On Jan. 11, 2023, the start of the year, LeKeisha Banks of Atlanta decided to change her life. At the time, she weighed 257 pounds, had an A1C of 7, and had become insulin resistant. Psychologically, the beginning of a new year symbolizes a fresh start for many people, and such was the case for Banks. This is often accompanied by a surge of motivation, and it may be helpful to use this energy to kickstart a weight-loss journey you’ve been putting off.

But the best time to start a weight-loss program or plan truly depends on individual circumstances. Before you begin, there are some questions you should ask yourself. Are you ready? Does your current schedule allow you to remain consistent with training? Did your doctor clear you for this lifestyle change? Do you have a support system? Do you have the resources needed to start and maintain this lifestyle? Having the answers to these questions will help you reach your goals.

Obesity and the Black Community

Obesity has increased within the Black community, but more so for women than men. Black men have slightly lower levels of obesity than non-Hispanic white men (41.1% vs 44.7%).

According to the U.S. Department of Health and Human Services Office of Minority Health, African American women have the highest rates of obesity or being overweight compared to other groups in the United States, with about four out of five Black women considered overweight or obese. Body mass index (BMI), a figure calculated from your weight and height, is used by many in the medical community to gauge your risk of disease. A BMI of 30 or higher is considered to be obese.

Nevertheless, the number itself is important but it does not paint the entire picture. “BMI can be helpful in certain cases, but it does not give us all the information we need,” says Supriya Rao, MD, quadruple board-certified physician in internal medicine, gastroenterology, obesity medicine and lifestyle medicine. “We know nothing about a patient’s body fat percentage or their skeletal muscle mass. In terms of a person’s overall health, we also need to consider sleep patterns, age, blood pressure, cholesterol levels, cardiovascular health, physical activity, diet and family history.” In June 2023, the American Medical Association (AMA) acknowledged issues with using BMI as a measurement “due to its historical harm, its use for racist exclusion, and because BMI is based primarily on data collected from previous generations of non-Hispanic white populations.” They recommended that BMI be used in conjunction with measurements of visceral fat, body adiposity index, body composition, relative fat mass, waist circumference and genetic/metabolic factors.

Additionally, a small study of 39 African American women and 66 white women, published in the International Journal of Obesity, revealed that African American women who follow the same diet as white women and exercise just as much tend to lose less weight because they burn fewer calories. The results suggest that behavioral changes – and not just weight loss – are what matter for improving health.

Get the Green Light From Your Doctor

Rao says that before her patients embark on a weight-loss journey, she makes sure they have realistic goals. “Weight loss doesn’t happen overnight. It’s often a lifelong journey and you need the right team in place, including accountability partners. That could be anyone from a friend to a dietician to your doctor.” Rao reviews the lifestyle of her patients, patterns of their diet, exercise, sleep and stress. She discusses any preexisting conditions or screens the patient for currently undiagnosed health issues that might hinder the weight-loss process. Diabetes and hormonal imbalances, for example, can make it hard to lose weight. A thorough medical exam can usually take care of this.

Weight-Loss Medications and Surgery

Behavior change is hard, so it’s important to set realistic expectations. Banks can attest to this. She had an endoscopic sleeve gastroplasty, a minimally invasive weight-loss procedure that reduces the stomach’s size and volume by about 70 percent. Prior to surgery, she weighed 257 pounds and was taking metformin, an anti-diabetic medicine, at its highest dose. She says she led an active lifestyle, playing sports, working out occasionally, and enjoying the outdoors, but she was not consistent. After the ESG, done by True You Weight Loss in North Carolina, she lost 65 pounds in 11 months, and has adopted a new relationship with food and exercise.

“I feel like a completely new person,” she says. “My health is truly bouncing back. I’ve lowered my A1C from 7 to 5.6 and my blood pressure is trending in the right direction.” Maintaining a healthy body weight can improve symptoms and lower your risk for serious health conditions like Type 2 diabetes, heart disease, and high blood pressure.

“Some might say using any form of surgery to assist in weight loss is cheating, but I beg to differ,” says Banks. “That’s the easy part. Changing your relationship with food, understanding what your body needs, all the support systems, is what is needed to conquer this battle.”

In the weight management and obesity medicine space, there are also several medications that can be used in conjunction with improved diet and lifestyle choices. Much of 2023 was spent with the spotlight on options like Ozempic. Medications have helped many people achieve a healthier weight and reverse some of their chronic medical conditions when used as part of a comprehensive lifestyle change. Unfortunately, many have side effects that can make them difficult to tolerate. They are also expensive and aren’t always covered by health insurance.

Weight-Loss Goals and Mental Health

Weight loss usually involves some form of exercise and movement. This can improve your mood. Losing weight can also improve your physical health, which can boost your self-esteem. Racine Henry, LMFT, PhD, shared that whenever a person can hold themselves accountable and achieve a goal, there are hormonal benefits and an increased sense of pride. “As a therapist, I often emphasize that we can always make different choices and control ourselves. Weight-loss goals emphasize that ideology and can bring a sense of accomplishment.” Losing weight can also reduce your risk of depression and anxiety and improve sleep quality.

How to Stay on Track

So you have a plan. You have been cleared by your doctor, your program has been set, and you have an accountability partner. Certified personal trainer Garrette Campbell shared the following tips for staying on track to reach your goals.

• Be specific about your goals. Is it weight loss? Muscle building? Cardiovascular fitness? Flexibility? Or do you want to create routines that involve a combination of all of these things?
• Be honest about your current fitness level. If you’re a beginner, start with beginner-friendly exercises and gradually progress.
• Consider hiring a personal trainer. A personal trainer can help create a personalized program based on your goals, fitness level, and any existing health conditions.
• Set specific workout days and times in your weekly schedule. Treating your workouts like appointments can help you prioritize them.
• Use alarms or reminders on your phone to prompt you to start your workout. This can be especially helpful in the beginning.
• Keep a workout journal or use fitness apps to track your progress. Seeing improvements can be highly motivating.

Remember, the key is to build a routine that suits your lifestyle and preferences. Consistency is more important than intensity, especially when starting out. Be patient with yourself, and celebrate the progress you make along the way.