Coppin State/Medifast Study Examines Obesity Among African-Americans in City
Sudler was once a fit 190 pounds, and he liked to play softball. But after a work-related injury in 1992 forced the 5-foot-10 Sudler to give up his career as an upholsterer, his problems and his weight ballooned.
Sudler was diagnosed with carpal tunnel syndrome, a painful repetitive-stress injury that made it difficult for him to work. His employer refused to put up money for an operation that would relieve his symptoms, and Sudler could not afford the surgery himself. He had problems supporting himself and his family and he became depressed. He says he ate to relieve stress and quickly put on more than 200 pounds.
Sudler says that at one time he may have weighed close to 600 pounds, but doesn't know for sure because his scale didn't go that high.
"One day I woke up and realized, Wow, you're big!," he recalls. "I would eat to feel better and feel bad because I ate. I had no social life."
Sudler says he attempted to lose weight, trying many weight-loss strategies, including fads like the cabbage-soup diet, but he had little success. Part of the problem, he says, is that his inner-city neighborhood offers few healthy-eating options and even fewer opportunities for exercise. He describes his Northeast Baltimore neighborhood as peppered with fast-food restaurants. He says there are no gyms or fitness centers, and he can think of only one supermarket within a seven-block walk of his home. Being overweight makes him "miserable," Sudler says, but he found losing weight extremely difficult because it just wasn't practical.
"It's far more convenient to get a ready-made meal than it is to get a healthy meal at the supermarket," he says. "Actually, you can't find a healthy prepared meal at the supermarket, unless it's salad."
Sudler is now part of a Coppin State College study on obesity among African-Americans in Baltimore. The study, called called "Healthy Habits = Healthy People," aims to prove that African-Americans who live in the inner city are affected by not only poor nutritional choices but also their urban environments. Coppin's Helene Fuld School of Nursing and Owings Mills prescription weight-loss company Medifast teamed up on the project, which was launched on Nov. 11, 2003, to determine what obstacles inner-city residents must overcome to battle obesity. Coppin and Medifast will follow the progress of two groups of individuals living in the city: The first group will receive dietary replacements and assistance from Medifast. The other will be provided with healthy-diet recommendations and advice but will shop for food from local stores and restaurants in their neighborhoods. The study has 100 participants, ages 12 to 60.
Sudler was one of the first to volunteer to take part in the Coppin State/Medifast study.
"I feel like I'm carrying a refrigerator around on my back," he says. "Little children are petrified of me walking close or near them. When I go to pick up my nieces, they cringe." (To put the girls at ease, Sudler teases them, "Don't worry, I won't eat you.")
Sudler began the program on Dec. 1, 2003. He is part of the group that is receiving meal replacements and guidance from Medifast. Coppin's School of Nursing monitors his diet and his progress. So far, he says, he has lost 52 pounds. He is hoping to lose 248 more pounds before the study is over, which would put him at his target weight of 220.
Coppin State President Stanley Battle says this kind of research is long overdue because, although statistics indicate that the number of obese African-Americans is rising, few have examined the problem--partly because African-Americans tend to shy away from participating in this kind of medical survey.
"As a people, we don't trust doctors," Battle says. But he believes the reputation of Coppin, a historically black university that has been in the city for 103 years, has helped attract participants for Healthy Habits = Healthy People.
According to Healthy People 2010, a set of health objectives for the nation created by the U.S. Department of Health and Human Services and the Office of Disease Prevention and Health Promotion, 77 percent of all non-Hispanic black women and 60 percent of all non-Hispanic black men are overweight. According to the Washington-based nonprofit American Obesity Association, women and individuals in lower income brackets are particularly susceptible to obesity, and as a result, many weight-related diseases like diabetes, hypertension, cancer, and heart disease affect poor African-Americans and other minorities disproportionately.
Marcella Copes, dean of the Fuld School of Nursing at Coppin, points out that most African-Americans are confronted with the increase in obesity in their communities every day.
"If you look at your family, friends, colleagues, people you pass on the street, you realize that most of them are overweight or obese," Copes says. "And, more importantly, there are generations of individuals who are overweight and obese."
She says that in poor neighborhoods like the ones surrounding Coppin's West Baltimore campus, there are plenty of fast-food options but too few options for healthy eating.
"It's easy to find high-grease . . . fast food," she says. "But it's not easy to seek out institutions with healthy nutrition without taking three buses or cabs."
Copes says she hopes the Coppin/Medifast study will make the connection between economics, environment, and obesity. If people's economic conditions and environments improve, she says, they can overcome weight gain and its related health concerns. "[We want] to prove that given the right resources, people in the inner city can and will lose weight and keep it off," Copes says.
"In our communities, people have to go to the store, and the only way they can get their food back home is by way of a hack," Sudler adds. "And sometimes they don't actually have the dollars; they have to barter with food stamps. . . . There are obstacles that people face in the inner cities that you'll never see in the suburbs or the county."
Dr. Wayne Anderson, medical director of Medifast (which distributes its products through subsidiary companies Jason Pharmaceuticals and Take Shape for Life), says the company is familiar with "the pivotal role nutrition plays in recovery from illness."
"I strongly believe education, tools, and support are required to create long-term solutions to optimal nutritional health," says the board-certified anesthesiologist and critical-care specialist. He says he and Medifast have a commitment to "taking care of the whole person."
The notion of examining obesity through education and support has allies in some interesting places. Dr. Michael Schweitzer, assistant professor of surgery at Johns Hopkins Hospital and the first doctor in the eastern region of the country to treat obesity through laparascopic gastric surgery, agrees that a new approach to obesity needs to be addressed.
"Clearly surgery is not the cure," Schweitzer says. "Prevention is the goal. We need to start over in educating parents and kids about how to eat properly." He adds that the National Institutes of Health need to devote more money to obesity research.
The first stage of the Coppin/Medifast study will last for six months, during which time Copes says both Medifast and non-Medifast users will be studied. She says both groups "will be followed and monitored" and provided with nutrition education, fitness information, and exercise suggestions.
"In six months, [the groups] will switch models--those that are on Medifast will go to whole foods, and vice versa," she says. When participants eventually reach their target weights, they will be placed on weight-maintenance plans that could last up to two years.
Sudler will be monitored for an additional amount time because of the amount of weight he needs to lose. Though it may seem a daunting task, he says that participating in the study makes him feel like he just got "a million dollars."
"I've been desperate, trying everything," Sudler remarks. He was even tempted to try gastrointestinal surgery despite the fact that he had an obese brother who died as a result of such a procedure. "I always felt as though I needed some hope," he says. "I just didn't have the power to do it on my own."
Since joining the program and losing a little weight, Sudler has resumed worship at his church, Brown Memorial Baptist Church in Park Heights, because he once again can walk from his car to the church and up the steps. He looks forward to the day when he can play basketball again with his 14-year-old son and marry his girlfriend, Yvonne. Up until now, he says, he wouldn't make plans for a wedding.
"I know she loves me, but I want her to marry someone with promise," Sudler says. "Not someone who's ready to die."
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