Fighting obesity: Tools for a year-round effort

Every time the calendar flips to a new year, millions of Americans vow to trim their waistlines, making weight loss and exercise among their top resolutions. Health clubs get 12% of all memberships in January -- the most of any month -- according to the International Health, Racquet & Sportsclub Assn.

But if the obesity epidemic is any indication, those resolutions and gym workouts are soon scuttled, and many people lose their battle of the bulge. Consider that two in three U.S. adults are either overweight or obese. The obesity rate rose about 50% from 1990 to 2005, said a study in the Dec. 3, 2009, New England Journal of Medicine.

At the same time, diabetes has been steadily increasing nationwide, growing from 5.6 million people diagnosed with the disease in 1980 to 17.9 million Americans in 2007, according to the Centers for Disease Control and Prevention. A Nov. 20, 2009, CDC Morbidity and Mortality Weekly Report showed that diabetes is striking hardest in states with the highest rates of obesity and poverty, including many counties in Alabama, Georgia, Louisiana, Mississippi, Tennessee, South Carolina and West Virginia. The cost to the health system also will grow as cases of diabetes climb: More than $336 billion may be spent annually by 2034 on diabetes-related care, according to a report in the December 2009 Diabetes Care.

The American Medical Association is among those fighting to ensure the obesity epidemic doesn't go unchecked.

Giving physicians the tools to combat obesity also has been a key component to the Association's efforts. The AMA Healthier Life Steps program provides background information and helps doctors support patients in changing their diets, physical activity levels and use of alcohol and tobacco. The program's Web site offers tip sheets and tracking calendars to start and maintain healthier behavior in patients (link).

The AMA, meanwhile, has collaborated with the Dept. of Health and Human Services to produce Roadmaps for Clinical Practice, a series that helps physicians integrate disease prevention and health promotion into routine clinical care.

The Assessment and Management of Adult Obesity roadmap, available online, consists of 10 booklets with practical advice, such as evaluating patients for health risks related to weight, improving communication and counseling, and understanding medication and surgical options. Patient handouts cover topics such as weight loss management and exercise (link).

These tools reflect a number of policy positions that the AMA has taken over the years. The Association has long been on record as recognizing that obesity in adults and children is a major public health problem, and that racial and ethnic disparities exist in the prevalence of obesity and diseases related to diet, such as diabetes, coronary heart disease, cancer and stroke. The AMA supports efforts to reduce health disparities by basing food assistance programs on the health needs of participants.

In addition, the AMA is targeting nutritional labeling at restaurants. For example, it recommends that fast-food and chain restaurants include calorie, fat and sodium information on printed menus. The AMA also supports providing the public with ingredient lists for menu items at school and workplace cafeterias.

In 2007, the AMA, CDC and others convened an expert committee that provided recommendations to assess, prevent and treat child obesity. They include behaviors for diet and physical activity that promote healthy weight and methods to screen for medical conditions and risks.

Unhealthy weight may be a New Year's obsession, but it is a 365-day-a-year problem. The medical consequences often lead to the physician exam room -- a good place for patients to find the knowledgeable support to avoid or correct an unhealthy lifestyle.