insurance only explained part of the discrepancy. Cultural and “racial” factors were mentioned as possible barriers to the weight loss treatment. The weight of black women in particular has been in the news in recent years, with a particular focus on a perception that African-American women are comfortable being overweight.

Cultural factors as barriers

The New York Times infamously published an essay that had originally been titled Why Black Women are Fat, before changing it to Black Women and Fat in response to the backlash over what many saw as a tasteless and condescending title.

Yet, the article opens with the statistic, “[four] out of five black women are seriously overweight.”

The author continues, “One out of four middle-aged black women has diabetes. With $174 billion a year spent on diabetes-related illness in America and obesity quickly overtaking smoking as a cause of cancer deaths, it is past time to try something new.”

Essay author, bestselling African-American novelist Alice Randall, explains that this “something new” involves a deep desire on the part of black women to lose weight.

“What we need is a body-culture revolution in black America,” she writes. “Why? Because too many experts who are involved in the discussion of obesity don’t understand something crucial about black women and fat: many black women are fat because we want to be.”

Randall’s shocking observation might shed light on why at least not as many African-American women who are eligible take advantage of bariatric surgery, as opposed to black men. The acceptance of and even desire to attain overweight status might just be one of many social factors that are in play, but study authors did not invest resources in plumbing what those mysterious reasons might be.

Considering bariatric surgery 

In the meantime, African-American men and women may want to consider, if they or a loved one need this treatment, what may be stopping them from taking advantage of it. The possibilities engendered in the surgery, which can lead to the black community being more free of the ravages of obesity, such as heart disease and diabetes, are too important to take for granted. Currently black women and men suffer more than any other group from these illnesses.

“In conclusion, a significant racial difference exists in the use of inpatient bariatric surgery among eligible adults,” the study authors state. “Considering the recent evidence showing immediate metabolic advantages to bariatric surgery and the exceptionally large proportion of black women who are obese, a more concerted effort to increase the use of this strategy among those refractory to standard weight loss strategies may be worthwhile.”

In plain English, black women — and men, although that is a finer subtext — need to get on the ball and look into bariatric surgery if their BMI (Body Mass Index) exceeds an acceptable range, and normal weight loss means such as dieting and exercise have not been effective for you. If you need it, and you have access to the procedure, you can spare yourself or a loved one needless medical expenses, suffering, and even death.

This is certainly a “body-culture revolution” worth embarking on.

Follow Alexis Garrett Stodghill on Twitter at @lexisb

This article has been updated to explain that bariatric surgery is recommended if dieting and exercise fail to result in consistent weight loss.