Why Don’t Obesity Programs Work For Young Black Girls? | A Black Girl's Guide To Weight Loss

Why Don’t Obesity Programs Work For Young Black Girls?

001.pg

I happened to catch a glimpse of this article:

Two large initiatives designed to prevent African-American girls from becoming obese are not very successful at it, according to two new studies.

The two-year programs consisted of either practical advice and goals for staying fit and healthy, or regular dance classes along with an intervention to reduce the amount of time girls spent playing video games, watching TV, or on the computer.

However, over the course of two years, 8- to 10-year-old girls who were enrolled in either program were just as likely to gain weight as girls who did not participate in the interventions.

It’s not clear why the programs had so little impact, lead author of one of the studies, Dr. Robert Klesges at the University of Tennessee Health Science Center, told Reuters Health. However, “the environmental factors that promote sedentary behavior” – such as TV and video games – and preferences for high-calorie foods “probably overwhelmed” the effects of the program, he suggested.

Obesity has become an epidemic among American children, and African-American girls are particularly at risk – a recent nationwide health survey found that approximately one-quarter of black girls are obese.

Read that again: “approximately one quarter of Black girls are obese.”

For the sake of clarification… where do they get these numbers? That’s not to say that it isn’t possible, because I’m actually wondering if the number isn’t higher.

Okay… continue:

To see whether targeted programs help prevent young girls from becoming obese teens, Klesges and his colleagues followed 303 girls in the Memphis area for two years. They randomly assigned half to a program designed to prevent them from becoming obese by giving them goals for healthy eating and exercise while teaching their parents about providing healthy foods, and the other half to an alternative program that did not focus on diet and exercise, but just self-esteem in general.

They found that girls who completed the obesity program tended to consume more water and vegetables, and fewer sweet drinks, than girls in the other program. But both groups were just as likely to gain weight, and both decreased their amount of physical activity over the two years.

“For those girls who changed these eating patterns and didn’t see weight gain prevention, they probably just replaced these calories with other foods,” Klesges noted. The next step, he suggested, could be to encourage girls to reduce their overall calories, not just shift the calories they’d get from soda and fatty foods into other food types.

And younger girls appeared to benefit more from the program, Klesges noted, suggesting it is worth continuing this program in that age group. “We didn’t do a cost analysis but the intervention is definitely portable and could be implemented for very low cost,” he said in an e-mail.

In the other study, also published in the November issue of the Archives of Pediatrics & Adolescent Medicine, researchers randomly assigned 261 black girls in Oakland, California, to either participate in an intervention to reduce their “screen” time along with regular dance classes that included African, hip-hop, and step dancing; or receive newsletters about health issues for young girls and attend occasional family health lectures.

Here, too, girls in both groups were equally likely to gain weight during the study period, but those in the dance program showed improvements in some other aspects of health, such as lower cholesterol and insulin levels and fewer symptoms of depression. “I felt really good about (those findings),” study author Dr. Thomas Robinson at Stanford University School of Medicine told Reuters Health.

He added that the program experienced a few unexpected challenges that may have affected the findings – for example, transportation for the girls fell through early in the program, which likely lowered attendance. Implementing a similar program at a school would cut down on costs considerably, Robinson added, so the only expense would be paying the dance teacher, who might be willing to volunteer. “We haven’t given up on the concept,” he noted.

Furthermore, girls who were at higher risk of weight gain – those who watched more TV overall and were being raised by unmarried adults – appeared to benefit more from the program than other girls, Robinson said. (Erika’s note: In other words, latch-key children?) “They have more room to go, and are more likely to benefit,” he suggested. “Our intervention definitely helped a lot of girls.”

The next step, Klesges suggested, is to ensure children have regular access to physical activity that they enjoy, and find ways to encourage people not to opt for fast foods. “While we have a long way to go, promoting healthy diets from the time a child is very small is needed,” he said. “If more people wanted healthy alternatives, (fast food restaurants) would sell them.” [source: Obesity programs little help for black girls]

I have a LOT of thoughts, but I’d rather search out the individual studies from the November issue of the Archives of Pediatrics & Adolescent Medicine before I say more.

There are a few things I’d like to point out, though.

They randomly assigned half to a program designed to prevent them from becoming obese by giving them goals for healthy eating and exercise while teaching their parents about providing healthy foods, and the other half to an alternative program that did not focus on diet and exercise, but just self-esteem in general.

They found that girls who completed the obesity program tended to consume more water and vegetables, and fewer sweet drinks, than girls in the other program. But both groups were just as likely to gain weight, and both decreased their amount of physical activity over the two years.

