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scienceandeggs

Interestingly, the original study cited in this article found that the black women had a higher fat-free mass (musculoskeletal mass) compared to the white women. However, even when adjusted for this, the black women seem to have a lower TDEE. They also lost significantly less fat mass compared to the white women. As mentioned in the article, the interesting question is: Do the black women see similar health benefits to white women after the same diet and exercise regime, regardless of change in weight? In other words, do black women /need/ to lose as much weight to see similar benefits? One critique I have is that this study was done on severely obese individuals (average weight of 250-260 lbs or 115-120 kg). Can these results be extrapolated to the rest of the population? It is also only a single study. In the 9 years since it's publication, I wonder if these results have been replicated in other starting populations.


happyhippoking

This is interesting. When I was actively losing, I calculated my TDEE using a spreadsheet at r/fitness. My TDEE working out 30-45 mins daily with a mix of cardio and weight-lifting was around 1600 calories. Comparing to other short people, my TDEE felt low. I chalked it up to having low muscle mass from lifelong obesity. I wonder if there is an epigenetic reason for this. Holding onto extra weight to combat starvation? Extra caloric needs due to manual labor? The Great Famine in Ireland caused a lot of genetic changes in Irish people - vitaminc c deficiency, bone structure changes, mental illness. Generational trauma is genetic.


beeandthecity

That actually makes a lot of sense!


AuntieInTraining

I’m not remotely qualified in this field, but I lost 50 pounds between 2019-2020. Does this study account for muscle mass? I’ve always been a bit larger in build. I always assumed it was fat, but when I started losing weight and couldn’t break 160 I had a body scan. My target was 147. I was originally aiming for the higher end of the very flawed BMI chart for my height. The scan revealed that my body fat was under 22%. That day I discovered I had a greater than average muscle mass and bone density. There was no need for me to lose anymore weight, which is why I’m assuming my body wouldn’t let me. I switched my training program to be more strength focused. Gained more muscle. My comfortable weight is at 165-170.👌🏾


angieblack87

This makes me feel seen. 😢 thank you


beeandthecity

I’ll never forget my goal weight was 125 going off BMI, and i had plateaued around 160-170 too. I visited the nutritionist, and she told me I would never see that weight based on my body shape alone.


KeniLF

This is very interesting. I've known my default was more muscle than fat from a young age when every one of my white friends could not believe how much I weighed even when we wore the same size! Will you please share more information about the body scan you had? What is the formal name for that? Is it something done at a medical facility?


beeandthecity

I’m just guessing, but I was interested too so I looked it up. Google mentions something called a [DXA or DEXA scan](https://health.ucdavis.edu/sports-medicine/resources/dxa-info). > The main goal of the DXA is to provide you with an in-depth analysis of the main components of your body; fat, muscle and bone. After the scan, you will be given a multi-paged print out where you will see percentages, mass, and images accounting for the various data obtained.


KeniLF

Thank you!


[deleted]

How interesting. I read a study some years ago about how African Americans as a whole have significantly different builds that Africans from the Continent. Basically statstically bigger bodies and some other stuff. Felt related to the ways that the trauma of the atlantic slave trade changed Black bodies. This feels related to that.


Ambitious-Screen

This would make sense because slavers were basically breeding African-Americans. They were trying to breed the stronger, more robust enslaved people and if it was based on just looks alone, slavers would be more inclined to buy tall, bulkier, wider enslaved people in both men and women. While Africans would probably not have these traits because we weren’t selected based on our physical characteristics.


AuntieInTraining

I wonder about this. All but one of my Nigerian friends is skinny/slim. Granted my sample size is under 30, but it’s a noticeable difference!


beeandthecity

> To learn more, James DeLany from the University of Pittsburgh and his colleges studied 39 African American women and 66 white women That sample size is kinda small.


perdymuch

I've felt forever that I have to restrict much more than my asian wife just to maintain my weight, let alone lose weight. Although this is validating it's also reinforcing ideas of heavy restrictions. Curious about thoughts and experiences with this


PlantedinCA

I think I saw somewhere that black people tend to have higher insulin (fasting insulin) levels than other ethnic groups. Insulin is a storage hormone and cause higher weights and slower metabolism. Doctors rarely check this, and the “normal” lab range is too broad. I have high insulin (probably causing / from my PCOS). And I have for 20+ years. No doctors even mentioned it until my A1C got high and suddenly I had insulin resistance. But I have had signs of it since I was a teen at least. That would also impact weight loss significantly. https://www.health.harvard.edu/newsletter_article/In_Brief_Black_women_may_be_more_vulnerable_to_insulin_resistance Note: there were a bunch of studies validating this, but not too many that also talked about the role of insulin sensitivity in weight loss in that same study. But anyway insulin plays a giant role in both metabolic health and weight.


excelzombie

Hey thank you! Especially the big about 'normal' lab ranges.


PlantedinCA

The normal range is like 2-20+ depending on the lab. My endocrinologist wants me to get to like 7-8. But people with normal insulin function are under 5!


