Racial Discrimination and Weight Bias in America…A Remarkable Resemblance!

| October 1, 2020

by Adrian Dan, MD, FACS, FASMBS

Dr. Dan is Medical Director, Weight Management Institute at Summa Health in Akron, Ohio, and Associate Professor of Surgery at Northeastern Ohio Medical

FUNDING: No funding was provided.

DISCLOSURES: The authors have no conflicts of interest relevant to the content of this article.

Bariatric Times 2020;17(10):16–17


“Systemic racism and weight bias are merely resembling cousins.”

When James “Butch” Rosser, Jr. showed up for his first day of internal medicine clerkship at the University of Mississippi, he arrived hours before the rest of the team to make certain that he knew his patients as well as humanly possible. He eagerly expected to make a positive difference as a student doctor. What he did not expect that day was hostility and animosity from a patient whose ailments he was hoping to better. Despite all efforts to go beyond the call of duty, he was jolted by a racially charged outburst as the medicine team later entered a patient room. “Get that big ****** out of here,” screamed the man in the bed.

Butch had grown up in rural Mississippi during the height of the Jim Crow laws and had long ago conditioned himself to deal with racist insinuations, but on that day, he was not prepared to also be harassed for his weight. Those were indeed different times in 1970s Mississippi, and thankfully much work has since been done to eradicate what is possibly the most vicious factor in our society: ignorance.

There are obstacles in life that many of us never have, or ever will, experience; social and individual circumstances can undoubtedly direct our life’s course and ultimately shape our destiny. Me, I immigrated to the United States from Romania via Germany at 12 years of age. Despite a few hardships and difficulties, I was blessed to be in a country filled with opportunity, which has afforded me the ability to live the American dream. But that good fortune is often still out of reach for many citizens born in this country. Many of us, who have been privileged with an easier path in life, have never encountered the headwinds of discrimination and hatred based on race, weight, gender, sexual orientation, disability, religion, and origin, among many others. For those fortunate to not have tasted such bigotry, it is time to wake up, listen, empathize, learn, and answer the call for action to evoke change. It is time to reject discrimination of any kind, as in the words of Dr. Martin Luther King Jr., “Injustice anywhere is a threat to justice everywhere.”

Since that time, Dr. Rosser has becomes one of the most prolific innovators in the realm of minimally invasive surgery and surgical education. The full account of his resolve and his contributions to our craft are beyond the ability of this column. His perseverance to overcome racial discrimination and his openness about undergoing metabolic surgery in his own battle with obesity are the topics of his soon-to-be-released book Fat and Black in America: A Surgeon’s Journey Overcoming Racial Injustice and Weight Bias. Systemic racism and weight bias are merely resembling cousins, and that should resonate with all those who care for patients who, in parallel, are victims of both.

I have been humbled to call Butch a great friend, and together we have partnered on several projects, including this very column. How do two people with such diverse backgrounds come together to forge a friendship and collaboration, you ask? It occurs with the realization that we have so much more in common than we could possibly imagine. We are both subject to the same spirited tailwinds of hope and determination to pursue excellence. In America, that impetus should be within the reach of every citizen. The social responsibility to ensure that it is must be accepted together.

At the time that I write this column, we are less than 60 days away from a national election and the airwaves are full with political rhetoric. We live in tumultuous times, and our world has been transformed by a global pandemic. Our media are reporting scenes of social unrest that have jarred our immediate communities and have shocked our moral conscience. We can and must do more to educate those who do not know any better, and thus not allow the ignorant to remain ignorant of their ignorance. Those who do not understand the importance of inclusion to attain our best selves have likely never themselves experienced the divisiveness and detrimental effects of exclusion. We can and must take action to ensure that opportunity is available to all based upon merit and never based upon anything else.


Guest Perspective

by James “Butch” Rosser, JR., MD

Dr. Rosser is Clinical Professor of Surgery, Jacobs School of Medicine at the University at Buffalo in Buffalo, New York; Director, Center for the Advanced Treatment of Heartburn, Gila Regional Medical Center in Silver City, New Mexico


Systemic racism and weight bias are scourges of society that erode the fabric of humankind and stifle humanity from reaching its manifest destiny. But just think what it is like to live a double negative of being fat and black in America. When I was born as a “fat and fine” 20-inch, 11-pound African American child in the Mississippi Delta, I never thought I would be starting a perpetual effort to overcome the stigma of possessing two physical characteristics that would force family, friends, society, and a nation that I loved to struggle to love me back. From then on, my life has been about outperforming the hate. I wanted the public to say, “He may be black, but…He may be fat, but….” This was my attempt to escape the ravishes of the heavy eroding pressures of racism and weight bias.

Growing up in the ‘60s, one of my favorite TV shows was the Fugitive. Dr. Richard Kimble was the accused murderer of his wife. On his way to be executed, he escapes. The only chance to prove his innocence is to find the person who killed his wife, the one-armed man. Lt. Gerard relentlessly pursued Kimble, but he always managed to keep one step ahead of the law. That day outside that patient’s room, I felt as if I was a fugitive that had been suddenly cornered by the law. My race and obesity had caught up with me and became a factor where I never dreamed—taking care of patients. I believed that the white coat and the alphabets behind my name would allow me to be invulnerable to the sticks and stones that had been hurled at me all my life because of my race and weight. In today’s society, the reality is there is no escape from these behemoths that are systematically embroiled in the DNA of American society. It is enough to make you want to give up.

When looking through my life’s narratives that have shaped me, I could easily have given up on my friends, family, society, and our nation. I have felt the piercing assault of racism being terrorized by the KKK with phone calls threatening to burn our house down when I was home alone with my younger siblings while my parents were helping to secure the right for black folks to vote. I was scared after being stoned by a group of white teenagers for daring to be the first black paperboy in Moorhead, Mississippi, to deliver papers to whites. I have shouldered the humiliation of being told that I could not come to my college’s alumni meeting because it was being held at a country club that did not allow blacks. The incidents do not stop with being a black man in America. Remember, I am also a fat man in America. I have endured the years of being teased and bullied as a child just because of my weight. On my first visit to a new physician, I have felt like a ghost in the exam room as he kept his eyes fixated on the chart before finally saying, “You have a weight problem”. And finally, I have survived the humiliation of having two of my surgical colleagues go to my research sponsor and say my grants should be taken away from me because my fatness does not represent their corporate image. I hate the F word. It is the new N word to me.

When I want to give up, I find comfort in the words given in one of the numerous interviews that author and civil rights activist James Baldwin took part in with Dick Cavet in the 1960s. This is what Baldwin shared when asked about what he sees in the future for the Negro in America:

“I can’t be a pessimist. Because I am alive. To be a pessimist means that a human life is an academic matter. So, I am forced to be an optimist. I am forced to believe that I (we) can survive whatever I (we) have to survive.”

In addition, I am inspired by the response of the medical team that day in that patient’s room. My intern immediately began to speak to the man, “Sir, I am sorry about the way you feel about extern Rosser. But, if he cannot attend to you, the remainder of our team cannot take care of you.” My bottom lip almost dropped to the floor. He continued, as he placed his hand on my shoulder, “He is one of the most knowledgeable, considerate, and hardworking medical students we have”. I did not expect their response. That day in the heart of Dixie, surrounded by the descendants of slave owners, all the doubt that I had in the American Dream did not totally disappear. But, I witnessed the foundation of the reason for me to push on. You can never underestimate the amplitude for good by the American people.

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Category: Current Issue, Perspectives

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