For starters… “teaching parents about providing healthy foods” is very different from increasing access to such. Access plus education, to me, is the only formula that will provide results.

Secondly, I wonder if this study corrected for the “liar effect.” What is “the liar effect?” Well, if you’re telling young Black girls [who are likely to be latchkey children who are excited to have an adult paying attention to them... and I say that as a latchkey child] to eat healthily, then you ask them to report what they are eating.. how likely is it that they’re telling the truth? They’re not going to want to disappoint the person who’s paying all this attention to them.

I’m not trying to be insulting or disrespectful when I say that, either. It’s a matter of fact – people who are asked to report what they are eating often lie. People who are asked to report what they eat are, also, often mistaken about how much they eat… dependent upon how large the portion size actually is (and regardless of the weight of the person reporting.) There’s an element of shame associated with reporting your food intake that people want to avoid… and young girls who already have body image issues are no different. So, if you have young Black girls who are eager to please and you ask them to report their intake… I think it is highly likely that they’ll lie.

Furthermore, girls who were at higher risk of weight gain – those who watched more TV overall and were being raised by unmarried adults – appeared to benefit more from the program than other girls, Robinson said.

Because we’re talking about young girls – not adult women who should be able to make their own conscious choices – I’m going to ask this question. What does “raised by unmarried adults” mean? Two unmarried parents in one home? Divorced with two active parents? Divorced with only one parent? Or only single parenthood? Why does the “raised by unmarried adults” aspect make such a huge difference? Is it because no one is around to further enforce the healthier choices? (Doesn’t this also lead to that point about lying on their food intake reporting?) Is it because fewer time is spent with the parent embodying the essence of healthier living for the child? (I admit that this is only my assumption, and based on my own early experiences.)

The next step, Klesges suggested, is to ensure children have regular access to physical activity that they enjoy, and find ways to encourage people not to opt for fast foods. “While we have a long way to go, promoting healthy diets from the time a child is very small is needed,” he said. “If more people wanted healthy alternatives, (fast food restaurants) would sell them.”

Y’all always think I’m playing when I say “We have more power than we think,” but I’m dead serious.. and that emboldened quote is exactly why I say it. Businesses go where the money is. If the money is in the sugary, fatty and salty… why on Earth would a business ignore that? Even the “healthiest” of fast foods succumb to using these tactics. No one is exempt. When the conscious public demands more, they’ll get it… and not a second sooner.

What do you think is going on here?

The proud leader of the #bgg2wlarmy, Erika Nicole Kendall writes health, fitness, nutrition, body image and beauty, and more here at #bgg2wl. After losing over 150lbs, Kendall became a personal trainer certified in fitness nutrition, women's fitness, and weight loss from the National Academy of Sports Medicine. She now lives in New York with her family, and is working on her 4th, 5th and 6th certificates.

18 Comments

  1. zenlizzie

    November 29, 2010 at 1:04 PM

    I think this kind of goes back to our Twitter convo about public health programs. Both of these programs meant well, and they didn’t attempt to address all the levels of influence: individual, parental, school, community and policy. Of course, those programs are expensive and time consuming and hard to fit into a 2-year program. I don’t know if the researchers really expected a lot from only targeting one/two-ish levels, or if the girls in the program were interested or motivated to avoid weight gain. And how did they not realize that transportation might be an issue? I’m in a class about program planning right now, and one of the first things we learned is that you have to assess the community needs before you start deciding what should be done.
    If girls need access to healthy food choices and access to transportation to physical activities, then those needs have to be addressed first or in conjunction with behavioral/educational elements.
    I’m glad that there is research being done and I don’t think these are impossible issues, but it is hard for me to believe that the researchers didn’t foresee some of these issues before they started.

    • Erika

      November 29, 2010 at 1:28 PM

      “If girls need access to healthy food choices and access to transportation to physical activities, then those needs have to be addressed first or in conjunction with behavioral/educational elements.”

      See, I think this is why I want to see the actual details of the studies involved. Why wasn’t this considered early in advance? Is there such a disconnect between the researchers and the people that they’re researching that they figured this would be THAT easy?

      Or maybe that – the idea that this IS “THAT easy” – is the problem? The idea that this issue isn’t as multi-faceted as many of us know it to be?

  2. Lynn Franklin

    November 29, 2010 at 1:19 PM

    I feel exactly the same as you in most of this. What they should have done is really involved the parents in the study. I figure they would have gotten a more accurate outcome. Like you said most of these kids may have not been truthful about their eating habits because I know for a fact that even without changing the diet young black girls WILL lose weight if activity is introduced into their lifestyle. We have groups at church and my own nieces and best friends children have done so and it has been proven that when we started making them workout with us on a regular basis even if they didn’t change their eating habits ALL of them lost weight. ALL of them, but we were making sure that they were working out on a consistent basis and that was the ADULT factor. If we had been just taking THEIR WORD for it, I am sure we would have seen no results. I think that if they are gonna do a study they should get the parent involved and allow them to monitor the girls eating habits and activity and also any monitored classes that they give them and then see what the outcome will be.

