Obesity in African American Girls and Women: Summit insights and implications for pediatric psychologists
By Idia B. Thurston, PhD, Stephanie L. Fitzpatrick, PhD, and Monica Mitchell, PhD
Obesity is a major health concern in the United States, with children of diverse racial and ethnic backgrounds experiencing significantly higher rates of obesity than their peers. Based on the 2009-2010 National Health and Nutrition Examination Survey data, African American girls (24.3 percent) and women (58.5 percent) have the highest prevalence of obesity compared to other racial/ethnic groups. Children and adolescents who are overweight or obese are at higher risk for lifetime physical and mental health complications including hypertension, diabetes, obstructive sleep apnea, heart disease, stroke, depression, and low self-esteem.
Given these high prevalence rates and gaps in the literature, the APA and the Association of Black Psychologists (ABPsi) co-sponsored a summit in October 2012 to discuss the epidemic of obesity among African American girls and women at the University of the District of Columbia in Washington, D.C. Topics included: determinants of obesity, obesity prevention and intervention, public policy, and development of an action agenda.
Impact of stress
Dr. James Jackson presented on the impact of stress on obesity prevalence. Suggested areas for future directions included: 1) exploring the role of the unhealthy lifestyles and stressors contributing to unhealthy behaviors among African American families; 2) designing interventions that teach healthier coping mechanisms to replace unhealthy strategies; and 3) policy and advocacy efforts to improve the physical and social living environment to reduce stressors.
Guided by Bronfenbrenner’s socioecological theory, Dr. Susan Bennett Johnson’s presentation highlighted the psychologist’s potential role in addressing the obesity epidemic at multiple levels, including:
- Individual developmental issues — such as how food and activity preferences develop; and lifestyle behavior change — exploring the role of food and exercise in individuals’ lives
- Family — understanding the cross- and intergenerational effects on biology, values, beliefs, perceptions, and behaviors
- Systems — investigating the roles of schools and colleges, health care systems, and research enterprises
- Communities — exploring the contributory effects of religious, social and work environments
- Policy — becoming strong advocates at local, state and federal levels to impact and become agents of change
- Prevention — working to decrease the obesogenic environment
- Partnering — creating interdisciplinary collaborations with other research teams, organizations and agencies to influence systems, communities and policymakers
This summit provides implications for the field of pediatric psychology. It highlights the need for multi-disciplinary collaboration in order to develop effective, holistic, culturally tailored clinic and community-based interventions to lower rates of obesity in girls and women from diverse backgrounds. It also underscores the role pediatric psychologists can play in influencing the hospital environment related to the care and treatment of overweight and obese youth.
Pediatric psychologists can raise awareness about the need for psychological assessment and intervention in weight management programs, emphasize the importance of reimbursement for the psychological services provided, and model ways to engage patients in a culturally sensitive way in order to decrease dropout from care.
APA and ABPsi representatives are working together to develop a joint action agenda based on the summit presentations. This document will be an important resource for pediatric psychologists working with overweight and obese youth in clinical, research, and community settings. However, as pediatric psychologists who are in unique interprofessional positions, we could also reflect on the role we may play in raising awareness and decreasing obesity disparities from the clinical assessment tools and language we use in our reports, to our culturally sensitive treatment interventions and insightful questions we ask in our research initiatives.
"If you want to plan for a year,
if you want to plan for a decade,
if you want to plan for centuries;
— West African proverb
Idia B. Thurston, PhD, chair, Training and Mentorship Committee Diversity Special Interest Group, Division 54
Stephanie L. Fitzpatrick, PhD, vice chair, Health Research Council, Division 38 (Health Psychology)
Monica J. Mitchell, PhD, newsletter chair, D54 Diversity Committee