All efforts welcome in the battle against obesity

AMA Leader Commentary. By J. Edward Hill, MD. May 5, 2003.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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I was pushing my 3-year-old granddaughter, Virginia, around Wal-Mart in a grocery cart not too long ago. When we got to the aisle with all the potato chips and snacks, she wistfully looked up at me and said, "Grand Doc, I just love those saturated fats."

At the time, I didn't know whether to laugh or cry, but I did know this much: My little granddaughter could have been speaking for all of America's kids and many of its grownups. We Americans do love those saturated fats, just like we love to lie on our couches, watch television and play video games.

Virginia is luckier than most Americans, though. Her mom is trying to make her aware of good nutrition and exercise early in life, so she won't become yet another victim of the epidemic that's ravaging our nation: the epidemic of obesity and overweight.

Today, 300,000 Americans die prematurely each year due to overweight and inactivity, second only to tobacco-related deaths. Unfortunately, these numbers seem sure to increase. Overweight and obese Americans now make up more than 60% of our adult population. Like our waistlines, this percentage is growing.

The epidemic of overweight and obesity is one that physicians must put at the top of our agenda -- for ourselves and for our patients. Obesity and overweight are linked to the nation's No. 1 killer, heart disease, as well as diabetes, hypertension and many other chronic and deadly conditions.

At the AMA, obesity and overweight rank high on our list of public health priorities. That's why, back in April, we joined the American Public Health Assn. and other public health organizations in sponsoring National Public Health Week. The theme for the week was "Getting in Shape for the Future: Healthy Eating and Active Living." Its aim was to educate adults and children about the health risks linked to excess weight -- and the benefits of developing healthier lifestyles.

Curtailing the epidemic of obesity demands more than just educating patients, however. Physicians need information, too. That's why the Journal of the American Medical Association recently produced a theme issue on obesity. The issue brought together a number of studies, delving into such topics as obesity and television, low-fat versus low-carbohydrate diets, and the effectiveness of commercial weight-loss programs compared with self-help. You can access this research and more through the JAMA Web site (www.jama.com).

More physician-oriented materials are also in the pipeline.

This August, the AMA will release a series of booklets aimed at helping physicians assess and manage adult obesity. The series, which was generously funded by the Robert Wood Johnson Foundation, is part of the AMA's "Roadmaps for Clinical Practice: Case Studies in Disease Prevention and Health Promotion."

In the words of Robert Kusher, MD, the author of the series, "We have developed this product for gearing confidence in physicians so they have the knowledge and sensitivity to care for these patients." You will be able to order the booklets this fall at the AMA Medicine and Public Health Web site (www.ama-assn.org/go/medicineandpublichealth).

We also have a specific site for the "Roadmaps" series (www.ama-assn.org/go/roadmaps)

We're not just concerned about overweight adults, however. Perhaps the most troubling aspect of this silent epidemic is how it is affecting our children. As more kids play video games than play soccer and tag, the percentage of children and adolescents who are overweight has risen dramatically. Today, approximately 30% of American children age 6 to 11 are overweight; 15% are obese.

To help combat this problem, the AMA Program on Child and Adolescent Health plans to host "The AMA Educational Forum on Adolescent Health: Promising Programs in Physical Activity and Nutrition." Experts on childhood overweight and obesity will speak to physicians about the issue -- and how we might best approach it in practice. Proceedings from the forum will be available on the AMA's Adolescent Health Web site (www.ama-assn.org/go/adolescenthealth).

In the meantime, there's still a lot that physicians can do to help slow the spread of this epidemic. To start, we can take time to talk to our patients about weight issues and, when appropriate, direct them to good resources. This means keeping up with the latest research and maintaining knowledge of relevant programs and specialists.

It also means setting a good example. If we're going to preach healthy lifestyles to our patients, we have to try to live healthier lives as well. I know this isn't easy -- it isn't easy for anyone, including me. I like to head to McDonalds with my grandkids as much as the next guy. But it's important to make good lifestyle choices for ourselves, even if that means skipping a serving of supersized fries or turning off the television to garden, golf or take a jog.

We also need to take social responsibility. What do I mean by this? I mean physicians have to help create healthier communities for our patients -- and for ourselves and our families. There are so many ways to make a difference in this regard that the hardest choice you'll face will be what direction to take.

Consider the possibilities. You could get on the school board and keep candy machines from being installed in your local middle school. You could start a walking club or coach T-ball. You could talk to a high school health class or help that school develop a strong comprehensive health education curriculum. You could lobby your city council to build bike paths -- or to require sidewalks in new housing developments.

There are so many ways we can contribute to the battle against obesity and overweight, both inside and outside of our offices. All it takes is recognizing the magnitude of the problem -- and mustering the determination to address it. So let's improve human health -- and save lives. Let's do what we can to stop the epidemic of obesity and overweight, and help build a healthier America.

Dr. Hill, a board-certified family physician in Tupelo, Miss., was AMA board chair during 2002-03 and served as president during 2005-06.