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Jun 4

Black voices, Black bodies: Life in the age of Ozempic – STAT

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STAT teamed up with Word In Black, a network of 10 Black news publishers, to report over the past year on the impact of new weight loss drugs on Black America.

When was the last time you thought about your weight?

If youre like most of us, it was probably today while getting dressed.

In the United States, youd think the greatest achievement in life is fitting into a smaller clothing size. We praise people for their efforts to lose weight, no matter the cost. And the societal obsession with weight loss has only gotten stronger with the arrival of Ozempic and a new wave of anti-obesity drugs. GLP-1 drugs started as treatments for type 2 diabetes and have since been approved for obesity and heart disease all chronic conditions more likely to affect Black Americans.

But to think about taking the expensive drugs means grappling with affordability and access, as well as centuries of oppression, systemic discrimination, and monitoring of Black bodies. Its not easy being Black and living in a larger body in a world that worships whiteness and thinness. So, we wanted to hear voices from the Black community about living in the age of Ozempic.

How do Black people feel about their health, the new obesity tools, and the relentless pressure to not be fat?

Word In Black and STAT surveyed and conducted extensive interviews with more than a dozen people nationwide. We wanted to get as many voices from the Black community as possible, but it became clear that the burden to lose weight falls far more often on women.

They spoke with brutal honesty as they shared their journey with weight loss, and their encounters with family and a medical system rooted in anti-Blackness.

Here are their stories in their own words, edited for brevity and clarity.

Sudi Kamose, Dundee, Fla., 33, teacher

I was at home and my moms co-worker came over and asked me what I wanted to be when I grew up. I said a model. She said, you cant do that unless you lose weight and then my mom agreed.

That has stuck with me since, and those dreams were gone because I kept gaining weight. That memory started everything I was 10. I struggled with disordered eating. Since age 11, I would go on diet after diet. It took me until, like, two years ago, to realize what I was doing was very disordered.

In 2020, I went to the doctor because my heart rate was high, and it was skipping a beat. The cardiologist said my heart was fine but that Im too large, and that its putting a strain on my heart. He said I needed to cut everything that I was eating in half. At this point, I was barely eating. I tried telling him my diet consisted of cereal he didnt believe me.

I told him I dont know what I should be eating. Im also on antidepressants. He said, it doesnt matter what you eat, you just have to cut everything in half. The cardiologist said, You cant be happy if youre overweight, I dont care what any of them say, theyre not happy.

That experience at the doctors office pushed me to be where I am now. He used my depression against me, and that was wrong. I never went back. I only got the courage to write a complaint in February of 2023.

Theres definitely a racial component to it. The way we as a society started to pathologize fat bodies or stigmatize them, is because its further away from whiteness. I think doctors need to recognize theres always been body diversity. And this is an issue because people are trying to profit off of our pain and our suffering.

The journey to being diagnosed with PCOS [polycystic ovary syndrome] was a very long one. I went to the doctor after I noticed I was gaining weight. I kept trying to lose weight and of course I wasnt believed. My diagnosis came when I had my period for three months straight. I did not want to go to the doctor because I was so afraid they were going to tell me it was my fault. Which happened anyway.

I finally went because I was bleeding so heavily, I could not work. I had to have someone come into my classroom so I could go and change my pad like every hour. Finally, I went to the gynecologist, and at 25 they diagnosed me with PCOS. Because of insulin resistance, that could be the cause of me gaining weight. And I realized it was not my fault, even though they kept telling me it was my fault.

It was a roller coaster of emotions, to lose weight and not lose weight. It really contributed to my depression, because its upsetting when you have a goal and everybody in the world is telling you, you are wrong for existing the way you are. And youre trying to change it but its not changing.

Moving forward, Im learning to dismantle my own internalized fatphobia and continue accepting myself. I still struggle with my ideal body type and what that would look like. My end goal is to understand that despite what body I reside in, I am still worthy of pursuing happiness, joy, and having fun.

Alishia McCullough, formerly of Carolina Shores, N.C., 29, licensed clinical psychotherapist

As a teenager, I dealt with a lot of restrictive eating. Sometimes it would mean eating a can of fruit a day or grabbing snacks throughout the day. I didnt have a lot of education or awareness about my body.

At that time, I would hear negative connotations about Black food, being labeled unhealthy or unclean. I started to internalize those messages and thought the way my family cooks and eats isnt acceptable. So I followed very rigid and restrictive diets as a way to modify my body the ideal was to be thin.

Now, Im so much more intentional about how I respond to my body. I dont look at food as good or bad. More so, what does my body need to feel nourished?

