Guest Post: Racial Diversity in Obesity Research and Practice

Fatima Cody Stanford, MD

Today’s guest post comes from my dear colleague Fatima Cody Stanford, MD, Associate Professor of Medicine and Pediatrics, Harvard Medical School. 

Particularly in the aftermath of the murder of George Floyd here in the United States, there has been greater attention to racial and ethnic diversity in every domain of human life. His brutal murder during the COVID-19 pandemic set the stage for those to consider the prominence of disparities and how they contribute to differences in health, quality of life, morbidity, and mortality- just to name a few. So now, more than any time since the 1960 civil rights movement catalyzed by individuals such as Martin Luther King Jr., we recognize that racial and ethnic diversity matters. 

But why does racial and ethnic diversity matter in the field of obesity? Why should we care?

The answer is quite simple. Disproportionately, individuals from racial and ethnic minority groups bear the brunt of the burden of obesity. As a Black woman obesity medicine physician-scientist, I can definitely say that the disproportionate burden of obesity in the Black community – particularly amongst those that are the descendants of the enslaved like myself here in the United States, brought me to this field. each and every day in this work I realize the importance of the focus on this issue. Yet, my daily focus on racial and ethnic diversity in the field is not genuinely shared by many of my colleagues. Hence as we seek to improve the care for persons with obesity, we fall short of being able to do so. 

How is this you might ask? Let’s take a pause and look at clinical trials that are performed around the world for anti-obesity pharmacotherapy. You don’t have to do a deep dive to recognize that the subjects included in those trials disproportionately do not reflect the diverse tapestry of individuals who are impacted by the disease of obesity. As we peruse the prominent publications in the top peer reviewed journals throughout the world, you also don’t see many authors that reflect racial and ethnic diversity.

So, how are we going to treat a disease when both the patients, physicians, and other healthcare providers that care for these patients don’t reflect the diversity of the population? How can we extrapolate data and presume it will apply broadly to a population that is underrepresented? We can’t. So we continue to fail. Yet, no one really seems to care.

You might push back at me for that. I am someone who eats, lives, and breathes as a Black woman in this world. Saying that you care and speaking about the issue of racial and ethnic diversity in obesity without taking any true steps to improve the status quo means you’re complicit in the lack of progress. 

So what steps can we take to make a difference?

Here are my personal thoughts of initial steps we can take to change the narrative and actually make a difference in persons from racially and ethnically diverse backgrounds in obesity.

1. Recognize the burden of obesity and racial and ethnic minority communities throughout the world and recognize that it’s prevalence stems from multiple biologic, social, economic, and other factors.

2. Empower individuals from racial and ethnic minority communities to pursue careers and work in obesity as this diversity in the workforce will lead to better quality of care for this patient population.

3. Ensure that trials of all kind: lifestyle, pharmacotherapy, surgical interventions have a diverse cohort of subjects so that the results can be extrapolated to all. 

4. Be a true ally. Don’t just talk about the issue of racial and ethnic diversity in obesity. Do the work. 

5. If you have no idea where to start, seek out those of us that do to assist you in this work.

The time for us to act is now. Let’s stop talking about the problem and be a part of the solution. You can start with you today.

Fatima Cody Stanford, MD
Boston, USA

About the author: Fatima Cody Stanford MD MPH MPA MBA FAAP FACP FAHA FAMWA FTOS is an Associate Professor of Medicine and Pediatrics who practices and teaches at Massachusetts General Hospital (MGH)/ Harvard Medical School (HMS) as one of the first fellowship-trained obesity medicine physicians worldwide. She is one of the most highly cited obesity medicine physician-scientists with over 150 peer-reviewed publications.