Weight is measured in terms of body mass index (BMI). For adults, a healthy weight is a BMI of between 18.5 and 24.9. Overweight is a BMI of 25 to 29.9. A BMI of 30 or higher is considered obese.

Health experts say roughly 66 percent of American adults are overweight. The Obesity Society reports, 25.6 percent of Americans are obese. The extra weight is hard on the body and increases the risk for many types of chronic health problems, like heart disease, stroke, type 2 diabetes, high blood pressure, elevated cholesterol levels, certain types of cancer, osteoarthritis, sleep apnea, liver and gallbladder disease and respiratory problems.

Obesity in African Americans

The Center for Disease Control and Prevention (CDC) reports rates of overweight and obesity are higher among African-Americans than whites. In a health survey conducted between 1999 and 2000, researchers found 69.6 percent of blacks and 62.3 percent of whites were overweight. There is a much higher disparity in rates of obesity, with 39.9 percent of blacks being obese versus 28.7 percent of whites. Among African-American women, four out of five are overweight or obese. Low-income African-American women have the highest risks of being overweight.

For some, African-American culture plays a role in weight and body image. Weight issues often begin in childhood. According to the CDC, black girls are more likely to eat high fat/high salt foods and less likely to get the recommended servings of fruits and vegetables. In adulthood, blacks are more likely than whites to be physically inactive. The CDC reports only 24.7 percent of black adults engage in regular physical activity compared to 33.8 percent of whites.

The Role of the Physician

Weight is a sensitive topic and many patients are reluctant to talk to their physicians about weight loss needs. Recently, researchers at Temple University School of Medicine, held focus groups to discuss weight loss issues with black women. Each group had 2 to 12 participants and was led by a black nurse practitioner. The goal of the discussions was to find out how well participants felt their health care providers dealt with weight loss issues. The researchers also wanted to find out what kinds of motivations and barriers patients had to weight loss and if these issues differed between women and men.

Internist, Stephanie Ward, M.D., says one of the main findings of the focus group research was that participants wanted physicians to initiate discussion of weight loss needs. Participants also reported they would be more encouraged to lose weight when doctors provided positive encouragement about the benefits of weight loss, rather than telling them the negative (health) effects of remaining overweight. More specifically, participants wanted to discuss personal weight loss challenges, eating patterns, the healthiest ways to achieve weight loss and how to incorporate exercise and healthy snacks into their daily life.

Ward says participants were especially concerned about the use of the word, “obese.” Medically, the term refers to people with a BMI of 30 or higher. But those on the lower end of the obesity scale often don’t see themselves as obese. In fact, focus group participants associated the term, obese, with massive overweight. Instead, participants preferred the terms, “fat,” “thick” or “heavy."

Ward would like to eventually develop computer programs or educational materials that could be used by physicians to more effectively communicate with patients about weight issues. In the meantime, Ward advises patients who have concerns about their weight to not be afraid to bring the issue up to their physician for discussion, rather than waiting for the doctor to initiate the conversation.

For information on weight, obesity and health:

American Obesity Association

The Centers for Disease Control and Prevention

The National Heart, Lung and Blood Institute

The Obesity Society

U.S. Department of Health and Human Services, Office of Minority Health