Michele’s POV

Speaker: Michele Tedder, MSN, RN, Senior Program Manager, Black Women’s Health Imperative (BWHI)

What has your journey with obesity care looked like?

I’ve lived with obesity since childhood, and I remember, you know, as young as probably seven, eight years old, my mom having to shop at the chubby girl stores. So it’s it’s not something that I am unfamiliar with.

And I would say that, you know, my experience, like the experience of many, is that, you know, you go to the doctors, you get your checkups, and it’s like, “Oh, you should eat less and exercise more.” And if I had a quarter for as many times as someone said that to me, I’d be very wealthy, and we would have cracked the code on this. But I think the thing that always sticks out to me is that as many of those providers who would say that, they really didn’t have any strategy or recommendations other than eat less and move more.

Ultimately I, you know, developed a lot of comorbidities that comes along with living with obesity. You know, I had in adulthood, I had developed type two [diabetes]. I had developed a lot of like joint issues, sleep apnea, high cholesterol, all of the things that are associated with living with obesity. So I think that was has been the hardest part.

And so after many years of of managing that and dealing with that, I finally met a physician who was amazing and she really helped me to understand that obesity is a disease and that it wasn’t my fault, and that was really the game changer for me, and she was the person who really helped me to explore and eventually get comfortable with the idea of weight loss surgery. So in 2017 after much investigation, asking people who’d had it, and working with my doctor, I got comfortable enough and had the gastric sleeve, and have lost and kept off about 80 pounds.

But you know, it didn’t stop there. I, you know, have a trainer and work out. I have a dietitian, and I also take one of the GLP-1 medications to help to maintain my success.

And the good news, the non scale victories—and I think it’s important for people to hear that— the non scale victories have been that my type two went into remission; I no longer take cholesterol medication; the blood pressure medication that I was taking, one was eliminated, the other one was cut in half; and my pulmonologist is very happy with my sleep apnea numbers at this point. And we are still hopeful that eventually I can get to the place where that will be a thing of the past too.

So I have truly, truly benefited from having access to comprehensive coverage. And, you know, I think the reason that I do this work is because I want to see everybody have access to that, because it literally has improved the quality of my life and changed my life for the better.

What obstacles do Black women face when trying to access obesity care?

For Black women in particular, you know, you’ve got to acknowledge the the cultural nuances that we manage from day to day, right?

So, I think the intersectionality between us showing up as women of color, things that are structurally in our society that create inequities. I think the level of stresses that we have to live with just being. Just being, you know? Managing work environments, managing family and then, you know, not always being able to find care providers who look like us and understand us. So I think that’s a huge barrier.

And from a Black woman’s perspective, and I think the fact that there are structural things, like BMI, that don’t tell the story across cultures, I think that it’s important for us to acknowledge that we are different, and we do have a different set of needs that need to be acknowledged and addressed.

How can policymakers and employers help improve obesity access and coverage?

I would say to policymakers and employers, and providers I’m going to add, that you have an opportunity to work together to change the narrative, first off, right? Because part of why we don’t have adequate coverage is because there’s a narrative that obesity is the result of moral failure or choices, or, again, not taking care of yourself.

I feel like policy makers, I feel like providers, I feel like employers can really work together to help to change that narrative, in terms of messaging, in terms of really coming from a place of curiosity about people living with the disease, and then, them becoming advocates to say, “You know what? Here’s our position on it. You know, we accept that people living with this disease, it is not their fault. And not only do we accept it, but we want to put practices and policies in place that protects people who are living with this disease so that they won’t be discriminated against, that they will have access to comprehensive care options, and that they have access to providers who can help them to navigate through this.”

My point is that everybody living with the disease of obesity should have the freedom and the access to work with their provider to develop a treatment plan that works for them and their individual situation.