It wasnt until I got into graduate school where I learned the term eating disorder I could resonate with that experience. In grad school, I interned at a counseling center where I started to help lead their eating disorder support groups. But I noticed the training was through a white lens. I had to work with clients with a diverse background to learn that the BIPOC experience is different.

The medical field uses BMI to equate weight with health. But theres lots of research to show that BMI is a made-up construction the purpose was to see what the average white man looks like. That instrument got adapted into mainstream society, when insurance companies figured out they can use it as a way to increase peoples premiums, recommend weight loss surgeries and medications and quite honestly discriminate against certain patients.

In my household, we grew up watching My 600-Pound Life or The Biggest Loser, with constant messages from the media showing that fatness is bad, fatness is disgusting. The premise of these shows is this idea that these people are thin, lovable, desirable people within a fat body. And if you can burn off all the fat, you can uncover the person within.

A lot of our bias is coming from these media messages. When people say youre fatter and more likely to have chronic illness, I challenge back and say, do thin people also not experience chronic illness?

The way we define health is so limited. Our mental health and stress go into our health concerns. Were seeing higher rates of health issues in Black communities but a big part of it could be that we have been exposed to so much chronic stress over time, that its manifested into health issues that we dont see in other communities. I think it is a result of living in these very racially high-stress environments, and its been passed through generations. When we look at health, it does need to be more expansive healing our culture systemically and culturally can play a big piece too.

Its not actually the fat itself that makes people unhealthy. A lot of times its the fatphobia and weight stigma they experience when they go to a health care provider. If folks go to their provider and know theyre gonna say all these negative things about their body, they are less likely to see a medical provider.

Ive heard so many stories of folks being dismissed because a provider blamed everything on a persons weight.

Fatness was not labeled as unhealthy or bad until Black folks were enslaved. Body size became a way of creating a culture of hierarchy around human worthiness. And it became this whole messaging around Black people being gluttonous, or promiscuous, and all these things associated with the Black body.

Our medical system could benefit from seeing people as experts on their body.

As Black women, theres so many layers in our relationship to our bodies. On one hand were lifted up as the standard, we see that with the [Brazilian butt lift]culture, and on the other hand, were being degraded and hypersexualized.

One of the things diet cultures promote is thinness at all costs. Youd rather be thin and dead than another size and alive.

Jonathan Gustave, Orlando, Fla., 38, licensed marriage and family therapist

Ive been overweight my entire life. As I got older, I realized that losing weight had a lot to do with how I saw myself. I felt that if I didnt lose weight, Id be less than a person and less than acceptable in society.

My relationship with food has been very terrible. As a child, my father abandoned my mother and I, in a cold basement of Chicago. Then, my mother disowned me, she left me in the hands of my grandparents, she never came back for me.

And my grandmother suffered with a lot of depression after my grandfather passed away when I was 5 years old. There was a lot of abandonment and neglect in my life from the time I was born, until I got married and had my own family.

Ive learned that every single human being desires connection, in some way. So, in the times that I was bored, lonely, and frustrated as a child, I found comfort and connection with food. It just became a crutch for me, because of the lack of connection that I had with family members.

I was recently diagnosed with type 2 diabetes in August 2023, and I was forced to change my diet. I also have more love in my life my wife and my kids. So, I do my best to connect with them, so that I dont seek that connection and comfort from food. But its difficult because Ive been operating like this for 37 years.

Funnily enough, people have never said that I was overweight. But thats because Im 6 feet 8 inches, my weight now is like 335. My weight has fluctuated from 320 to 365 throughout my adult life.

My primary care physician suggested that I get on Ozempic. Now that Im type 2 diabetic, if I stay in this range, the cascade effects of losing a toe, foot, going on dialysis, and kidney failure has me more focused on my body being healthier.

Tigress Osborn, Phoenix, Texas, 49, executive director of the National Association to Advance Fat Acceptance

Theres an increasing discussion around the idea that obesity is, in the words of obesity experts, a complicated chronic disease. There are many people who are resistant to the framing of obesity as a disease, and its not because we are in denial about whether there are health impacts of being in a larger body. Its because we are resistant to our bodies being inherently pathologized, medicalized, and classified as a problem.

The only way obesity is classified as a disease is through correlation with other diseases. Some of those same diseases correlate with Blackness.

A lot of Black folks are bigger because we have different body types that werent taken into account when we created these standards of how we designate body types. These huge capitalist entities are increasingly seeing Black folks as a market. As a fat liberationist, my perspective is that anti-fatness is a much more serious problem for Black and brown folks than being fat.

When I think of fatness, its just a kind of human diversity.

Anti-fatness is a form of systemic discrimination its pervasive and insidious. One of the systemic injustices is the medicalization of fat.

So, what I want is for people of all sizes to have true body autonomy. Where we are presented with research that starts from a neutral perspective.

