On any given day in the United States, more than 100 million adults are dieting. In a struggle that mirrors the frustrations of people trying to quit smoking, dieters usually make four or five unsuccessful attempts a year to slim down. And most people who manage to whittle off a few pounds regain that weight and more within a few months. American adults are in an epic battle against bulging bellies, and so far, they are losing.
Part of the problem may be weight-loss advice that focuses exclusively on the body, without considering the mind, suggests the latest research from Haslyn Hunte, PhD, MPH, a Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program alumnus (2006-2008).
“I examine the effect of internalized discrimination, across racial and ethnic boundaries, to see how it impacts weight,” says Hunte, an assistant professor of social and behavioral sciences at West Virginia University. By teasing out what may be a hidden trigger for emotional eating, he may have found a new approach to tackling obesity for individuals and health care providers.
Willpower May Not Be the Solution
Spend a few moments with the staff at any of the nation’s most popular weight loss programs—Jenny Craig, Weight Watchers or NBC’s ”The Biggest Loser”—and you will hear very similar advice. Each promises that controlling portions, eating low-calorie fare, and getting lots of exercise are the solution to winning the battle of the bulge. But Hunte’s work is the most recent in a series of studies suggesting that for many people, addressing emotional issues is the first and most important step to maintaining a healthy weight.
Social Factors, Weight Gain and Race
Adult obesity rates remain high across all racial and ethnic groups, according to the RWJF report, F as in Fat, but Hunte found that reactions to racial stereotypes had a particularly damaging impact on Black American men, a group with one of the highest levels of obesity in the nation. More than 38 percent of Black men are obese.
Working with co-author Lauren J. Parker, MPH, a PhD candidate at Purdue University in Indiana, Hunte asked: What happens to body weight when individuals internalize negative stereotypes about their racial or ethnic group? Using data collected for the National Survey of American Life, Hunte and Parker reviewed questionnaires completed by 3,265 Black Americans and 1,332 Black Caribbeans who live in the United States. Survey respondents were asked to rate as true or untrue questions that included: 1. Blacks/Caribbeans are lazy; and 2. Blacks/Caribbeans are violent. The answers were measured on a four-point scale.
There was a strong link between endorsing stereotypes and being obese among African American men. Hunte and Parker were surprised to find that among the Black Caribbeans in the study there was no connection between stereotypes and obesity. The results were explored in “Examining the Relationship Between the Endorsement of Racial/Ethnic Stereotypes and Excess Body Fat Composition in a National Sample of African Americans and Black Caribbeans,” published in the Autumn 2013 issue of the journal Ethnicity & Disease.
“We are not sure of the exact relationship between internalized stereotypes and obesity, but there are several possible factors. Once someone internalizes a stereotype, it may set up a defeatist mindset. It may make healthy weight goals seem unachievable,” Hunte says. “These people may also experience depression so they eat or drink more. Emotional reactions to discrimination may also arouse the stress response and we know that has been associated with changes in the body that can contribute to obesity.”
This work builds on Hunte’s previous research and other studies suggesting that interpersonal discrimination has a similar impact on white Americans. “I’m really examining the effect of internalized discrimination across cultural boundaries,” Hunte explains. “This has an impact on everybody. With more research, we may begin to understand how we can change this.”
How We Treat Each Other Matters
“As a society we have to realize that interpersonal behavior has real consequences,” says Hunte of the link between racial stereotype-related obesity and public health, “though it can be difficult to disentangle the cumulative impact of discrimination such as racial profiling or limited social and financial resources from weight gain.” After several years of studying this aspect of obesity, Hunte has some advice for individuals and providers. He suggests:
Focus on stress: One of the underlying issues related to discrimination is the stress it causes. “We each need to develop ways of coping with stressful, hurtful events without damaging our health. It may help for people to realize that there is a connection between experiencing racism and overeating, so they can try to manage their response in some other way, such as taking a walk.”
Change medical practice: “We [his research team] are trying to convince providers to include discussions about discrimination when they talk with patients who may be having a difficult time losing weight. Physicians must recognize the role of interpersonal stressors,” he adds.
Hunte wants public health experts to understand that “there’s a massive web of causation contributing to obesity in America. We have to learn how to disentangle it.”