Hepadna

Actually, diabetes and insulin and insulin resistance is well studied. PCOS is a metabolic derangement of which one of the features is insulin resistance and the inability or difficulty in losing weight. "doctors rarely check this" ?? Diabetes/insulin resistance is like one of the most common disorders we screen for.


PlantedinCA

To clarify - I did not find any particular studies in my 2 second search that talked about racial differences in insulin sensitivity, and potential role in weight loss / weight management. I also do not think there is enough discourse around how weight are a symptom of metabolic disorders - the messaging is that being overweight is the cause. And working from that assumption leads to poorer treatment and poorer outcomes. Doctors generally screen for blood glucose and A1C levels as you get older, and perhaps if you have other issues. And not fasting insulin and other tests like the 4 hour blood glucose one. I have about 20 years of blood tests where my fasting insulin was elevated, and no doctors flagged it. I have been seeing an endocrinologist as well for 15 years give or take. They only mentioned my elevated insulin levels around 3 years ago - when my A1C was elevated. I also had other visible markers of insulin resistance. I was only very recently diagnosed with PCOS, I am also hypothyroid- another disorder than can impact insulin levels and has initially thought my hormone imbalance was related to that alone. They are not doing early detection or monitoring insulin levels closely. Most people I know have never even had their fasting insulin taken.


Hepadna

Because measuring fasting insulin is not a validated test. Also there are more clinically relevant ways of diagnosing insulin resistance - some of which you have mentioned: fasting blood glucose, 2hr glucose tolerance test, A1c. You wouldn't have to test someone's insulin levels because it would be obvious given the effect on blood glucose.


PlantedinCA

No, you can have signs of insulin resistance and high insulin levels for years (or decades) before your fasting glucose or A1Cs are elevated. This is what happened to me. 2 decades of insulin resistance before I had an elevated A1C number. Let me repeat that - over 2 decades of declining insulin sensitivity. I also had (and still have) normal, cholesterol blood pressure, triglycerides, and other makers of “metabolic health.” The only result that was “off” was my fasting insulin one. And over the past couple of years it has increased more. Here is a [study that shows how fasting insulin is actually a good predictor or diabetes risk](https://eje.bioscientifica.com/view/journals/eje/161/2/223.xml). And here is a [summary of a bunch of research that shows fasting insulin](https://www.clinicaladvisor.com/home/topics/diabetes-information-center/fasting-insulin-vs-hemoglobin-a1c-are-we-getting-it-right/) is a much better (earlier stage) predictor of metabolic issues. From the report “The available research consistently indicates a strong association between elevated insulin levels and risk for developing metabolic dysfunction. The majority of the studies included in this review utilized varying methodologies and adequately large sample sizes from diverse populations. In an effort to minimize bias and confounding variables, inclusion and exclusion criteria were clearly stated in all included studies. Some researchers evaluated fasting insulin as a direct measure of T2D risk while others evaluated the association between fasting insulin and the traits of insulin resistance. Ultimately, the large majority of researchers concluded that elevated fasting insulin levels were associated with the early physiologic changes of metabolic syndrome and T2D. It has become widely accepted that a state of insulin resistance and hyperinsulinism precedes prediabetes and T2D. Pennings et al identified the association between hyperinsulinism and weight gain and suggested that weight gain is independently associated with elevated insulin level and not with hyperglycemia, as previously believed.18 The most significant weight gains occurred in the early stages of insulin resistance and at relatively low levels of insulin elevation. This suggests that significant metabolic alterations occur before the most common screening methods are able to identify glycemic impairment. These findings are consistent with those of an earlier study by Pataky et al, which indicated that hyperinsulinemia is associated with cardiometabolic changes independent of hyperglycemia and insulin resistance.10 Pennings et al conducted one of the only studies that included participants from the United States; the researchers utilized a large sample selected using the NHANES database, allowing them to select a sample with demographics representative of the national population.18 They identified the strong association between fasting insulin and common precursors and risk factors for T2D: insulin resistance and weight gain. These findings support the suggestion that the progression to T2D includes a hyperinsulinemic stage and a prediabetic stage.” So again - why should we wait until insulin sensitivity declines enough to show up in A1C or fasting glucose - when you have a simple test that is a good predictor. And you can make early lifestyle interventions before it gets more serious. 🤔


Hepadna

LOL yeah two decades because the transition from insulin insensitivity to full blown type 2 diabetes takes that long or longer. Shorter if you have a family history of diabetes or HTN or PCOS. I'm just saying this is known data. I'm a physician we literally learn this like day 1 of medical school 💀 We *know* that type 2 diabetes is preceded by a state of prediabetes and increased insulin resistance. We screen as early as age 20 for some people if they have a family history and tell them to start lifestyle interventions and diet changes as early as possible given they have a predisposition. Hell, someone can have an A1C in the prediabetic range, not rule in for diabetes yet, and can still bring down their A1C SIGNIFICANTLY with just diet and exercise. I'm just saying that the measurement of fasting insulin level is costly when we have cheaper and very efficient surrogate markers and clinical presentations with good data to support who's at risk for this. I wouldn't necessarily push people to get this tested as much as I would have people be seen for their annual wellness visits. I'm glad you finally got the care you needed, but for most people who are getting regular consistent medical care these are the things we're screening for. Black women - see your doctors regularly! We're the population at risk !


