It's not news that Americans are dealing with an obesity epidemic. But the problem is particularly acute among African-American women.
Four in five African-American women are obese or overweight, according to the U.S. Office of Minority Health, and carrying those excess pounds can spike the risk for several conditions including heart disease, Type 2 diabetes, high blood pressure and stroke.
About half of African-American women in the U.S. are obese, compared to 30 percent of white women. Black women not only carry more weight, but they start adding extra pounds years before their white counterparts.
So when does it begin, this excess and unhealthy weight? Research suggests the problem starts early, and it may have a lot to do with when girls give up regular exercise.
Experts want kids to exercise at least 60 minutes every day, but among all children, black girls are most likely to report they got no physical activity in the past week. A lack of access to exercise opportunities may be one big reason why, says Shiriki Kumanyika, an epidemiologist and public health professor at the University of Pennsylvania.
Research shows that opportunities for recess, sports, physical education -- or just to go outside -- aren't spread evenly among children.
"If you kind of add up those situations in urban, inner-city neighborhoods -- where most African-Americans live -- they are not as available. That's been documented," says Kumanyika, who studies patterns of illness and health behavior.
But research suggests that even those girls who do engage in sports and other forms of regular physical activity tend to abandon it in their teen years -- and that's true not just for urban girls or black girls, but all girls.
A National Institutes of Health study that followed girls for 10 years, beginning at age 8 or 9, found that, over time, leisure-time physical activity declined dramatically. That drop off was steepest for African-Americans girls.
"What they found was that by the age of 17 -- so that's the junior, senior year of high school -- more than half of black girls, and nearly a third of white girls were reporting no leisure time physical activity at all," says Temple University researcher Clare Lenhart.
There are lots of reasons why teen girls drop exercise from their lives, says Lenhart: "They have found changes in enjoyment of activities, in peer support or social support for physical activity. They found a lot of competing interests -- be it part-time jobs or caring for younger siblings or other family members."
Walter Stewart says he's witnessed the phenomenon first-hand. He's the longtime coach of the Anderson Monarchs, a soccer team of mostly African-American girls from inner-city Philadelphia.
"Eighth grade -- that's where it gets to be difficult," he says. "They are making the transition from young kids to more teenagers, and they are more interested in boys and what boys think."
Jennifer Johnson was determined not to let that happen to her daughter, Alexandria. Johnson discovered the Monarchs when she was looking for an affordable way to keep Alexandria active.
Alexandria is now 15 and an assistant coach with the team, but her interest in soccer dipped in middle school, around age 12, says Johnson.
"In come the friends, and in come the extracurricular activities at school, and as a parent you really have to press on. I said to her, 'If it's not this, you will be involved in something,'" Johnson says.
So Alexandria stuck with soccer, and so did her mother -- Johnson is on the sidelines at games and during most practices.
That's an approach that obesity researchers would approve of. Researchers say that family support -- especially mom's presence -- may motivate girls to keep playing.
Researchers are beginning to count up the cost of obesity, and say women can pay a hefty price in dollars-- and health.
A sedentary lifestyle and obesity may account for 25 to 30 percent of some major cancers, including colon, kidney and breast cancer in postmenopausal women, according to the National Cancer Institute. Avoiding weight gain, by contrast, can cut cancer risk.
In September 2011, researchers at Boston University reported that overweight and obesity in African-American women increases their risk of death, particularly from heart disease. The investigators reviewed body mass index--a measure of body fat--and death rates for participants in the ongoing Black Women's Health Study. A BMI of 25 is considered overweight. The study found a significant increased death risk at a BMI of 27.5--that's the BMI for a 5-foot-4-inch tall woman who weighs 160 pounds.
Nearly 10 percent of all health care spending in the United States, $147 billion a year, is related to the obesity epidemic. Individually, obese people cost nearly $1,500 more a year in medical expenses compared to healthy-weight people, according to estimates from researchers at George Washington University. Some of that extra expense is paid by individuals, some is passed along to their employers.
This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente. This story is part of a news partnership between Kaiser Health News and WHYY.