On Blacks and Fat: Dr. Ian K. Smith

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(The Root) — Obesity is more common in African Americans than in other ethnic groups. But when it comes to black people and weight, that's where the agreement seems to end. Is food the culprit? Is exercise the solution? Is there even a real problem to begin with, or should we be focusing on health — or even self-acceptance — rather than the number on the scale?

Against the backdrop of the first lady's mission to slim down the nation's kids, black celebs getting endorsements after shedding inches and a booming weight-loss industry, The Root will publish a series of interviews with medical professionals, activists and fitness enthusiasts that reveal the complexity of this issue and the range of approaches to it.

For the 10th in the series, we spoke to Dr. Ian K. Smith, author of The Fat Smash Diet, Extreme Fat Smash Diet, The 4 Day Diet and Happy: Simple Steps for Getting the Life You Want. He is a medical contributor on The Rachael Ray Show and host of the nationally syndicated radio show HealthWatch on American Urban Radio Networks. He was also the medical and diet expert for six seasons on VH1's highly rated Celebrity Fit Club. In addition, he is the creator and founder of two far-reaching national health initiatives — the 50 Million Pound Challenge and the Makeover Mile — and was appointed by President Obama to the President's Council on Fitness, Sports and Nutrition.

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As African Americans, Smith says, "We have to separate aesthetic beauty versus medical fitness." He told us about why he believes the Steve Harveys and Tom Joyners of the world have a role in spreading this message and why, even though he is a self-proclaimed "diet guy," physical activity is his most important prescription for health.

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Read the rest of the interviews in the series here, and check out The Root's other obesity coverage here.

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The Root: According to the latest statistics, African Americans are 1.5 times as likely as whites to be obese. What's going on, from your perspective, with black people, obesity and overall health?

Ian K. Smith: There are a lot of cultural entrenchments that keep us on the wrong side of the scale. African Americans, for generations, have eaten a certain way that, while satisfying one's appetite and one's sense of taste, has had deleterious effects on us from a physical standpoint. We didn't think about this 80, 90 and 100 years ago — it was just the way we ate. The way in which we eat has had this long-lasting impact on us, and it's been a very difficult habit to break. Dietary habits are some of the most notorious habits to try to break.

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The other part of it is that it requires either education or the belief that you can connect the dots between eating poorly and one's health. I think we've lagged behind the curve in the African-American community in making that connection. I think we're starting to do that now as we see the skyrocketing rates of obesity and diabetes and heart disease. But what we're seeing now is a manifestation of years of dietary neglect and years of lack of knowledge as to the fact that eating poorly will have negative effects on us.

IKS: There's so much. African Americans have to really listen to messages and the advice about the dangers of poor eating habits and lack of physical activity. Here's the deal with us: We have to not just pay lip service to the idea that we have to change our habits. There are not many people on Earth, regardless of education, who don't realize that eating poorly is going to lead to medical complications. That battle is won. Just like people know that drugs are not good for you, but people still use drugs.

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What we have to figure out in the African-American community is how to get people to realize that even a slight modification in behavior can make a major difference in the risk profile that we disproportionately suffer from. That's our task. We have to keep sounding the bell. The Steve Harveys of the world, the Tom Joyners, the local school board members … everyone has a role to play in the fight.

TR: If you could make just one suggestion for people to implement in their daily lives with respect to weight and health, what would it be?

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IKS: Physical activity. Physical activity is the absolute number one thing that promotes better weight management and long-term health. Diet plays a big part, too, but if I could only write one prescription, it would be 30 to 40 minutes of moderate physical activity four to five days a week. Physical activity can affect your blood vessels, it can affect the blood flow to your heart and to your brain, your muscle, your balance, your bone. I'm a diet guy, but if I had to choose one, I would choose physical fitness.

TR: Are there any other cultural, historical or psychological issues that you think make the black community's relationship with weight and health unique?

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IKS: From a cultural standpoint, [we] have had a very romantic version of what is considered to be healthy physically. When African Americans have historically talked about being healthy, our image is much different from the medical definition. So we've had to spend the last years or so trying to reconcile what we've grown up believing is a great body habitus, versus what is a proper body habitus for good medical clearance.

You have celebrities and a lot of [influencers] who are overweight or obese and are saying it's fine, it's beautiful, there's nothing wrong with it. That message is a very dangerous message. As African Americans, we need to separate aesthetic beauty versus medical fitness. And yes, you can love yourself aesthetically being overweight, but we should not settle for that when it is medically damaging.

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Follow Dr. Ian Smith on Twitter.

Jenée Desmond-Harris is The Root's staff writer. Follow her on Twitter.

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