In Texas’ Rio Grande Valley, a push for residents to lose weight and curb diabetes

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BROWNSVILLE — It was an unusually cold Saturday morning in the Rio Grande Valley but that didn't stop hundreds of people from forming a line that wound throughout the south side of the Brownsville Farmers Market.

Maria Ibarra and her son, Jesus, were among those waiting in line to have their measurements and blood pressure taken. They were signing up to take part in “The Challenge,” the city’s annual fitness initiative that encourages residents to eat healthier and be active.

The mother-son duo were motivated to participate for the first time this year for different health reasons. Jesus, 15, said he has struggled to maintain a healthy weight. He wants to eat healthier and be active like his mother was.

Maria, 53, had taken up walking and eating healthier options, partly out of fear of developing diabetes, a disease that disproportionately affects Black and Hispanic populations and which her mother developed.

"It could potentially become a problem in the future for me if I don't start exercising now," Jesus said. "I'm taking this as an opportunity to improve my health before it gets any worse."

About 11% of adult Texans have diabetes, according to the American Diabetes Association. Though the disease is partly attributable to genetics, it is largely believed to be caused by a person's lifestyle such as diet and exercise.

Plagued by annual surveys listing the region as the "fattest" in the country, city officials in the Rio Grande Valley have adopted various fitness initiatives throughout the years. However, the needle has not moved much during that time. However, researchers are hopeful they can identify new solutions as cities continue to invest in infrastructure that enables residents to engage in physical activity.

The Challenge, launched in 2008, is held annually by UTHealth Houston School of Public Health and the city as part of the university's efforts to address obesity and chronic illness in the community.

The university expanded the fitness challenge to the other parts of the Rio Grande Valley including Edinburg. They also collaborate with other neighboring cities to provide access to free gyms, nutritional information along with other resources through a program called "Tu Salud ¡Si Cuenta!" which translates to "Your Health Counts."

Over the years, 15,000 people have participated who have collectively lost more than 23,000 pounds, according to Lisa Mitchell-Bennett, senior project manager at UTHealth Houston.

The program does not encourage extreme weight loss. Instead, participants are encouraged to lose about 5% of their weight over three months which can lower the risk of developing diabetes.

“It's really kind of about well-being and energy and healthier habits,” Mitchell-Bennett said.

The average weight loss among the participants who return for the final weigh-in at the end of the three-month period is 4.8%, Mitchell-Bennett said.

But how successful the Challenge and other weight loss programs are in turning the tide on a regional level is unclear.

The university collects data from a group of more than 5,000 Hispanic residents from Cameron and Webb counties who provide personal health information for research purposes.

Mitchell-Bennet said the data collected from these residents showed the region had seen a drop in obesity and diabetes rates between 2004 and 2020, the start of the COVID-19 pandemic.

The obesity rate sits at 50% — down 1.5 percentage points. The rate of Type 2 diabetes is 25%, down from 30% in 2010, according to Joseph McCormick, professor of epidemiology at UTHealth Houston.

Measurements taken by the University of Texas Rio Grande Valley are higher. About 60% of the Mexican-American adult residents in the Valley are obese and 85% are classified as overweight, according to Dr. Sarah Williams-Blangero, director of the South Texas Diabetes and Obesity Institute and chief of the University of Texas Rio Grande Valley School of Medicine’s Division of Human Genetics.

Thirty percent are diabetic and 25% are classified as prediabetic.

Despite the progress reported by UTHealth Houston, Williams-Blangero said there is still a struggle to move the needle dramatically comes down to a reality everyone knows all too well –– losing weight is hard.

Research shows that about 50% of changes in body mass index can be linked to genes as well as 50% of changes in a person’s blood-glucose levels. Those levels can determine whether a person is diabetic.

But that’s only part of the story, according to Williams-Blangero who added that obesity and diabetes are increasing at a rate that cannot be accounted for by genetics alone.

What likely accounts for that increase are environmental factors like diet and exposure to pollutants, which can be common in agricultural communities. A study is currently ongoing to identify those pollutants.

