THE ADVOCATE Q1

From the Doctor’s Desk

By: Dr. Chuck Freedman – Associate Medical Director, CMN Inc.

Obesity.... Is it The Next Pandemic?

One of the most common problems we face as a society today is obesity, in children as well as in adults. Recently Michelle Obama launched a nationwide campaign in the US to combat the problem. Interestingly, this is the first time that childhood obesity has become a high priority of both the President and First Lady.

It is estimated that $100 billion will be spent in the US alone on managing obesity in the U.S. population. That is approximately 5-7% of all health expenditures. It is estimated that about 2/3 of adults and 1/3 of children are overweight or obese.

How do we determine if a person is overweight or obese? We use a measure known as the Body Mass Index or BMI for short. BMI is calculated by dividing a person’s weight in kilograms by their height in centimeters squared. This results in a number that can then be checked on a table to see if someone is overweight. A BMI under 25 is considered normal, 25-29.9 is considered overweight, and over 30 is considered obese. People even have BMIs in the 40s and 50s and they are considered morbidly obese.

So what if kids and adults are overweight, what difference does it make? The problem is that along with obesity come many other problems such as heart disease, high blood pressure, prediabetes, diabetes, cancer, and asthma. Prediabetes means that your blood sugar level is higher than normal, but it's not yet increased enough to be classified as type 2 diabetes. Still, without intervention, prediabetes is likely to become type 2 diabetes in 10 years or less. And, if you have prediabetes, the long-term damage of diabetes — especially to your heart and circulatory system — may already be starting.

Not only does this raise the cost of (individual) health care astronomically, it also leads to premature death.

There has always been a question as to whether or not being overweight as a child leads to being overweight as an adult, and, what the consequences of this might be. A recent study of approximately 5000 American Indian children who were born between 1945 and 1984 looked at the factors that led to premature death. They found that the heaviest kids were more than twice as likely to die prematurely, before age 55, than the thinnest kids, and that kids with pre-diabetes were also more than twice as likely to die prematurely as well.

Obesity is an extremely difficult problem because food in our society is so plentiful and the unhealthiest foods for you are also the least expensive. It is much easier to go to McDonalds and get a Big Mac, fries, and a soda for under 10 dollars than it is to go to the store and buy vegetables, whole wheat bread and other healthy foods. There is also the avalanche of video games and computerized games that kids can sit for hours and play and hardly move a muscle.

So, what can be done to combat this serious problem? Education and public awareness is definitely a big part of the solution. For the First Lady to become involved and secure a commitment from the suppliers of school lunches to decrease the fat, sugar and salt in their foods, is significant. It is not just enough to say eat more fruits and vegetables and do more exercise, because this won’t motivate most people. There have been studies to show that the best way to lose weight and exercise more is to have a personal trainer, but obviously, most people cannot afford this. There is no easy solution, but hopefully the generation that is growing up today will be more aware of obesity and its problems and will begin to combat it at an early age so that they learn good habits and develop a healthy life-style that will last their entire lives.