Courtesy of Columbia University

(The Root) — Obesity is more common in African Americans than in other ethnic groups. But when it comes to black people and weight, that's where the agreement seems to end. Is food the culprit? Is exercise the solution? Is there even a real problem to begin with, or should we be focusing on health — or even self-acceptance — rather than the number on the scale?

Against the backdrop of the first lady's mission to slim down the nation's kids, black celebs getting endorsements after shedding inches and a booming weight-loss industry, The Root will publish a series of interviews with medical professionals, activists and fitness enthusiasts that reveal the complexity of this issue and the range of approaches to it.

For the ninth in the series, The Root talked to Dr. Olajide Williams, the founder of Hip Hop Public Health and its Hip Hop H.E.A.L.S. (Healthy Eating and Living in Schools) program, which has been presented to more than 25,000 New York City students over the last seven years. An academic neurologist at New York-Presbyterian-Columbia University Medical Center, Williams works to empower African-American and Latino school children with the behavioral skills necessary to navigate the food environment in their homes and communities. The H.E.A.L.S program uses an interactive, multimedia format that includes animation and hip-hop music developed by Artie Green and performed by rap vets such as Doug E. Fresh and Chuck D of Public Enemy.

The doctor talked about why he considers hunger and obesity to be two sides of the same coin and why the lack of personal discipline is an oversimplified explanation for poor health outcomes among African Americans.

Read the rest of the interviews in the series here, and check out The Root's other obesity coverage here.

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The Root: According to the latest statistics, African Americans are 1.5 times as likely as whites to be obese. What's going on, from your perspective, with black people, obesity and overall health?

Olajide Williams: It's a perfect storm of multiple factors working together to drive the epidemic overboard. If you go to an urban community, for example, there are many challenges. One is economics — the cost of healthy food. We know that healthy foods cost more than unhealthy foods. And fruits and vegetables cost more than a dollar meal that you can get from the fast-food restaurant.

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We know access is an important barrier as well. Not only is cost prohibitive, but access to these healthy foods is also prohibitive in a lot of black communities. There are areas that we refer to as food deserts, for example, where among the bodegas and fast-food restaurants, you might be lucky to find one store that sells fruits and vegetables. So they have to work harder in these communities to find healthier foods that are also more expensive.

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And then you have other factors that include things related to cost. For example, if a family has a very limited budget and that mother needs to feed four kids, the question is, "Do I buy a couple of pounds of lettuce or go to a fast-food restaurant and spend $5 getting five 'dollar meals' for the kids?" And it just so happens that fast food has the highest caloric density and lowest food value.

TR: When it comes to African Americans and obesity, what is the biggest myth or misunderstanding?

OW: That's a difficult question, but while I believe in personal responsibility — and I do truly believe in personal responsibility — I think that people are too quick to judge and too quick to dismiss communities as being irresponsible, without really examining the playing field.

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Yes, there are certainly those who are not as personally responsible as they should be, but the problem is painting an entire community with the same brush — because there are many in the African-American community who struggle to do the right thing, but the playing field is so uneven that it's really hard for them to sustain the gains that they might make, and regression is much more common just as a result of the great odds that they have to deal with just to try to be healthy.  

TR: If you could make just one suggestion for people to implement in their daily lives with respect to weight and health, what would it be?

OW: Physical activity. I'm a physician, and I've always said I would rather you go buy a pair of sneakers than spend that money on visiting me. Because honestly, physical activity — Thomas Jefferson said it — is a great invigorator of the body. So if someone asked me to recommend one thing that they could do, it wouldn't be "Don't eat this, don't eat that." It would be "become more physically active." That is something that has eroded over generations.

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TR: What cultural, historical or psychological issues make the black community's relationship with weight and heath unique?

OW: There's a vicious cycle of poverty, hunger and obesity interacting with one another. How does hunger lead to obesity? The truth is, they're two sides of same coin. Paradoxically those who are poor try to maximize caloric intake per dollar, but they're doing that at the expense of their health and at the expense of their bodies. So they fall into this vicious cycle of hunger and obesity. The cycle of poverty tends to feed into obesity … just because of the economic structures governing food access and food costs.

These are daunting challenges for any families, and then you couple that with educational status, and knowledge and literacy, and you realize that just not knowing the nutritional value of your food can put you at risk. A lot of time people are not well-educated about smarter options they could make, even within a very constrained or constricted environment.

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So those factors mean there's an opportunity for an educational intervention — even in this environment, there are smarter things you can do to avoid eating an over-burdensome amount of unhealthy food. Education has the ability to mitigate but not to eliminate this problem. Eliminating the problem will require multiple sectors coming together to address all the different components that drive the obesity epidemic.

Jenée Desmond-Harris is The Root's staff writer. Follow her on Twitter.

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