America is getting fat. Nearly one third of adults in this country are obese. To help combat obesity, some cities have banned unhealthful ingredients in restaurant food. Other communities support listing students' weight on their report cards. A new effort in Philadelphia is turning to religion.
This community-based weight-loss program is part of a four-year study of the prevention and treatment of obesity in high-risk populations. Temple University researchers have partnered with churches to test whether an Internet-based telemedicine system can help overweight and obese African Americans in the nearby community lose weight.
Participants attend weekly meetings at a local church, led by a trained facilitator. Each group has 8 to 12 members, because when it comes to losing weight, it is known there is strength in numbers. Participants focus on improving their communication and listening skills, and learn how to get support from friends, family and each other. They look at what they are eating and what changes they could make in their diet and activities. They also learn new ways to deal with stress.
Jill Coleman is the group leader for the pilot phase of the study at Philadelphia's Mt. Zion United Methodist Church. "To me what is motivating our group is the fact that it is a lifestyle change and a behavioral change," she says, explaining that getting healthy is a lifetime commitment. "This is not just a diet. [We don't say] 'lose 20 pounds. Here's your menu. Once you reach your goal, you know, let's do a commercial.' This is a real lifestyle-behavior change."
Coleman uses a variety of methods to keep her group engaged and energized. She plays rousing spiritual music to get people moving around. At each meeting she prepares healthy snacks like steamed cabbage or sweet potato puffs, recipes she gleans from the cookbook A Taste of 5 A Day, Black Churches United for Better Health.
And she relies heavily on scripture for motivation and strength. "How can you serve your lord or be a better Christian?" she asks the group. "The way you can serve is taking care of your body so that you are healthier. So you have a healthier body, healthier mind and a healthier way to serve. I think that the church in the black community is basically grounding for the black community. You know you come to the church to improve your lifestyle on all different levels. Why not through health and healthy lifestyle and diet?"
Her group members hear the same message when they come to church on Sundays. The Reverend Thomas James, tells them, "If your body is the temple of God, let us treat it as a temple of God; let us treat it as best we can and in so doing that we can try to become healthier. As our love grows for God and so our temple grows also."
The Mt. Zion pastor is also a participant in the study. He says he has tried diet programs before to help manage his hypertension and diabetes, but never found a group that stayed together beyond the classroom.
Now he hopes what's happening in his church will be an example for the entire city of Philadelphia. "When the study is complete and we have learned what we needed to learn, we'll try to bring other members of our congregation into lifestyle change by the way we eat," he explains. "Many churches that you will go into you will see folk that are overweight but our culture is used to eating certain kinds of foods, but we can try to teach them how to chose different kinds of foods that would be more beneficial for them."
The program also uses technology to maintain the sense of community people find in their congregations. Temple University's Center for Obesity Research and Education has given each participating church one computer, and group members are learning how to use e-mail, participate in blogs and chat rooms with their group, sharing recipes or scheduling meetings outside of church.
Telemedicine expert William Santamore is one of the lead researchers on the study. He has high hopes for this Internet-based component. He sees it as a way to bring basic health care and health care information to communities that need it. "We are using it more as a means to connect patients or individuals with their healthcare provider, or in this case, with their group leader. And to maintain the group, this is going to be important for this particular intervention." He expects the on-line experience to help keep the group dynamics going after the study ends.
Santamore admits that getting participants to use the computer will be a hard sell, and Reverend James agrees. "Our congregation is basically an elderly congregation," he points out, "so these new things - computers - are not what they are used to." He adds that people don't like to change, and "it takes too much effort to learn how to work the computer and so they don't bother with it too much." But he says he'll keep pushing them. And if the program works, the effort will be worth it.
Around the world, churches play a role much greater than a house of weekly worship. Temple University researchers hope the same passion that people bring to the practice of their religion will be applied to their desire to live a healthier life by losing weight.