Trying to lose weight? Ethnicity might matter — and the differences point to a larger issue, study says
Considering joining a weight-loss program? Your ethnicity may have more of an effect on your success than you'd think.
A new study from York University researchers suggests Black, Latin, Middle Eastern or South Asian people may lose significantly less weight in clinical programs compared to White, East Asian and other ethnicities.
'We know that in terms of obesity rates, there's large differences between ethnic groups,' said Jennifer Kuk, the lead author and a professor at York University. 'So we thought it's important to look at whether or not there are differences in the weight loss achieved as well.'
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Her team's results imply the ethnicities at greatest risk for obesity also stand to benefit the least from traditional weight loss programs, Kuk told the Star. She believes the reason lies in socioeconomic and cultural differences, from lack of access to private health insurance to generational trauma.
'I think it's a very important study,' said Robert Ross, a professor of exercise physiology at Queen's University who is unaffiliated with the research. 'It recognizes that referral and access to treatment programs varies across ethnicity.'
The paper was published this week in peer-reviewed journal Clinical Obesity. Here's what you need to know.
Ethnic differences in weight loss
The retrospective study reviewed the weight loss journeys of 14,695 people enrolled in clinical weight management programs across southern Ontario.
Each participant was asked to self-identify their ethnicity into the following broad groups: white/Caucasian, South Asian, East Asian, African Heritage/Black, Indigenous or a free-form field that would be categorized as Latin, Middle Eastern, Mixed or Other.
Among all the ethnic groups, white people experienced the most weight loss, losing an average 4.9 kilograms. East Asian ethnicities lost an average 4.3 kilos, while 'other' ethnic groups lost 4.4 kilograms on average.
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In comparison, Indigenous people lost an average 3.9 kg, South Asians lost an average 3.5 kg, Black individuals lost 3.3 kg on average, Latin ethnicities lost an average 3.0 kg and Middle Eastern people lost 2.7 kg on average.
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When Black people were further asked to identify as African American, African Black or West Indie Black, it was found African Americans lost the least amount of weight out of all the groups — averaging 1.2 kg of weight loss. Prior studies show Black individuals also tend to have the highest obesity rates in Canada.
Ross was surprised to find about a third of all ethnicities discontinued the weight loss program after just one visit. Indigenous people are most likely to discontinue, with 41.9 per cent stopping the program: 'I think that underscores some of the challenges we have in addressing obesity,' he said.
Why is this happening?
The study didn't delve into why these differences exist — it merely tracked how much weight people of each ethnicity lost. But previous research offers some clues.
Kuk noted that systemic racism, which can lead to unequal job opportunities, educational disparities and wealth inequality for certain ethnicities, can also result in food insecurity and hamper the ability for people to eat a healthy diet.
Similarly, different ethnicities have significant disparities in access to health care. Indigenous, Black, South Asian and Latin individuals are less likely to have access to a regular health provider compared to the general Canadian population, for example — meaning less access to clinical weight and obesity management.
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Kuk added that generational trauma could modify one's genes in a way that predisposes their children to obesity, even if these children never experienced that trauma themselves.
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'Thus, factors such as racism, immigration, and lower wages may also contribute to (genetic changes) that may contribute to obesity or impair obesity management,' the study read.
But Ross notes that, due to the nature of the study, we don't know exactly why this is happening. More research is needed to further understand this relationship.
How does Ozempic factor in?
The study was performed near the start of the advent of Ozempic, right when similar weight-loss drugs hit the mainstream.
The paper noted there were no ethnic differences in the rate of Ozempic prescriptions. That said, it had no data on how many of these prescriptions were being filled, how long they were in use or how effective the drugs were.
Kuk noted that Ozempic and other effective obesity medications present another barrier to care for certain ethnicities. These drugs are not often covered by health insurance, forcing patients to pay out of pocket — 'compounding the ethnic differences in terms of salary, private health insurance access and so on,' Kuk said.
In Canada, data show Black and Latin individuals have among the lowest income of all other ethnicities. They also have some of the highest obesity rates: 'This is just making it even harder for the groups that potentially need obesity treatment the most,' Kuk said.
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