Perhaps nothing has been written or talked about or wrestled with more in health care circles the past few years than obesity. For good reason. According to a report from the Centers for Disease Control last week:
- Obesity is quickly becoming a national epidemic, and the costs to treat its related ailments is approaching $150 billion a year.
- Nine states in 2009 had an obesity prevalence above 30 percent, triple the number with such high rates in 2007. A decade ago, no state had an obesity rate above that threshold.
- Different ethnic groups suffer the scourge disproportionately. Black women, for instance, have the highest obesity prevalence, at 41.9 percent.
- Education levels are also a factor, with non-high-school graduates reporting obesity levels of 32.9 percent.
As I said, this is not new … these are just the latest numbers. Fortunately, many people and groups are doing something about it. During a Grand Rounds presentation on the obesity problem last week at Cincinnati Children’s Hospital Medical Center, Chris Bolling, MD, pointed to several encouraging signs in the battle against obesity.
Among them: First Lady Michelle Obama’s “Let’s Move” initiative; efforts by the Clinton Foundation to draw attention to the problem; and guidelines and recommendations from the American Academy of Pediatrics and the National Committee for Quality Assurance. Those guidelines include screening for obesity during well-child visits and counseling children and their families about nutrition and activity.
“This is becoming the standard and not something that some of us just happen to do,” said Dr. Bolling, who has a private pediatric practice in Northern Kentucky.
Just in time for National Childhood Obesity Awareness Month in September, Dr. Bolling also offered his “seven steps” for doctors to attack the obesity problem through their own practices:
- Screen for Body Mass Index (BMI) and BMI percentile for age and gender in kids from age two to seventeen years.
- 2. Use straight talk. Don’t sugar-coat the problem. (Pun added by author)
- Practice basic prevention (like encouraging breast feeding and limit fruit juice)
- Use messages that work, such as 5-2-1-0 to remind parents and children about eating five fruit servings a day; limiting screen time to two hours a day; being physically active one hour a day; having zero sugar-sweetened drinks.
- Pay attention to patient and family readiness to adopt healthier behaviors.
- Learn how to triage: Get comfortable with what to do in the office and what to refer out.
- Support local community efforts.
Obesity is a problem that will not be solved quickly. But it certainly won’t be solved at all if we ignore it. As Dr. Bolling pointed out last week, just like smoking, society needs to address it on many fronts and eventually the high cost of obesity will start coming down. In a news report last week, CDC Director Thomas Frieden echoed that: “Obesity is a societal problem,” he said, “and it will take a societal response.”
We’re working on it.
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