Fatima Cody Stanford is pioneering work in obesity and health and advocating for equity in medicine

Thank you for agreeing to do this interview with TAIK. What drew you to focus on obesity, health policy, and health disparities?

There are several factors. Worth noting is that I was born in Atlanta, Georgia which is not only one of the areas where slavery was practiced, but it later became the cradle of the Civil Rights Movement and was the home of Martin Luther King Jr. I grew up in such an environment and its influences on being intentional on building and contributing to a sense of community were amplified in me. So, the factors of seeing blacks facing the highest prevalence of obesity and health disparities impressed me to be more intentional in dedicating more than 25 years of my life to pioneering work in this field. I also want to highlight that obesity is more pronounced in black women. My focus is on helping to elucidate reasons and solutions. The first part is on preventative measures which have the largest potential impact. The second is on the treatment of obesity, surgery, and post-surgery for children and adults.

Can you explain the significance of assisting in developing both a standardized approach for the use of weight-loss pharmacotherapy for adults and the pediatric treatment program for the Massachusetts General Hospital Weight Centre?

Obesity is a multifactorial disease. The National Institutes of Health had declared obesity a disease in 1998 and American Obesity in 2008. Only in June 2013 did the American Medical Association (AMA) House of Delegates vote to recognize obesity as a disease state requiring treatment and prevention efforts. It is a complex multifactorial disease of the brain. Only 1% get medication mainly because it is a new phenomenon.

My work is considered pioneering and one of the reasons was the misconception that obesity is linked to lifestyle. The standardized approach is for obesity in general and post-surgery. It presents guidelines for adult and pediatric treatment.

Non-Hispanic blacks still have the most prevalent obesity levels, would it be fair to assume this is one of your reasons for focusing on obesity? What have you observed in these numbers since you joined?

Yes, having seen this growing up and the fact of this phenomenon holding globally to all people of African descent. According to the Centres for Disease Control and Prevention, in the US about 49.6% of Non-Hispanic Black adults have obesity and this is the highest age-adjusted prevalence of obesity.

Since it’s a disease that was recently recognized we have seen 1% only of patients with obesity taking medication but this is on the rise when we factor in surgery. I am very intentional in sharing and disseminating information on the work we’ve done. For example, I dedicate my time to giving 50 interviews per year to educate on obesity including yourselves, TAIK, to share with your readers in Africa and Africans in the diaspora.

Your paper entitled, ‘Medicine, Structural Racism and Systems,’ highlighted issues faced in medicine that were more apparent in the current Ukraine Crisis, can you share more on how medicine must participate in redefining these systems.

War has a negative direct impact on health and is worsened by racism. I co-wrote this paper with a student I am supervising, and we wanted to highlight how medicine is having a reckoning with systemic racism and social causes of disease. Some continue to hold the belief medicine is apolitical and confined purely to science, history, and research reveals that medicine is inseparable from underlying systems, laws, and policies. We used obesity as a case study to show that there are more policy and legal barriers for Black, Indigenous, and People of Colour (BIPOC) who are obligated to contend with multiple layers of oppressive systems. We further highlighted medicine can and must be instrumental in redefining these systems. Thus, medicine alleviates power disparities.

How do you think governments should approach digital infrastructure and health literacy during the pandemic and going forward to attain equity in the supply chain?

Governments need to influence coverage for people to gain access. In the US, the 117th Congress passed the Bill on Treat and Reduce Obesity Act of 2021 offering clinically – and cost-effective solutions to the obesity epidemic. This bill expands the Medicare coverage of intensive behavioural therapy for obesity and medication coverage for treatment of obesity for weight management. All these changes are inclusive because they now cover low-income groups which have stimulated insurance companies to extend their coverage to them.

With the late recognition of obesity as a disease, it has affected its slow progression. Thus, there is a need to increase teachings in all medical fields i.e., medicine, nursing, and dieticians.

Also, there must be a concerted effort to equitable care. For example, Black people have low access whilst they have the highest prevalence. Other chronic diseases are accorded higher recognition thus benefiting higher focus whilst obesity causes these.

In contributing to health literacy, I have given more than 150 lectures and 200 invited presentations on the topic of obesity at local, regional, national, and international meetings. Recently, I gave a talk that was well-received by the medical association of African doctors.

What would you say to encourage people of African descent to enter your field?

I would encourage more people of African descent to join the field and they should focus from their early childhood to advanced degrees. I am aware of the structural challenges people of color face, but we need to find a way of addressing these whilst increasing enrolment in education. For example, in the US people of color have disproportionately higher educational debts.

Which courses did you enroll in? Which topics should someone who is interested in your field study?

I received the following degrees:

• Bachelor of Science in Anthropology and Human Biology (major), Dance (minor) – Emory University
• Master of Public Health (M.P.H.), Health Policy and Management - Emory University.
• Doctor of Medicine (M.D.), Medicine – Medical College of Georgia at Augusta University
• Master of Public Administration (M.P.A.), Public Administration - Harvard Kennedy School
• Master of Business Administration (M.B.A.) - Quantic School of Business and Technology

My advice is finding out what works for them. I don’t aim to follow anyone’s path. Spiritually, this directs my path until the ‘Aha’ moment. In the middle of the storm, they should listen to their inner self and inner intuition, consistently, to pull to a certain direction, not failure. Think about it, even identical twins, their paths are not the same.

Which habits do you think were instrumental to your success?

My experiences have taught me to be persistent. Notoriety in solving challenges. I’ve come to appreciate that whenever I am told NO, to take it in the same breath as a challenge to continue trying. For example, looking at my journey of pursuing education one will be tempted to think I got it easy, but the back story is multiple applications until I am accepted.

TAIK wants to inspire people of African descent. Which quote has helped to shape you?

My faith, human guides, and my experience with congressman John Lewis have played a part in my pursuits. There are a couple of quotes, I want to share:

• “Do unto others as you would have them do unto you”
• “You were put on Earth for a purpose. My purpose is fighting for justice and equality.”

Let’s end this interview with you telling us some improbable facts about you.

1. I was christened aged 5 months in the United States of America. My faith has been my guide and source.
2. My maternal grandmother was a Grade 1 teacher who taught me at home the Grade 1-course content. When I started elementary school, I only spent 1 week in the first grade, and I was promoted to the second. Also, in my second grade, my teachers wanted to promote me before summer, but my parents insisted I continue. My grandmother inculcated a great sense of my pursuit of education.
3. In 2001, I received the Gold Congressional Award, the highest honor that Congress bestows upon America’s youth presented by Congressman John Lewis, who’s one of the main figures who played a pivotal role in America’s Civil rights movement. He said to me, “Never stop fighting for injustices.” His words echo to this day because my work still addresses health disparities throughout the world.