{"doi":"10.1111/joim.13379","title":"Reply letter to Adamson and Calac: Complexities of obesity across racial and ethnic groups","abstract":"Dear Editor, We thank Adamson and Calac for their thoughtful comments [1] on our article [2]. We share their urgency in addressing obesity in indigenous groups in the United States. Indigenous people have a substantially higher obesity rate than non-Hispanic white Americans, according to limited research data [3]. Unfortunately, obesity among indigenous populations is understudied and they are routinely excluded from data collection [4]. The writers aim to differentiate the experiences of indigenous Americans by pointing, for example, to the displacement from their lands. We think this point can be situated in a larger conversation about the tension between allyship and individuality. We note that Black communities across the United States are subject to land theft and displacement on a routine basis [5, 6]. We think there is fertile ground to identify not just differences, but commonalities, although this is a complex balance, informed by affected communities themselves. The writers cite the importance of intersectionality in discussions of obesity, but the piece is light on analysis of intersectionality. Intersectionality is not merely about difference but about groups with various overlaps and differences that can participate in self-definition [7]. Terms like BIPOC, “queer,” and LGBTQ+, which are generally (but not always) accepted by the communities they refer to, recognize the overlap that is part of that tension. By painting indigenous people as separate from other BIPOC, the writers make a large implicit claim about what that definition should look like. We think there is another way to highlight the unique experiences of both individuals and groups while seeing common mechanisms by which systemic racism may increase or cause obesity in racial and ethnic minorities. We disagree with the bottom-line conclusion of the writers that medicine-oriented programs informed by communities may be “the key” to overcome health inequities. The writers do not fully engage with the importance of racism as a cause of obesity, which was central to our piece. Racism is not curable through a medical program. While medical services informed by affected communities can help alleviate health disparities, we wrote the ten-point plan to provide a basic framework for addressing the intersection of systemic racism and obesity, which includes a robust preventive component. Public health goes beyond individual treatment; as COVID-19 has shown us, the health of everyone is interconnected. This is true not just for communicable diseases but also for conditions like obesity that are strongly rooted in unrestrained capitalism, historical and modern injustice, and underinvestment [8]. Our suggestions included securing culturally appropriate and comprehensive health coverage for all (including obesity care), eliminating racism and bias, ensuring broad access to healthy food, connecting with social movements, and redirecting blame from individuals to systemic factors and to corporations that profit from obesity by participating in racial marketing. Our current system has underinvested in protecting people from racism and its public health and medical impacts, including obesity. We applaud the writers for bringing more attention to the specific circumstances of indigenous groups. The authors declare no conflict of interest. National Institutes of Health and Massachusetts General Hospital Executive Committee on Research (ECOR) (FCS); National Institutes of Health NIDDK; Grant Numbers: P30 DK040561 (FCS) and L30 DK118710 (FCS).","journal":"Journal of Internal Medicine","year":2021,"id":226846,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9549,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":233855,"name":"Fatima Cody Stanford","orcid":"0000-0003-4616-533X","position":1,"is_corresponding":false},{"id":830197,"name":"Daniel Aaron","orcid":"0000-0003-4490-7504","position":0,"is_corresponding":true}],"reference_count":7,"raw_metadata":null,"created_at":"2026-07-18T23:54:38.004707Z","pmid":"34564894","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}