Weight Loss Programs
for Minority Populations
JOHN P. FOREYT
The prevalence of obesity among minority populations in the United States generally exceeds that of the majority white population (see Chapters 75 and 79). Among females, for example, approximately 22% of whites, 37% of African Americans, and 34% of Mexican Americans are obese (body mass index > 30). Among males, 20% of whites, 21% of African Americans, and 23% of Mexican Americans are obese. All these figures appear to be increasing as new data become available. We are losing, not winning, the obesity war.
Obesity is a major risk factor affecting mortality and morbidity, including hypertension, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea and respiratory problems, and some cancers, including endometrial, breast, prostate, and colon cancer (see Chapters 76, 79, and 84). Although some data suggest that these relationships may be less strong in minority populations than in the white population at this time, these differences may be only temporary, while these populations are undergoing current epidemiological transitions. Other methodological issues, such as selective nonresponsiveness to surveys or cohort effects, also may be responsible for the observed differences.
Poverty and lower levels of education are associated with higher levels of obesity, and these factors affect proportionately more individuals in minority populations than in the white population. Different minority populations appear to share a preference for highfat diets and low patterns of physical activity, and in general seem to be less concerned about weight than the white population. Minorities typically have less access to health care, including counseling about potentially effective weight management strategies. The