According to womenshealth.gov, black American women have the highest rates of being overweight or obese compared to other groups in the U.S. About four out of five are overweight or obese.

Well, okay, you’ve probably seen these stats before. Maybe as a nurse or doc, you’ve spent a lot of time counseling patients on weight, or treating them for conditions that stem, at least in part, from excess weight.

Now, one in four black women, 55 years of age or older, has diabetes. That’s type II diabetes, which is directly related to lifestyle, primarily obesity.

The reason I am bringing this up is because of Obama’s pick for Surgeon General. You can read all about her qualifications, and she seems like a devoted family practice physician who would like healthcare for all.

However, at the risk of being exceedingly un-PC, the woman is overweight. Noticeably overweight. And yes, it was the first thing I noticed when I saw her photograph–sorry if I couldn’t look past it and be totally gender, color and weight blind–but what I saw was an overweight black woman.

Some people feel her credentials are weak, given that her career has been largely concentrated in a small rural area serving the poor. But the Surgeon General is less about credentials and more about image. I think her credentials are just fine, and even bordering on the heroic. However, the Surgeon General is a public figure who has little power but who is supposed to set an agenda.

Now I’m not the only one who’s noticed her extra weight, but many defenders of Dr. Benjamin have jumped on the bandwagon, calling detractors racist among other things, or that overweight people can be healthy, or that the woman is simply big boned, or that we place too much emphasis on appearance in our society, or that we should be looking at her qualifications and not her weight, and so on.

But we can blather all we want about it, but the fact remains that this woman will be in the public eye. She will mount the podium and speak on public health issues. Aside from access to healthcare and insurance coverage, the #1 health issue facing this country is overweight and obesity. And if the nation slimmed down, the need for many healthcare services would dramatically decrease. Preventive health will be the most life saving and cost effective proposition, but will people really take an overweight Surgeon General seriously?

Again, it is about image. Public eye. TV appearances. Public talks. Speaking to schoolchildren. No one is going to look at this overweight woman and think, “gee, maybe there’s a genetic reason why she’s fat. Or maybe she works out five days a week and runs 80 miles a day but just can’t shake the weight off.”

Or “she probably really eats healthy, never goes to MickeyD’s, eats broccoli every day, and shuns Frosted Flakes. It’s just a problem with her thyroid.”

And that’s what a lot of the people defending her have zeroed in on, as well as the fact that it’s somehow “normal” to be overweight “at her age.” Or that we should “consider her age, and the average weight of African American women of that age.”

Uh, that’s exactly what we don’t want to do. Black women should not be looking at her as a role model and thinking that “well if the Surgeon General herself is overweight, then nothing wrong with me carrying around all these extra pounds. Surely the doc wouldn’t be tilting the scales if it was such a bad thing.”

It is a big deal, considering the stakes at hand. The job of the Surgeon General is to get an agenda across, and one of our primary health agendas is to reduce preventable diseases. She says herself, that many of her family members died of preventable diseases like diabetes and lung cancer. I can’t imagine her discussing diabetes, and the need for lifestyle changes, if she seems incapable of managing her own weight. And even if she is the picture of health, with normal blood pressure, blood sugar, etc., the public is going to still see a fat woman. There, I said the “f” word, but that’s way it goes. That’s the reality. And I’m being kinder than many of the comments I’ve seen posted about her weight.

There are thousands of physicians out there that Obama could have tapped. It would have been nice for him to have selected a physician who is truly involved in preventive health. And one who looks the part, that can serve as a role model.

So again, I know that this is so un-PC, but the feeling that the pick must be a minority, or a woman, or both, should not supersede common sense.