One of the challenges when we are talking about weight loss drugs is that we are talking about them as the end of fatness. Its all over the media, Ozempic, Ozempic, Ozempic. And the chorus behind that is, so why are you still fat?

People are still fat because even if they take these drugs, fat people are still gonna be fat. If I lose 20% of my body weight right now, Im still going to be a visibly fat person. Im not going to turn into Beyonc by taking Ozempic, even if I take it for the rest of my life.

Culturally, weve been waiting for magic. And we like the narrative that magic has arrived. But those of us who are more suspicious of that narrative may be more cautious in relation to our health choices and may choose never to opt into these drugs.

Novo Nordisk has never had my best interest at heart. The idea that we can undo the social or systemic pieces, by asking individual fat people to lose weight, is preposterous. Injustice should not be solved by asking the people who are subject to the injustice to change themselves.

Im a pretty confident fat girl. Im middle-aged, disabled, fat, and Black there is no cultural preferencing of me in the world. Ive learned to self-advocate for myself and Im willing to. We want to build a world where people dont have to advocate for themselves because were all advocating for each other at a community level.

I am aware of the days that I am unhappy in my body. Its hard to live in a fat disabled body. I celebrate my body a lot, but Id be lying if I said there were never moments where I think it would be easier if I had some other body. But I dont have that as a permanent mentality the way many people do.

The reason I feel like that is because the world is terrible to this body. I want the world to treat me better as an individual in my body and everyone better in that way.

I am concerned that we as a community buy into these oversimplified health narratives like soul food makes all Black people unhealthy, but is it though, or is it racism?

Timothy Conley, Los Angeles, 46, department chair of cinema and film at California College of ASU

When I was a child, I was bullied. My family has a way of saying things that can be hurtful. Even my own relatives made fun of my weight when I was a kid. I was sad and I felt like the only friend I had was food. I started gaining weight in elementary school.

Around 2007 and 2008, I lost 123 pounds. I was eating six meals a day like a bodybuilder. I was in pretty good physical shape, but I was not in a good emotional shape.

A lot of it was ego driven. Someone bet me that I couldnt get down to a certain weight. Off of that bet, I was determined to get down to that weight. The problem was there were no healthy mental, emotional habits as I began to lose weight, I was just determined to prove people wrong.

So, I ended up gaining all that weight back, and more. I became a type 2 diabetic in 2012.

I was completely depressed. Growing up in the Black community, there was no promotion of seeking therapy, or other pathways outside of the Black church. What happens after church on a Sunday? Mac and cheese, fried chicken, barbecue ribs, greens, cakes, and pies that was not a place I could go to for health and wellness.

I have been as heavy as 422 pounds and as lean as 250 pounds. Even when I weighed more than 400 pounds, because of my height of 6 feet 6 inches, and being an ex-athlete, I dont look like an obese person, I look like a large ex-football player.

My relationship with food has been like a rough marriage that needs counseling. I love food, but then I hate food. Im addicted to fast food.

I used to be the guy that at 1 a.m., Im go through the Jack in the Box drive-thru and load up on the $1 menu. I would eat all that food and somehow go to sleep after.

I used food as a coping mechanism, like some people use alcohol or drugs.

I looked forward to the sensation, the taste of refined sugar and processed crap. I tried going to Overeaters Anonymous; that didnt last very long, because I wasnt really connecting with anybody. There were no Black folks in there, it was a bunch of white folks in a room.

Now, I am an advocate of mental health support, especially in the Black community. Personally, I think that every human being on this planet should have somebody to talk to, that is not a relative or a loved one. The problem is the medical industry has made this unaffordable or really hard to access.

Before going to therapy, I used to say I hate you in the mirror. Even when I lost all that weight I hate you.

Sixteen years since thats happened, Ive done a lot of work. Now my practice is being mindful. I use positive affirmations for myself and tell myself that its going to be OK and that youre loved. And loving myself regardless of what size Im at because you got one shot at this thing called life, in this body, and youve got to make the most of it.

Ozempic was a suggestion from my doctor to get my A1C blood sugar levels down. The challenge with Ozempic is Im not really hungry, so I have to remind myself to eat.

I started Ozempic in the middle of October. Ive had issues with diarrhea and nausea, and some stomach pain when Im eating certain foods. My doctor didnt give me a time frame he said its either Ozempic or surgery. Its a big industry to keep people on drugs, and Ozempic is making a lot of money.

Im hopeful that itll be worth it. Im at an age now, where a lot of folks that look like me start passing away as they enter their 50s. I do have my concerns because I know the medical industry makes a lot of money especially off of the Black and brown community.