“It's hard to lose weight, It's hard to get exercise routinely integrated into your day and so it's just a difficult problem to address,” Williams-Blangero said.

Through UTRGV’s newly launched Center for Human Genetics, Williams-Blangero said the intent is to find out what other biological factors increase the risk of disease and to assist in developing new drugs to prevent or treat diabetes.

Combating diabetes

This year is the third time that Deborah De Leon and her sister, Falisha De Leon, signed up to participate in the Challenge.

They don’t consider themselves to be physically active but, through the Challenge, are motivated to check out local gyms and be more conscious about what they eat by checking nutrition labels.

Deborah, 25, has begun cooking more for their family to try to find healthy substitutions which can be a challenge within carb-heavy Tex-Mex cuisine.

“I'm still making our authentic foods, just in healthier ways,” Deborah said.

Members of their family were diagnosed with diabetes or high blood pressure including their mother and grandfather, who lost his eyesight due to diabetes.

Seeing what their grandfather went through, both Deborah and Falisha, 30, knew something needed to change when they discovered they were pre-diabetic.

“It was very scary,” Deborah said, especially because of her young age. She made changes and both were successful in getting their blood-glucose levels to drop.

Not everyone manages to make those positive changes in time and severe consequences can follow, said Dr. Pedro Mego, an interventional cardiologist.

Mego specializes in the treatment of peripheral artery disease which develops when arteries are blocked, reducing blood flow to the legs or arms.

In some of the worst-case scenarios, the disease can lead to leg amputations. In 2023, Texas reported 5% of every 10,000 hospital discharges were for diabetes related amputations and each Valley county exceeded that rate: Hidalgo reported 6.8%, Cameron reported 7.8%, Starr reported 11.% and Willacy reported 12.9%, according to the Texas Department of State Health Services.

Being aware of the high prevalence of amputations, Mego opened his clinic, the Mission Vascular and Vein Institute to treat patients with blocked arteries to avoid unnecessary amputations.

“The Valley has one of the highest incidence of amputations in the whole country,” Mego said, estimating about two to three amputations a week at each local hospital. “I was overwhelmed, everybody was overwhelmed.”

The constant drumbeat of headlines referring to Valley residents as obese or otherwise unhealthy motivated him to become board-certified in obesity. He launched a weight-loss program and began producing educational YouTube videos, though both were discontinued due to time constraints.

Changing trends

Getting an entire region to take advantage of recreational activities and change their habits is a giant endeavor, but Mego is encouraged by positive changes at the individual level.

Patients of his who were classified as obese were able to lose weight by changing their eating habits and believes that people who participate in community health challenges at least start thinking about making positive changes for their health.

“In individual cases, I feel like I have seen more but as a whole community, probably, definitely, is not at the level that we would like,” Mego said.

And while fitness challenges haven’t had a major impact on the rates of obesity and diabetes in the Valley, Williams-Blangero said they have an impact for some people. Her advice would be to implement longer-term changes like healthy cooking and adding exercise classes to their daily routine.

McAllen, the second-most populous city in the Valley behind Brownsville, has been working to implement more recreational spaces and programs for their residents over the years including expanding their 34 miles of walking trails and developing a campground that will include an archery range and a mountain biking trail. The city has also held a marathon run every winter since 2013.

“We're extremely proud of that, knowing that people here in McAllen, people here in the Rio Grande Valley, love to exercise, love to get out, love to be active,” said Denny Meline, director of McAllen Parks and Recreation.

He pointed out that despite the negative perception when it comes to obesity, McAllen has come out on top for the last seven years in the large group category of the annual Healthier Texas Challenge, a statewide competition held annually.

Meline also highlighted the efforts of officials from neighboring cities and Hidalgo County who have launched their own fitness initiatives and are collaborating with McAllen to connect their walking trails.

“We definitely identify that there is a concern here,” Meline said regarding the unflattering labels the city has received as being the “fattest” in the nation. “Taking those initiatives and putting those out in the community is how we help try to curb that.”

Reporting in the Rio Grande Valley is supported in part by the Methodist Healthcare Ministries of South Texas, Inc.