Posted on January 17, 2006

Lightening the Burden

Krissah Williams, Washington Post, Jan. 17, 2006

Last year, 12-year-old Alejandra Rojas acknowledged that she was a little too chubby, or gordita , as her Spanish-speaking mother, Gabriela, would say. At 5-4 and 145 pounds, she was overweight, her pediatrician told her, and at risk of becoming obese.

In their Adams Morgan apartment, Alejandra and her mother slathered their breakfast bagels with butter or cream cheese. The girl’s lunch was usually a Hot Pockets sandwich, followed by chips and cookies.

At dinnertime, Gabriela Rojas, 48, a single mother from El Salvador, cooked mostly pork and red meat and piled their plates with fried yucca, fried plantains and rice. When Gabriela, who is not overweight, was too tired to cook after a long day cleaning houses, she bought her daughter burgers and fries at McDonald’s or fried chicken at Popeye’s.

“I ate whatever I liked, but I was always hungry,” said Alejandra. She also had little energy during gym class. She and her mother have no car but they rarely walked, preferring to take the bus. They hardly ever exercised, Gabriela said, because they did not think it was important.

The Rojases’ experience is common in the U.S. Hispanic population of 41.3 million, where excess weight is a problem. According to the 2005 National Health Interview Survey of the Centers for Disease Control and Prevention (CDC), at least one of every four Hispanic adults living in the United States is obese, which is defined as having a body mass index, or BMI, of 30 or more.


A study released in September by the District’s Council of Latino Agencies assessed the health of Washington’s Hispanic community (population 47,258, according to the 2000 Census). The study — which involved 800 Latino adults, 99 percent of whom were recent immigrants — found that 61 percent were overweight or obese. Community activists now are struggling to change habits that may contribute to this problem, starting with women like Gabriela Rojas.

“We realize that this is an emergency for us,” said Eugenio Arene, executive director of the Latino council. “Mothers are the key informant of our culture and customs, and we tell them, ‘You have a big responsibility in front of you. We are getting overweight, and we have to do something about it.’ “


Madeline Wilks, a primary care physician at La Clinica del Pueblo in the Columbia Heights, which serves a largely Latino clientele of more than 5,500 patients a year, thinks some of the answer lies in cultural norms.

“Being a little gordita is almost seen as a positive,” she said. “When people are at an appropriate BMI, they are almost seen as being too skinny.”

That view holds in much of Latin America, where people are familiar with the sight of thin, frail children in impoverished areas, health professionals said. Gabriela Rojas carried that perception and a love of starchy foods with her when she fled El Salvador’s civil war for the District in 1987. She saw no harm in frying food in cupfuls of oil or in feeding Alejandra lots of sweets even as her daughter grew heavy.


The lure of fat-laden fast food also gets frequent mention as a cause of weight problems.

It’s not just that fast food presents an easy option for immigrants who “struggle with too much to do, just like anyone else,” says Alejandra’s pediatrician, Rachel Tellez, who works at Unity Health Care’s Upper Cardozo Clinic in Columbia Heights. Some immigrant parents actually take pride in buying their children fast food — a luxury that many could not afford back home, she says.

“I think for a lot of Latino families it is a privilege to provide their families with fast food,” Tellez said. “They could not afford it in their home countries, [and] now they are happy to buy their kids fast food.”


Gabriela Rojas said she did not recognize the danger in her family’s diet until Tellez referred her to a free nutrition course sponsored by the Upper Cardozo Clinic and the Capital Area Food Bank. The six-week course, conducted in Spanish and held on Saturdays last year, was designed to help Latino families change habits that may have contributed to the community’s weight problems.

Local chefs, a nutritionist and a clinic volunteer instructed Alejandra and her mother in the basics of healthy eating. At a grocery store, the instructors translated nutrition labels and taught the families to look for foods high in fiber. In the clinic kitchen, Alejandra and her mother were startled to see the chef prepare a chicken dish with only a capful of oil.