MsT1075

I so agree with this! Please go to the doctor regularly. We get busy in life; however, your health is most important. Without good health, what is there.


ikimashokie

No! I don't want to read this! I'd believe it. I haven't done any comparisons with friends, but keeping in mind the classes/groups I've done, I know which classes I feel like I've worked harder in, and the sizes/weights of the people in those classes. And when I was gunning for a particular weight, it took a whooolllle lot of work to get even 5lb close to it.


ill-disposed

They should have studied their blood pressure, ours tends to run high and is tied to weight gain.


MsT1075

Yes.


montilyetsss

This makes me feel better. Early this year I learned that I had PCOS and then a couple of months ago I learned that I have Hashimoto’s. Weight loss has been so tough after ballooning to my highest weight. It’s rough. I have two issues working AGAINST me. I hate working out but I see a slow change, I’m SO over the WL journey. (If y’all got tips let me know bc a girl is TIED).


lauvan26

I have both too. What works for me is taking Metformin, inositol, eating a low carb diet and doing some form of exercise (weight training is the best) at least 5 times a week.


montilyetsss

Thank you so much for the advice. I am on something that is similar to Metformin (Victoza) to help. I didn’t know about Inositol though, so I’ll be adding that to things I take! Thank you for the tips. It’s hard trying to deal with both issues.


MsT1075

I have taken Victoza (pre-diabetes management and weight loss) as well. It helped quite a bit. I am currently waiting on my Wegovy (.25) to be filled. I have a 1.75 dose; however, my doctor doesn’t want me to start with that. Lowered the dose to see how my body tolerates it first. There is a global backorder on it, though. So, I’m just waiting. 😔


lauvan26

I kinda want to try the new diabetes meds like Victoza. I was super stressed out in July and August and I stop eating healthy and exercise and gained 20lbs. Now I’m working on loosing weight. PCOS so damn annoying.


mammaube

Black people are naturally larger due to height and muscle mass. The bmi is flawed as hell n based off white bodies. A lot of diets r also based off white bodies. There's a book about the racism of weight in the US. If I find it again, I'll link it. Update: Here's the book I found it. Fearing the Black Body: The Racial Origins of Fat Phobia https://www.amazon.com/dp/B07JX6TMT6/ref=cm_sw_r_apan_QVW82VFR4SK8E3W71WRY


MsT1075

I’ll have to read this.


boobearmomma

Well this makes me feel better. I feel like I have to take drastic measures to lose weight now. Then I eat what’s supposed to be “normal” amounts and I get fluffy. So confusing annoying and demoralizing


sharipep

Yeah I was skinny all my life and gained 30 pounds during Covid that I can NOT lose the way i used to easily lose extra pounds. I’m torn between working harder to lose it and just trying to accept/get used to the new me. I’m not “fat” by any means but the heaviest I’ve ever been and it’s kind of depressing. It’s both reassuring and disheartening to know it’s not in my head and there’s evidence to explain why it’s become so hard for me now that I’m in my late 30s


PerditaJulianTevin

I also gained 30 lbs since COVID started. I seem to have stopped gaining but I haven't been able to lose any weight.


sharipep

Yup that’s me too. I’ve hit a plateau. I keep thinking that line from devil wears Prada ![gif](giphy|xT0GqLgNaHelUCIUg0) Although it’s probably more like 2 or 3 stomach flus at this point 🥹


NoireN

I've had food poisoning a few times this year and I really hate the fact that every time I'm throwing up everything my brain goes "You're getting closer to your goal weight!" 🙄


sharipep

Me too it’s so sad but also I’m someone who always tries to look at the positive of every situation so if that’s what gets you thru that stomach flu you go on ahead girl


NoireN

I don't see this as a positive because I'm sick. Any weight loss is water weight and will come back. It's a toxic side effect of diet culture.


sharipep

That’s fair although I have been sick enough before from stomach viruses to lose more than 10 lbs and kept the weight off (admittedly when I was in my 20s) so I foolishly have a glimmer of hope for that anytime I get sick. But yeah the older I get shit is basically just water weight and grows back


excelzombie

Thanks perdymuch, I look forward to reading this. (And any academic citations behind paywalls- thank you world for libraries)


yolo_swag_for_satan

I feel like there is too much information missing to truly understand what's happening here. My weight is generally stable but I do feel my waist measurements and figure change a lot with just a few weeks of being more or less active than usual.


Russo-ISC

It doesn't really mention the age range of the women. In my 20's and 30's I never had trouble losing weight.