Doctors have battled obesity for decades. Some patients simply are not interested or lack the will power to make the lifestyle changes needed to overcome obesity. But, many try and fail. Despite trying our hardest to curb the alarming trends, we watch as Americans push their weight to the limit, bite by bite.
As a family practitioner, watching children and adolescents get caught in the epidemic is heart-breaking. We can expect them to lead shorter lives than their parents.
According to the most recent Robert Wood Johnson Foundation Report, 20 states now have obesity rates over 30 percent. Additionally, no state in the US has an obesity rate less than 21 percent. The foundation also reported that one out of every ten children become obese between the ages of two to five years.
According to the American Heart Association, there are 154.7 million people overweight or obese among Americans 20 years and older. A Gallup poll conducted in 2013 reports the adult obesity rate climbed from 26.2 percent to 27.2 percent. This one percent is the largest year-over-year increase since 2009.
Yes, we can break these statistics down into rural vs. city localities and across socioeconomic status levels. But, obesity is found across all strata of life.
This is not about appearance or looks, fashion does not run into a doctor’s goals to curb obesity. What keeps us up at night are the increased rates of other “sister” deadly chronic diseases like diabetes, hypertension, sleep apnea, and even some cancers. The rising morbidity rates directly linked to obesity rates.
Pediatrics and Obesity
Many doctors, especially those of us in family medicine and pediatrics, are seeing a big jump in the number of obese kids and teenagers. It is common to see teens with hypertension and type-2 diabetes mellitus. Teens are starting on life-long medications before they are even starting college. Early studies suggest the younger obesity is established, the harder it is to overcome.
Teens are starting on life-long medications before they are even starting college.
We are treating an increasing number of adolescents for hypertension and diabetes, these kids also face mental stressors. Many overweight and obese kids are stigmatized, not just by other children but also by teachers. Many are left out of activities and could develop depression or low self esteem. This mental anguish, along with their growing risk factors for early cardiovascular events, can play havoc on their well-being. While they are struggling, they are surrounded by a world that enables them to continue to make poor food choices and follow a sedentary lifestyle.
Even lunches at school have a long way to go to earn a healthy label. When an obese child or teen sits in the lunchroom, how is it possible for them to choose healthy food when everyone around them is not? Schools need to take a much more pro-active role in getting healthy foods in their cafeterias and eliminating those that are truly health defying. And, parents need to be better educated on what constitutes good nutrition. Perhaps, this is a task that schools can undertake as well. Because, unless, this is changed, we are facing devastating medical outcomes in younger and younger people.
Obesity and Chronic Disease
The complications of chronic disease occur when patients have been afflicted with these diseases over time. For example, patients who have had diabetes for 15-20 years are more likely to go on to have kidney failure, blindness, heart disease and peripheral vascular disease.
It is easy to see how this will lead to a decrease in our nation’s life expectancy and drive up healthcare costs. Another obesity-related disease is osteo- and degenerative arthritis on weight bearing joints. This will lead to an increased number of joint replacements being performed at earlier ages. The two examples above will require additional rehabilitative and dialysis centers. The stress on our already burdened medical system is very real.
Without significant investments in infrastructure we could literally run out of resources to treat the chronically obese and their co-morbidities.
While many feel this is an American/First World problem, its effects are going global. The American lifestyle is spilling over to other countries looking to emulate our successes, or should we say excesses. Those nations have access to more American foods and fast food franchises are now being seen on countries all over the world. The easiest food for our busy lifestyles are often the ones filled with fat and bad carbs. It is difficult to devote the time needed for beneficial physical activity.
The weight of this epidemic is being felt in doctors’ offices and hospitals across the US. In my own practice, our scale used to have a weight limit of 300 pounds.
We purchased a new scale with a limit of 500 pounds because we felt we were doing a disservice to our patients by continually writing 300+ pounds in their medical records.
In imaging centers, CT scanners now accommodate bigger bodies. There are many “wide-open” MRI scanners that provide imaging for more obese patients. Changes in medical facilities include, OR tables for larger patients, purchasing larger waiting room and exam room furniture, longer syringes for spinal procedures and much more. All of these changes likely cost billions across the entire medical spectrum.
Can we do anything to stop this epidemic? Of physicians polled on Sermo, only 27% felt that it can be stopped by healthcare workers in the exam room. While much of it is on the patient to make lifestyle changes, doctors still have a role in motivating our patients to change. It is going to take a concerted effort by physicians and all healthcare workers, schools, public educators, and the government.
Is there any hope that this epidemic can be stopped from turning into the impending healthcare crisis it is shaping up to become, before we start burying our children?
credit: Linda Girgis, MD
Bio: Dr. Linda Girgis MD, FAAFP is a family physician that treats patients in South River, New Jersey and its surrounding communities. She holds board certification from the American Board of Family Medicine and is affiliated with both St. Peter’s University Hospital and Raritan Bay Hospital. Dr. Girgis also collaborates closely with Rutgers University, University of Medicine and Dentistry of New Jersey (UMDNJ), and other universities and medical schools where she teaches medical students and residents. She recently completed a medical mission in Egypt.
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