Obesity in Black Women1

The marked excess of obesity among black women in the United States poses several interesting questions which provide the framework for this review: Is the apparent high prevalence of obesity in black women a valid finding? If so, does it show the expected disease and disease risk associations? Can the contributory genetic and environmental variables be identified? Regarding the validity issue, the high prevalence of obesity in black women seems to be neither artifactual nor primarily an indirect effect of socioeconomic status. On the issue of racial comparability of disease risks among women, the available evidence is less conclusive. Obesity appears to have qualitatively similar health consequences for black women and white women but may be less strongly related to some disease risks (for example, hypertension) in black women than in white women. Obesity risks of black women may, however, be enhanced by the presence of multiple risk factors. On the question of causes, no clear mechanism for the excess obesity in black women can be identified. There is some evidence to support hypotheses based on dietary, lifestyle, and metabolic influences. Genetic factors cannot be ruled out. Several relevant future research possibilities can be suggested. Epidemiologic studies of both genetic and environmental influences in female obesity are needed. Studies among black females might further specify patterns of body weight and body fat distribution according to degree of European admixture and developmental variables such as caloric exposure in utero and in early infancy. Studies to establish more clearly the relative risks of various health outcomes for obese black women are needed to assist in setting public health priorities. For example, what are the attributable and absolute risks of overweight or obesity compared with other risk factors that are potential intervention targets? Studies are needed to define effective means of preventing and treating obesity among black women. Effective interventions are likely to be culture-specific. Definitive comparisons of black women and white women on environmentally mediated aspects of obesity might contribute to models of obesity in the general population and might also elucidate points at which black women and white women diverge. For example, short-term prospective studies are needed to better specify the natural history of weight gain and weight loss among females of both races during critical periods such as adolescence, post partum, lactation and post lactation, and during major life stresses.(ABSTRACT TRUNCATED AT 250 WORDS)