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Latinos and Weight loss: Evidence-based
Strategies for Culturally Competent Care
Presented By: Laura Rubalcava, MA
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Objectives
1.
Gain deeper understanding of Latino culture: food,
health/illness beliefs, personalismo, role of family in weight
loss
2.
Provide easy to implement strategies for healthcare
professionals to effectively treat obesity in Latinos
3.
Know the barriers to treatment for Latinos
4.
Increase awareness of the personal well-being of the
healthcare professional
5.
Understand treatment options for referring to a obesity
treatment specialist
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Latino
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Background: Latinos vs. Hispanics
“Latino/a” is a term growing in popularity among US-born Latinos
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Represents a political consciousness
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Sense of ethic pride
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More often used in research
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Used in this presentation
Hispanic
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“Term created by federal order in 1978 by the Office of Management and Budget.
Hispanic is defined as, “person of Mexican, Puerto Rican, Cuban, Central or South
American, or other Spanish culture of origin (Marin & Marin, 1991, p.20).”
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Primary purpose of this label- categorize a group of people not by a specific
country or origin with unique history, religion, indigenous roots, cultural
traditions, and foods but rather by a common language, namely Spanish.
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The term “Hispanic” leads to people to believe Spanish-speaking individuals
from these countries have one common culture and that the term refers to a
racial category (Santiago-Rivera, p21).
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Background: Latinos
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Latinos constitute 16% of the US population (US Census Bureau,
2011), largest ethnic minority group in the US…the U.S. Latino
population for July 1, 2050 is estimated to reach 132.8
million, constituting approximately 30% of the U.S. population
by that date.
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Approximately 64% of the Latinos in the US are of Mexican
origin (Falicov, 1998).
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According to U.S. Census Bureau population estimates as of July 1,
2011, there are roughly 52.0 million Latinos living in the United
States, representing approximately 16.7% of the U.S. total
population, making people of Latino origin the nation's largest
ethnic minority.
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1.Latino Culture and Weight loss
Food, family, tradition
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Family support is significant in recovery of those with disordered eating behavior
“A Latino patient can only get as well as the family will allow them” (Lambert, 2011).
Health/ Illness beliefs
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Internal/ external forces
Curanderos/ santeros/espiritisa- can be viewed as having more power than a physician, this can
result in Latinos noncompliance with medical treatments prescribed by professionals who have
different beliefs about the etiology of illness” (Santiago- Rivera, Arredondo, Gallardo- Cooper,
2002).
Latinos are highly traditional in their healthcare practices
Personalismo with physician/staff
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“The valuing of warm, friendly, and personal relationships has important implications for how Latinos perceive and
respond to environments (e.g., hospitals, mental health agencies)that are quite often impersonal and formal”
(Santiago- Rivera, Arredondo, Gallardo- Cooper, 2002).
Role of family in weight loss
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Collectivistic orientation/ Familismo
Gender role
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Fulfill role of Marianismo, “girls must grow up to be women and mothers who honor the model of the
Virgin Mary… they must be pure, long-suffering, nurturing, and pious. Mothers are viewed as selfless,
self-sacrificing, and nurturing individuals (Lopez- Baez, 1999, Santiago- Rivera, Arredondo, GallardoCooper, 2002).
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+ 2.Evidence-based Strategies to
Improve Weight Loss in Latinos
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Motivation for change assessment
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Urge parent/ child to choose desired physical activity
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Exercise as routinely as you brush your teeth
Emphasize overall health- teeth, bones, immune system, psychological/ self
esteem, hair, skin
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Focus more time on those ready to change
The more we focus on only weight loss/obesity the more it wont change
Ask about exercise environment/ tools for exercise (indoor/outdoor)
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Ipod motivational songs, tennis shoes, nintendo wii, as a family
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Buy during tax season
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Place value on health/wellness, plan for future instead of present
Social identity threat- “psychological state when people feel at risk of being
devalued or negatively stereotyped because of social identity” (Major, B., 2011).
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3.Barriers to Treatment for Latinos
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Effects of healthcare professional bias
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Take the blame off the parent and patient
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Cultural attitudes to health and wellness (SantiagoRivera, Arredondo, Gallardo- Cooper, 2002).
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Language proficiency/ translating concerns
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Insufficient financial resources
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Obesity is commonplace in America- less likely to seek
treatment
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Lack of awareness- signs & symptoms of obesity
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Unable to adjust to life changes
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Physician understanding of diagnosing Binge Eating
Disorder (Hudson JI, Hiripi E, Pope HG, Kessler RC, 2007).
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Self-care of the healthcare professional- Role model
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Environment of the clinic/hospital/treatment center
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Magazines, chairs, scales (privacy)
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4. Well-being of the Healthcare
Professional
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Physician self-care
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Self sacrificing-eat, sleep to accommodate
others
Addressing your relationship with food
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Increase self awareness, we all live in the
same toxic food environment
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Address personal biases towards obesity
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Encourage healthy eating/ exercise in the
workplace environment
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Meatless Mondays
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Potluck lunches
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Walk during lunch
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Bring lunch to work
+ 5. Who are the Obesity Treatment Specialists
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Primary doctors
Bariatricians
 General doctors, family medicine, psychiatry,
endocrinology
Dietician/ Nutritionist ( MA in nutrition)
Supervised medical weight loss
Exercise physiologists- especially for morbidly
obese
Bariatric surgeons
Psychologists/ bariatric psychologists
Counselors/ social workers
Weight watchers
Health education coaches
Specialty clinics- Ex: National Center for Weight
and Wellness, University Clinics/ Research
centers
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References
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Hudson JI, Hiripi E, Pope HG, Kessler RC. (2007). The Prevalence and Correlates of Eating
Disorders in the National Comorbidity Survey Replication. Biological Psychiatry 61: 348-358.
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Lambert, S. (2012, February 15). Providing treatment across different cultures. [National
Public Radio]. Retrieved from: http://www.npr.org/2012/02/15/146936181/providingtreatment-across-different-cultures
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CDC 2013. Health United States, 2012. Retrieved
from:http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr12/index.html - See more at:
http://minorityhealth.hhs.gov/templates/content.aspx?lvl=3&lvlID=537&ID=6459#sthash.Y
Pxva3Vh.dpuf
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Major, B. (2011, November 11). Weight Stigma [The Rudd Report]. Retrieved
from:http://itunes.apple.com
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2012 National Healthcare Disparities Report. Retrieved
http://www.ahrq.gov/research/findings/nhqrdr/nhqrdr12/index.html - See more at:
http://minorityhealth.hhs.gov/templates/content.aspx?lvl=3&lvlID=537&ID=6459#sthash.Y
Pxva3Vh.dpuf
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Santiago-Rivera, A., Arredondo, P., & Gallardo-Cooper, M. Counseling Latinos and La
Familia: A Practical Guide. Thousand Oaks, California: Sage Publications, Inc.