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Who's Obese? Patients, Doctors Differ

Obesity Health Warnings Ignore Racial, Cultural Diversity

Blacks, Whites See Size Differently continued...

University of Cincinnati pediatrician Frank Biro, MD, associate director of adolescent medicine at Cincinnati Children's Hospital, has studied how different cultures see body size differently.

"You see in the scientific literature that African-American women are comfortable with a thicker body shape," Biro says. "That is the specific word they use -- thick. And it's a very good word. If you think about thin, someone could be thicker."

Where races differ less is in relating obesity to health. For both blacks and whites, the message isn't clear.

"When it comes to health, many African-Americans do not associate being overweight or obese with larger body size," Davidson says. "Even with white women, it was minimized. Some did not believe it. It is concerning that is so common, because health care providers only use the terms 'BMI,' 'overweight,' and 'obesity' to talk about body size."

When Body Size Does Affect Health

Feeling good about not being pencil-thin is a good thing. It shows that a person has good self-esteem. But there's a point at which being too thick or too thin just isn't healthy. And these days, being too thick is much more prevalent.

Regardless of how we see ourselves, there's a point at which our body mass makes us ill. Obesity is directly related to problems that include -- but aren't limited to -- diabetes, heart disease, asthma, and some cancers.

"Being comfortable with your body, that is good for self-esteem," Biro says. "But suppose your body mass puts you in the category of being very obese. That is not a good thing. At very high body mass, you increase the risks to your health. So being more comfortable with a moderately overweight body size is probably good. But being comfortable with an obese body size is not a good thing for you, because you put yourself at much greater risk of adverse health outcomes."

Unfortunately, Davidson found, people aren't connecting what doctors call obesity with too-big body size.

"The hard part is, regardless of how you see yourself, you are going to hit a certain weight that leads to illnesses associated with too much weight," she says. "We have to get away from weight being about beauty and attractiveness and desirability. We have to stop talking about those things when it comes to health. What predominately white health care providers are saying to African-Americans doesn't have any meaning."

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