Doctors a force in battle of the bulge

The scales can seem tipped against winning the war on obesity.

Supersized meals and junk food abound. Time in front of the TV and computer are taking the place of physical activity for parents and children alike. Amid the barrage of books, ads and infomercials on the latest diet and exercise fads, Americans on the whole are still putting on the pounds instead of shedding them.

But with the help of physicians, the nation can swing the balance the other way. It won't be easy.

Sixty-five percent of American adults are overweight, according to the Centers for Disease Control and Prevention. Thirty percent of adults are obese -- that's more than 60 million people. Perhaps most alarming, children are a big part of the trend. About 16% -- more than 9 million -- are overweight.

The statistics are even worse for women and minorities. Non-Hispanic black women have the highest rate of obesity -- 49%.

With the problem now so entrenched as to be described as an epidemic, a multifaceted and multicultural approach is necessary. Organized medicine has launched a widespread campaign against obesity that reflects that reality.

Witness the American Medical Association's summit on obesity last month. It was an outgrowth of the overwhelming interest in the subject expressed by doctors at the June 2004 Annual Meeting, at which the Association also built on years of policy by passing several measures including a handful aimed at making sure cultural differences are taken into account in the fight against obesity.

The October summit brought together hundreds of the major players -- doctors, other health professionals, school officials and public health workers.

Sessions covered myriad topics, from promoting healthier school lunches to encouraging physical activity at work. The need for consumer education was a major component. This is essential because, in the end, the decision to adopt or maintain a healthy lifestyle rests with each individual.

But physicians' role in fighting the crisis also was stressed. Doctors speak with a voice of authority. They can serve as the wake-up call that a patient needs to start down the road toward healthy living. Physicians can help patients sort through the bewildering array of sometimes mixed nutritional and exercise messages that bombard them in the mass media.

Doctors have room for improvement here. Only 40% confront their obese patients, according to the AMA. That's why the summit provided doctors with the information and approaches that enable them to help prevent, assess and manage obesity in their patients.

For doctors unable to attend, many resources are available that they can use in their practices. For example, the AMA in 2003 released "Assessment and Management of Adult Obesity," a series of 10 booklets that offer practical recommendations for the primary care setting. The product, produced with support from the Robert Wood Johnson Foundation and developed in collaboration with the U.S. Dept. of Health and Human Services, is available free on the Internet (link) or as a CD-ROM.

The stakes in the battle against overweight and obesity couldn't be higher. Excess pounds aren't merely a personal aesthetic problem, as some patients might view them. They harm health and can even contribute to early death.

Overweight and obesity are helping to fuel an epidemic of chronic diseases, such as diabetes and hypertension. Obesity resulted in 400,000 deaths in 2000 -- second only to tobacco use, noted then-AMA President Donald J. Palmisano, MD, in a March 2004 Chicago Tribune editorial.

Severely overweight people also put a strain on the nation's health care budget. Spending on obese Americans accounted for 27% of the $1,100 rise in overall inflation-adjusted, per-capita health spending between 1987 and 2001, according to an Oct. 20 article published on the Web site of the journal Health Affairs.

Although the nation is losing its battle against the bulge now, the medical community's recognition of the crisis and commitment to reversing it gives rise to optimism. With this help, the country can tip the scales back toward healthy living.