Let the start of school be the start of healthy living

A message to all physicians from AMA President Jeremy A. Lazarus, MD.

By — Posted Aug. 27, 2012.

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September is National Childhood Obesity Awareness Month. It is Alcohol and Drug Addiction Recovery Month. And just for good measure, it is also National Yoga Month.

All these “official” designations are just further proof that we are in the eye of a so-called perfect storm. This one is about:

  • Dangerous increases in obesity and chronic diseases among members of our population.
  • Media-heavy promotion of gardening and cooking and a proliferation of activist groups like the international organization Slow Food.
  • Celebrity endorsement of healthy lifestyle initiatives like first lady Michelle Obama’s “Let’s Move” program or food maven Alice Waters’ leadership to bring more fresh vegetables into school meals.
  • A continuing number of runs, walks, climbs and other physical activities to raise money for charitable causes.
  • Zealous — often savage — advocacy for farmers to produce more “natural” or organically raised meats and vegetables.
  • The Affordable Care Act’s emphasis on wellness and prevention.

It is coming at us from all sides. We can only hope that this particular perfect storm is blowing the American consciousness toward healthier lifestyles.

This is the perfect time to address that perfect storm.

Under the Affordable Care Act, 65 different preventive services, ranging from immunizations to obesity counseling to colorectal cancer, are already available to all insured adults and children with no co-pay.

Since Aug. 1, all new health plans and those that renew in January 2013 must offer critical preventive services and health screenings for women. These include well-woman visits, HIV screening and counseling, plus screening and counseling for domestic and interpersonal violence — all with no co-pay. This is good news for them — and for us.

Of course, it’s one thing for the new health care law to mandate wellness visits, but it’s quite another thing for a physician to know what to say to patients — and how to say it. It’s not easy to talk to an overweight person about losing pounds, and it’s much harder to talk to a mother or father about the fact that their child may be dangerously obese. But today it is often a medical necessity.

For example, only 42% of obese patients in a Centers for Disease Control and Prevention survey reported that their health care professional advised them to lose weight. That same survey found that people who said they did receive counseling on losing weight were significantly more likely to report trying to lose weight than those who did not.

The AMA is committed to improving health outcomes in our nation and has made this a key pillar in our five-year strategic plan launched earlier this year. The AMA offers several easy-to-use and simple-to-understand resources that can help you talk to your patients about living healthier lives.

The AMA Healthier Life Steps toolkit has downloadable, printable materials and links to more resources (link).

It was designed to help physicians counsel and assist patients to improve eating habits and physical activity levels, quit smoking or tobacco use and reduce risky drinking.

The materials include a program overview for physicians and staff, a patient self-assessment, an action plan, a document on talking about weight with your patients, and even a Weigh What Matters app for cellphones to make it easier to track progress.

Promoting Healthy Families, sponsored by the AMA, is designed to help physicians successfully talk about healthy behaviors with their adult patients in a way that may spark — and help sustain — positive changes for the whole family.

Related continuing medical education activities include two video modules, a more detailed essay and patient handouts. These activities have been certified for AMA PRA Category 1 credit.

The AMA website also offers links to other resources, such as the American Lung Assn.’s and American Cancer Society’s smoking-cessation programs, and several different websites with information on promoting physical activity.

For physicians, the AMA’s program, A Physician’s Guide to Personal Health, is invaluable. Written for physicians by physicians and scientists, the toolkit is designed to help us all take time for ourselves and reflect on which steps — almost all of them obvious — we may need to take to live a healthy life and maintain resilience in the 21st century.

I recognize that I have a basic problem when I send out a call to colleagues about exercise and healthy eating. I know that for many of you, the fact that I’m a marathon runner and triathlete makes you tired just to think about it.

I’m not asking you to get out there in your track shoes, although walking is a good idea for everyone. What I am asking you to do is take advantage of this perfect storm of opportunity — and great need — to talk to your patients about healthy lifestyles. And to be a role model, especially in the case of the children.

It is absolutely vital that children and their parents understand how exercise, preventive health and proper nutrition to fight obesity starting in early childhood will make a difference all their lives.

If we can get that message across, we will create a better future for our own patients, but we also will be creating a healthier society. We are only a few weeks past the truly inspiring Summer Olympics — but it is a sobering thought that for literally millions of Americans today the closest they will ever get to playing any of those sports is their television set.

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