Obesity disparity: a Latino MD's view.(GUEST EDITORIAL)

Ever wonder why it is that so many people are obese in America? As the epidemic grows, it is clear there are many factors that affect it, not the least of which are our exercise and eating habits. While the epidemic involves all ethnic groups in the United States, it is far more pronounced among economically disadvantaged African Americans and Latinos, the majority of my practice.

As a Latino and formerly obese patient myself, I am especially interested in identifying and overcoming the barriers to obesity treatment in this population.

Most of my Latino patients are new immigrants to this country. They consume certain foods because doing so reminds them of their home, their family, and their culture; food is connected to emotions and memories. When people eat to fill this psychological need rather than because they are hungry, the tendency is to overeat. After all, food can cure hunger, but it cannot cure homesickness.

When they arrived in this country, many of my patients found themselves in financial situations that required them to work all the time--10-12 hours a day, 7 days a week, with no sick days, holidays, or vacations. Such schedules left little time for exercise, proper food preparation, or learning English. For many, the cost of a trip to a health clinic--both in terms of doctors' bills and lost wages--is too great, so the opportunities for education and treatment are few.

Together, these barriers make it difficult for patients to learn what obesity is and how to treat it. Patient education materials are now available in Spanish on the Internet; however, this requires patient access to a computer, which may be unrealistic.

Long work hours create another problem: time away from the family. For the most part, my patients did not have much money in their homelands, but they were able to spend more time with their children. Here, that time is denied them, which makes them feel guilty. To combat the guilt, and perhaps to feel less disadvantaged, they may go out to eat. Fast food is the ...