    • Erika

      November 29, 2010 at 4:27 PM

      “I think that if they are gonna do a study they should get the parent involved and allow them to monitor the girls eating habits and activity and also any monitored classes that they give them and then see what the outcome will be.”

      I feel like, personally, if they’re going to do ANYTHING to affect the lives of children, it needs to be done with the parents serving as the intermediary, not with the children being the sole arbiters of their activity. Parents facilitate and encourage… if the only time they’re getting the facilitation and encouragement and the access is when they’re with the researchers (because the parents neither know or understand), then NO, you’re not going to see results, smh.

      Still digging for the studies, though.

  3. Latoya

    November 29, 2010 at 1:52 PM

    I think what they kept talking around is the cost of healthy food. That is a major issue. Talking about healthy eating, health goals, and access to healthy foods is different from the cost associated with healthy food. Undertaking healthy eating and healthy goals is very important. However, I’ve found that one of the reasons why I have been successful at losing weight is that I stay slightly hungry. I’m a poor graduate student trying to make healthier eating choices, and it’s expensive. Part of the weight loss process for me is just being hungry because I can only afford so much of the right kinds of food, and drinking water with/between each meal to help feel full. I can only imagine the limited access to money that some {I’m guessing a lot) of the girls in the studies may experience, which seriously effect their actual food choices.

    • Erika

      November 29, 2010 at 4:35 PM

      I don’t know if I can co-sign on remaining hungry, especially when there are so many inexpensive ways to healthily nourish oneself… which is why I’m a big advocate of addressing access, because it makes those resources more readily available to those who need them; and education because it teaches people how to use those inexpensive resources, you know?

      I don’t advocate going hungry or remaining hungry, specifically because I know what it was like and I know that I always overate when I finally DID eat. I have tons of posts on this site about how to eat healthily inexpensively:

      Avoiding That Starving Feeling and all of my posts tagged “saving money” should help.

      • Nicole

        September 6, 2011 at 8:34 PM

        Well, I think being a LITTLE hungry (especially in the early stages of weight loss) is par for the course. You are going to have to create a calorie deficit in order to loose weight. Right now my recommended calorie intake is about 23 weight watchers points (approximately 1,150 calories per day). That’s not a lot of food no matter WHAT you choose to eat. I can supplement my diet with zero point fruits and veggies, but those just DON’T stick to you very long.

        One of my favorite cheap and nutritious meals is a black bean and mango salad. It’s approximately $4.30 for two meals ($1.00 – mango, $.85 for black beans, $1.75 for cherry tomatoes and $.70 for a red onion) … double portions of this is VERY filling (black beans are CHOCK full of filling protein), but in the correct portion sizes it’s not satiating at all.

        So yes, healthy food in the correct portions can be cheap, but it’s not always filling when you HAVE to stick to a certain calorie count or portion size.

  4. Dre'Chelle

    November 29, 2010 at 10:39 PM

    Hi, I love the site! As for the article at hand, I am not surprised by the limitations that were pointed out in the study. To answer your question Erica, about whether the researchers thought it would be that easy..I think often times there is definetely a disconnect between the two communities and it takes studies like this to bring out the small factors that may make a big difference.

    As for parent participation, Lord have Mercy, depending on where you are, that can be litte to non existant. Which may explain the reason for focusing on the child. I do agree that the parents will have the biggest impact bc they buy the food etc.

  5. Pingback: Links of Great Interest: ..ARSENIC LIFE.. | The Hathor Legacy

  6. Lyn

    December 20, 2010 at 12:47 PM

    Not to mention the neighborhoods where these girls live. I have lived in predominantly black areas and the access to clean healthy food is a joke. Safe places to go out and excercise and not be harassed or in danger are few. Then you have the whole FAMILIAL influences to overcome. Think of it, these young girls arent the ones buying the groceries that come into the house. PARENTS set up eating patterns, and if mom and dad are frying everything, or microwave meals and snacks are what they live on and the adults in the house dont want to change what chance do these girls have. It has to become something like a boarding school situation where the girls go to a school that emphasises health and wellness, stress management, excercise and healthy eating, decision making and self esteem as part of the cirriculum. Girls will be taught how to shop clean and healthy and also given technical skills so they can earn a good living so they can AFFORD to eat healthy when they leave the environment of the school. My major struggle as an adult has been low paying jobs, once the bills are paid having $40 for two weeks of food doesnt leave alot of options.

