Blacks and Weight Loss: Why So Few Go Under the Knife

Dalelynn Bradshaw-Settle before and after her lap band surgery. (Courtesy Photo)
Dalelynn Bradshaw-Settle before and after her lap band surgery. (Courtesy Photo)
Dalelynn Bradshaw-Settle before and after her lap band surgery. (Courtesy Photo)

by Victoria T. Davis
Special to the NNPA from The Indianapolis Recorder

Within the last few weeks, Dalelynn Bradshaw-Settle, 28, did something she never thought she would enjoy-hiking.

“Come on, let’s go,” she screamed to her husband below as she made her way on Rattle Snake Trail in Black Mountain, N.C.

From her enthusiasm and physical state, no one would know Bradshaw-Settle sat at just over 300 pounds one year ago. Today she weighs in at about 210 pounds thanks to her recent bariatric lap band surgery.

Why Black Americans aren’t going under

In August of 2013, The American Journal of Gastroenterology released a study titled, “Inpatient Bariatric Surgery Among Eligible Black and White Men and Women in the United States, 1999-2010,” which discovered “a higher percentage of Black than white women and of Black than white men were eligible for bariatric surgery. But a higher proportion of eligible white women and men than Black women and men received bariatric surgery.” The study concluded this may be due in part to differences in insurance coverage for various races.

Dr. Steven Clark, medical director and bariatric surgeon at Community Bariatric Services – South says although African-Americans are eligible for bariatric surgery based on the Na-

tional Institute of Health guidelines, they aren’t the individuals going under the knife as often. About 80 percent of Community Bariatric Services – Souths patients are women and about 10 percent are African-American. Clark disagrees that insurance is a major barrier for patients.

“The thing I find very odd is, out of all the patient population, Black women suffer the most from obesity,” said Clark. I wonder if it’s (lack of) education, more in terms of people not recognizing that it’s available. Some of it is also cultural and I don’t think it’s as accepted in the Black community as in others.”

Bradshaw-Settle said she knows of African-Americans who have had surgery but refuse to admit it.

“A lot of people are ashamed to say they’ve had surgery,” mentioned Bradshaw-Settle. “I don’t know what there is to be ashamed about but I think it’s because a lot of people believe surgery is the easy way out so we let naysayers persuade our judgment. I’ve had people ask, ‘Oh, you didn’t do it on your own?”‘

According to the American Society for Metabolic and Bariatric Surgery (ASMBS), between 2011 and 2013, the number of bariatric surgeries performed in the U.S. grew by nearly 15 percent. In 2011 over 158,000 people received the surgery and in 2013 that number increased to 179,000. Among those procedures in 2011 were sleeve gastrostomy utilized at 42.1 percent followed by gastric bypass at 34.2 percent and gastric band at 14 percent.

“The good news is cases are growing again. The bad news is, this still represents less than 1 percent of the eligible patient population for surgery,” said Dr. Jaime Ponce, immediate past president of the ASMBS.

In the gastric sleeve procedure, about 60 percent of the stomach is removed laparoscopically, leaving behind a sleeve of the stomach. Gastric bypass works by laparoscopically reducing the volume of the stomach. The intestines are rerouted and a small stomach pouch is created by stapling off the main body of the stomach. Gastric banding involves placing a silicone gastric band with an inflatable inner collar around the upper stomach to restrict food intake.

Cultural factors aid in obesity

Bradshaw-Settle, who lost over 100 pounds thanks to lap band surgery, said her family’s eating habits and cultural traditions contributed to her rapid weight gain.

“It’s called ‘eating good.’ My family has big dinners every Sunday and we cook like it’s Thanksgiving year round,” she said. “We eat for any and all occasions with big, hearty meals, then nap.”

Experts say because eating traditions such as these aren’t uncommon in the Black community; this minority group has a high risk for obesity-related health issues. Meals considered “soul food,” which may include starchy vegetables; cornbread and collard greens with bacon fat have contributed to the overall downfall of Black Americans.

The American Diabetes Association finds type 2 diabetes among African-Americans is 1.6 times higher than that of the total U.S. population.

After losing her 34-year-old sister to a sudden aortic aneurysm in January 2014, Bradshaw-Settle became more aggressive with her weight loss plan.

“A mechanic was working on her car when she collapsed right outside of her home.

Some of the contributing factors to her death were stress and high blood pressure and because it went untreated, it exploded,” she said. “I had a panic attack after she died and went to the doctor to find out I weighed my heaviest at 302 pounds.”

Paying out of pocket, on March 3, 2014, Bradshaw-Settle began the process to undergo lap band surgery and March 17 was her official surgery date.

The day of surgery she experienced flashbacks of a thinner physique before she gained over 100 pounds in a year and a half due to depression and other factors.

“I started to cry because I’m the mom of two children and I thought back my daughter’s childhood when she would ask, ‘Mommy why are you always so tired?’ or “Why don’t you want to play?”

Clark at Community Bariatric Services – South said those with no prior diabetic health conditions and a body mass index (BMI) over 40 are eligible for bariatric surgery. Those with health conditions should have a BMI over 35 to have surgery. Currently 12.2 percent of African-Americans have a BMI over 40, with over 16 percent being 1 women. Next steps in the process involve in-office appointments to become aware of the types of surgeries

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