Tuesday, November 16, 2010

Obesity Poses Challenges

This country faces many challenges and a big one – no pun intended – is obesity. “Obesity has become an epidemic,” says Lee Kaplan, M.D., Ph.D.

Dr. Kaplan, a visiting professor from Massachusetts General Hospital and director of the MGH Weight Center, presented a lecture on obesity during Grand Rounds at Sinai Hospital last week. The lecture was dedicated to the late Albert Mendeloff, M.D., who was a gastroenterologist, nutrition expert and former physician-in-chief at Sinai.

“It’s one of those disorders everyone knows about, but not enough about,” Dr. Kaplan says. “Severe obesity is getting worse. All you have to do is look at any playground.”

Make no mistake: Obesity has become a worldwide problem, he says.

“Since 2005, more people are obese in the world than malnourished. Yes, the U.S. leads the way but other countries are catching up,” Dr. Kaplan says.

Obesity is challenging because of its complexity and health risks. For example, not every obese person overeats and sometimes a thin person can habitually overeat and not become obese. But the consequences of obesity can lead to life threatening illnesses. In the U.S., 1,000 people a day die of complications of obesity, Dr. Kaplan says.

Doctors often do not mention concerns about obesity to their overweight patients. “It is not recognized by most physicians,” Dr. Kaplan says. He offers suggestions on how physicians can approach the topic with their patients.
  • Respect the patient. Avoid pejorative language. “When most patients hear the word, ‘morbid,’ they think “disgusting,’” he says.
  • Do not indulge in the “blame game.”
  • Work to develop a therapeutic partnership and inform the patient that losing weight takes time. “There is no magic bullet," Kaplan says.
  • Discuss the causes of obesity and treat any underlying disorders. Acknowledge that some drugs patients take can cause obesity, and find drugs that do not.
  • Focus on a healthy diet, physical activity, stress reduction.
  • Surgery is an option but it should be the “therapy of last resort,” Dr. Kaplan says.
Obesity is a disease, he says. Complications from obesity can kill. “Obesity should be a global health priority,” Dr. Kaplan says.
-Sandra Crockett

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