  7. m o o n marked

    February 25, 2013 at 6:42 AM

    If you look at the end of the article, there are two links to the research articles—which answer some of the questions we have, but not all. One big concern is the way both studies looked at African American girls who lived in economically depressed areas but researchers acted as if that was not a factor. I expect that was taken into account by the actual community-based program practitioners who were interacting with the girls but those folks are different than the researchers who organized these studies. The Oakland program took into consideration transportation but had funding challenges and needs to change the location of the center that affected how girls got to the program. (I bet there was no problem funding the researchers, though.)

    The other thing that was weird is the downplaying of some important impacts at the expense of looking solely at obesity as a marker of appropriate weight, not as a challenge to health: [G]irls in both groups were equally likely to gain weight during the study period, but those in the dance program showed improvements in some other aspects of health, such as lower cholesterol and insulin levels and fewer symptoms of depression.

    Reading this blog always reminds me how much emotional health plays into physical health so I found that promising. I also wondered about the ways that lower cholesterol and insulin might be more important victories than the nominal weight gain at this age/stage of life, which seemed in both studies to keep the young girls in the same percentile—in other words, there was no “reversal” or weight loss but the weight gain was relative.

    But this quote illustrates the REAL problem with public health research: “Implementing a similar program at a school would cut down on costs considerably, Robinson added, so the only expense would be paying the dance teacher, who might be willing to volunteer.”

    Yes, incorporating programs into spaces where K-12 spend the majority of their waking time makes sense but WHAT? The relatively small expense of a dance teacher—so important, supposedly, to the success of the project—should be unpaid labor? That right there is why these programs don’t work. We cut physical activity and nutritional information (and access to good food) at the public school level as policy. Then we further don’t support people to do this “freelance” work professionally at a living wage (cause dancers are paid well elsewhere and their training/certification is free and they have health care and pensions so they can afford to volunteer their time). We send the message that, for example, it’s really not all that important to be active, as it’s not a fundamental part of what we need to learn, and that it’s not going be something you’ll need to budget for (time or money) all of our lives.

    I’m working on a small healthy living pilot project with an early childhood center in Brooklyn; we’re trying to get some of that “obesity prevention” funding to support teachers and parents and kids in making a difference using strategies that the community has been thinking about for awhile that incorporate access and rethinks how we talk about obesity.

  8. Veronica

    March 12, 2013 at 6:31 AM

    I believe part of it is the celebration of being “thick” in our culture is a part of it. When I think of the imagery being fed to our young girls about what is sexy, and attractive by the men in our culture I can’t help but think that’s a part that’s not being actively addressed in programs such as this. I know adult Black women who want to lose weight, but hear comments from men like, “Okay, but don’t lose your hips, and butt.” If all else is equal with programs such as this being successful with other groups we have to look at one huge element that’s different and that’s our culture. Other groups have as their ideal image as being thin girls in those group strive to be thin…sometime to extreme. Our culture has as it ideal body image being “thick” and having a big butt and our girls strive for that….not realizing that having that can easily cause them to be overweight and obese. We can’t discount the impact of what’s considered a positive or desirable image within a culture and the impact it has on girls.

    • Erika Nicole Kendall

      March 12, 2013 at 9:47 AM

      I think, with young girls, “thick” doesn’t apply yet because they’re still moldable clay; they’re still sponges, and aren’t solidified in their thinking yet. “Thick” might come up, but it isn’t the *thing* it is for women, yet.

      • Veronica

        March 12, 2013 at 8:26 PM

        That may be true, but I think you’d be surprised at what some young girls are thinking about their bodies. Perhaps the enviroment they live in dictates how young that all this comes into play. I volunteer with a organization that mentors young black girls around issues of self esteem and girls as young as 8 are fixated on how big their booty is, and saying that they want to look like certain girls in hip hop videos. They make comments to other girls like, “Boys don’t like skinny girls.” Sad, but true.

        • Erika Nicole Kendall

          March 13, 2013 at 11:18 AM

          But this only further highlights my point – kids are sponges.

          This doesn’t change the fact that that negativity can’t be undone.

          Also, this is giving me a major case of the sads.

  9. Gerri T.

    March 17, 2013 at 1:09 AM

    I think the term you maybe looking for is the Hawthorne effect (“liar effect”) ….I think. … my college professor would be proud :-)

  10. Lorenzo

    April 23, 2013 at 10:58 AM

    Thank you for this post. I really appreciate the critical analysis of the research, I learned so much.

Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>