DJ Rock, Brooklyn, N.Y., 28, fitness instructor

Ever since I started my transition and gone on estrogen hormones, weight distributes differently. Its more difficult for me to put off weight. In the past few years, Ive seen a lot of weight gain, a rapid transformation in my body. That has taken a while to get used to.

In some ways, gaining weight has been really exciting. I feel like I have an ass now. Ive talked to other trans women about the way our bodies and muscles work is just so different now than it used to be. That brings up anxiety.

Ive had some surgeries to feel better in my body, and part of that has been a fat transfer from my stomach to my hips.

There are some things that all women experience, which is societal pressure to look a certain way. For trans people in particular, there are concerns with my body for safety reasons. As a Black trans woman, I do feel safer after having gender-affirming surgeries because of my ability to not get outed when I walk down the street.

Ive connected transness, weight loss, and my fitness journey as like this loss of control. You just kind of get on hormones because I want to look a certain way, but I have to wait and see what happens with my body. Its kind of scary.

Most gym people fall into this cycle of bulking and cutting. For me, its constantly a challenge. I lose some weight and my stomach looks flatter and Im feeling good, but then my ass looks smaller. Then I want to gain weight and grow my ass back.

Ive never tried weight loss supplements. As a fitness instructor, Ozempic feels like cheating.

I dont think its cheating for everyone. I would never blame or fault someone for being on Ozempic. I would support my clients if they decided that was best for them. For me, it feels like I cant do it.

As a woman, I think about my body way more than I ever did before. Also, as someone who is always on display as a fitness instructor. Once I had gender-affirming surgery it felt like this is the body Im supposed to be in. In a weird way, thinking of my weight is gender euphoric because I really am a Black woman.

Paige Booker, San Diego, 34, IT supervisor

I ended up ballooning towards the end of college. I didnt realize I had gotten so much bigger until I saw my photos from my wedding. When I saw the pictures, I was like, Oh, my goodness, who is this?

Ive talked about this in therapy a little bit: When I was younger, I remember sneaking food in my room. As an adult, Ive come to realize Im an emotional eater.

Even when I was much smaller, growing up in the South, I had what we call a frog in my arm.

Im not supposed to be in this large body. It did not always used to be this way. I need to do what I can, to make it a body that Im proud of. What I found works for me is tracking my food, because I didnt know how much I was or wasnt eating. Most of the time, Im looking at the number on the scale, but Im into checking in more with how I feel. Ive tried a lot of different exercises like CrossFit, strength training, cardio boxing, HIIT, tennis, and hiking to see what sticks.

I feel like weight loss culture is ingrained in Black women. Theres always this need or feeling to be whatever is trending at the time. That changes, which makes it harder to always love who you are and celebrate your own uniqueness. I think about how many Black women I know who use waist trainers, or drink detox teas.

Especially if you have something special coming up, theres this need to put it all into overdrive. We deprive ourselves in order to be rewarded with a good time. Which is really sucky.

For all the things that have been said to me about my body, my husband has been a huge help as well. Hes like a cheerleader hes always complimented my body; hes never made me feel negatively about my body. While I have external sources that say, do better and be smaller, I also have my own voice and the voice closest to me thats saying youre doing good.

Joycelyn Terri Turner, Desoto, Texas, 59, corporate trainer

I gained weight in adulthood; after my only brother was killed in a car wreck when I was 29. I was very comfortable and happy in my body until my brother was killed. Ive always been a foodie after he died, food was my comforter. Food was always there if I didnt have anyone to talk to. It was there when I got home from work and when I woke up in the morning.

I went through a periodic succession of losses. My father died in 1990. My brother died in 1994. My mother died in 2003. In 2008, 2011, and 2019 I lost three very close girlfriends who were like sisters to me.

When I recognized I had a problem, it was about 10 years after my brothers death. From 1994 to 2015, I gained 140 pounds. I had gone through diets, fitness clubs, exercising on my own, and with friends. But in 2015, I made the decision to get gastric sleeve surgery. Once I had the surgery, I lost 95 pounds within six to seven months. Since then, Ive kept off 90 of the 95 pounds.

Growing up, I was always on the thin side. And I had a very positive self-image. As I gained weight, it was interesting to see the different treatment I received from people. That was new for me, not shocking, but surprising. When I was smaller, guys readily opened doors, but when youre a big girl, theyre not tryna open the door.

Im not nearly as confident walking into a room as I was, when I was smaller. As a smaller person, my attitude is very open and joyful. As a bigger person, Im much more reserved I dont like that because thats not who I am.

I would say for the past 10 years, its been hard for me to warm up to people, because Ive had so many losses. Im afraid to feel. As far as my psyche goes, Im coming to grips that Im a survivor. And my body is going to be what my body is going to be.

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Black voices, Black bodies: Life in the age of Ozempic - STAT

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