Obesity in Minority Populations

I gave a lecture to physicians at the University of Minnesota's Spring Refresher. My lecture was not included in the endocrine section. Rather, it is in the behavior modification session. How fitting.

Obesity is a major epidemic in the United States. It is affecting minority groups at a disproportionate rate, with Hispanic teens having the highest rates of BMI growth, and Black women having the largest membership in the extreme BMI (>40) group. Native Americans with obesity have the highest incidence of diabetes, and health care outcomes for these groups fare poorly compared to whites. Immigrant groups such as the Hmong in Minnesota also have high obesity and diabetes rates.

How can this be? Well, it is a societal problem. We are all in the same boat, consuming more calories than we need, and becoming more and more sedentary with the plethora of technology around us.

So behavior modification is important. I am talking about modifying the behavior of health care providers and third party payors, so obesity can be treated. We must stop just talking about it, and move to do something about treatment of obesity, and prevention of further obesity.

Here are concise suggestions:

Address obesity at every visit. Involve you office staff. In my practice I never bring up the issue of weight. I don't have to. My nurses already have, and the patients are anxious to talk about it.

• Reward positive behavior on the part of your patients.
• Do not threaten (i.e. if you don't take care of your weight you'll get diabetes).
• Refer for dietician consultations.
• Do not ask your patients to diet and excerise -- rather:
  • Do ask every one of your patients to improve their nutrtion and be more active.
  • Do use obesity medications. They are largely safe and effective, and the alternative of further weight gain is not desirable or healthy.
  • Do provide culturally and linguistically appropriate care. You must convey in simple, understandable terms, that inactivity and overeating are not okay, and that proper nutrition and physical activity add quality and quantity of life

Obesity is a treatable disease. Modify your behavior now, and Treat Obesity!

This information was provided by J. Michael Gonzalez-Campoy, MD, PhD, FACE, MAC Governing Council member. Dr. Gonzalez-Campoy specializes in endocrinology and is the medical director and CEO for the Minnesota Center for Obesity, Metabolism and Endocrinology. The Minesota Medical Association has additional information on this issue. (This link takes you off of the AMA Web site. The AMA is not responsible for content on non-AMA Web sites).

Disclaimer: This material is provided for informational purposes only and does not indicate endorsement by the AMA. Contact a physician if you have a medical or health concern.