Weighting to exhale

Replacing the pressure to be skinny with a plan to be healthy

BY: Felicia Carty

Science confirms what black men and women have known for centuries: Those curves, those hips and those butts are there for a reason.

Speaking candidly about weight issues and their effects on populations, Dr. Sean Wharton, MD, PharmD and Fellow of the Royal College of Physicians and Surgeons of Canada, uses layman's terms to push his health message to the public. As medical director of the Weight Management Centre, an OHIP-funded wing of the Wharton Medical Clinic, Dr. Wharton's message is backed by half a decade of work dedicated to bariatric medical practice and research. It is a specialty spawned from Dr. Wharton's interest in the direct correlation between weight gain and health issues within the black community.

"It was crucial for me to understand how I could help to prevent this epidemic of metabolic disease in people from my own ethnic background," Dr. Wharton says, listing diabetes, high blood pressure, high cholesterol and heart problems as culprits. According to him, these diseases of individuals have become symptoms of a societal problem.

In line with his aim to educate, Dr. Wharton says while there is biological truth behind the allure of an hourglass figure, problems occur when that Coca-Cola bottle shape that many black women boast, starts to become inverted.

"We are aware that visceral adiposity, the fat in the abdomen, is toxic to cells throughout the entire body, resulting in increased risk of heart disease, diabetes and high blood pressure," Dr. Wharton points out, armed with U.S. statistics. "Obesity is more prevalent in African American populations than any other. Eighty per cent of African American woman fall in the overweight to obese category."

The doctor explains that while Caucasian women should beware a body mass index (BMI) greater than 25, women of African descent, generally, can safely reach 30 (BMI is a statistical measure used to compare weight and height and serves as a diagnostic tool for health). This is because black women tend to have peripheral adiposity — weight captured in their buttocks and thighs — that does not tend to result in health issues.

"Once black women go higher, with a BMI of 35, 40, 50 or 60, they are at greater risk of multiple diseases," Dr. Wharton says. "Look at someone like Ella Fitzgerald. She died without any legs because of diabetes. Ella did not have a BMI of 30, it was well above."

Working out of the Hamilton-based centre, Dr. Wharton collaborates with a group of professional practitioners who seek not only to aid in weight loss, but in weight loss maintenance as well. They use a plethora of strategies with patients, including nutrition counselling, exercise, psychological profiling, use of medication, and at times, bariatric surgery. They also provide free lifestyle education classes, geared toward healthy living.

Dr. Wharton's patient roster is as ethnically diverse as Canada, often encompassing dietary practices far more complex than potatoes and steak. Fortunately, he finds patients from different backgrounds are generally capable of using resources to understand the caloric content of their own foods, "be it from curry roti, to chapatti, to butter chicken." The ethnic discrepancies, he claims, that successfully hinder healthcare tend not to walk through his door for help.

"It's been shown again and again in literature, there may be some degree of conscious or unconscious bias [within healthcare] against people of ethnic backgrounds," he says. "[Ethnic groups] know what it is we are supposed to be doing, but at times we bump into road blocks in a system that was not set up for us. North America is a white-dominated society, and as a result, sometimes there are challenges."

Most of these challenges, he says, stem from the socio-economic status held by many ethnic communities. Environmental factors, such as the lack of access to healthcare, poverty and lower levels of education, have left these groups in a viscous cycle that includes being vulnerable to healthcare issues and unable to manoeuver through the medical system to receive the appropriate care.

But what's the number one issue? "Being advocates of our own health," Dr. Wharton says. "We've paid our taxes. People should not be satisfied with poor treatment." So while Dr. Wharton may use American statistics as a point of reference, the border does not act as a line of symmetry in regards to healthcare — and that fundamental difference is the saving grace for Canadians.