While obesity can affect anyone, African-American women have the highest rates, with four out of five Black women being overweight or obese. These statistics are partially due to the striking disparities in obesity reduction behaviors and obesity interventions for Black women.

Failing to address obesity with updated resources is harmful. Yet, according to NIH research, “Black patients seeing White physicians had a 46% lower likelihood of receiving [obesity] counseling than White patients seen by White physicians.” Studies show clinicians of all ethnicities can have weight bias toward patients with obesity. As clinicians, it is our responsibility to be aware of our biases and educate ourselves on the complexity of obesity. Such knowledge empowers us to address the factors that uniquely impact each person with obesity, including the role of bias and health disparities.

The latest scientific evidence shows that obesity is a complex disease influenced by many biopsychosocial factors that disrupt the body’s metabolism. Traditionally, factors like psychological stress, sleep hygiene, socioeconomic status, psychological trauma, and racial discrimination have been underappreciated in diagnosing and treating obesity. Each uniquely impacts Black women and obesity, as do cultural expectations and beauty standards. Cultural beauty aesthetics, such as high maintenance hairstyles and preference for a “curvy figure,” can influence obesity rates as much as the pressure to be thin from healthcare and mainstream media.

Racial discrimination and psychological stress both contribute to obesity. On the individual level, racial discrimination causes psychological stress, which becomes physiological stress. On the molecular level, physiological stress disrupts several essential weight regulatory hormones that can lead to obesity.

Systemic racism and racial discrimination also impact obesity on the public health level. These harmful factors affect every aspect of obesity, from individual to systemic influences, such as policy and neighborhood planning. Studies show that Black women disproportionately experience racism and weight bias. Considering the known associations of racism and obesity, this may contribute to the high rates of obesity in Black women.