Obesity is weighing us down — physically and economically. Today, one in five U.S. deaths are associated with obesity, a rate three times higher than previously estimated, according to the American Journal of Public Health. As countries around the world adopt a Western diet, obesity is “jostling with armed conflict and smoking as a human activity with the greatest negative impact on the global economy,” according to McKinsey.
Treating obesity is no longer optional
According to the annual “State of Obesity” report from the Trust for America’s Health and the Robert Wood Johnson Foundation, New York state has the eighth lowest rate of obesity in the nation, and yet 25 percent of our population is obese. Obesity in our state affects men and women, all age groups, and white (24.9 percent), black (32.3 percent), and Latino (30.6 percent) New Yorkers in large numbers.
Obesity impacts nearly every clinical practice. It affects every organ and contributes to more than 236 conditions including heart disease, type 2 diabetes, hypertension, high cholesterol, obstructive sleep apnea, polycystic ovarian syndrome, infertility, stroke, as well as arthritis in weight bearing joints and many cancers (Yuen M et al. poster, Obesity Week 2016). Whether you’re a pediatrician or an orthopedic surgeon, you’ve almost certainly faced a patient with medical complexities arising from obesity.
The cost of obesity
According to the Partnership to Fight Chronic Disease (2004), eight obesity-related diseases account for $1.5 trillion, 75 percent of the U.S. health-care budget. The study revealed that obese adults spent an average of 36 percent more on health-care costs each year than non-obese adults, including 105 percent higher prescription costs and 39 percent higher primary-care costs.
Even on the lower end of the obesity trend, New York state is not immune to the medical and economic burdens. Data shows that 9.8 percent of adults in the state have diabetes and 29.3 percent have hypertension. Obesity-related cancer cases in the state totaled 306,188 in 2010 and are projected to more than double by 2030, according to State of Obesity.
Children, too, are at risk — in New York state and nationwide. The Centers for Disease Control and Prevention estimates that the prevalence of obesity affects about 12.7 million children and adolescents in the U.S. That is more than the total population of Ohio or North Carolina. The economic cost of childhood obesity is at least $14 billion a year and growing, according to the National Center for Children in Poverty.
An economic and moral imperative
As our nation struggles to address the rising cost of health care, treating obesity is both an economic and moral imperative. Accountable care models and the shift toward value-based payments are placing new pressures on clinicians across the board to show “results.”
Yet as a patient’s trusted source, we are not doing it.
We know it’s not enough to tell people to “eat less” and “move more.” The concept of “calories in, calories out” has long been disproven, and touting such advice to our patients is not only unhelpful, it is inaccurate.
Weight loss is a science, not a secret formula. And health-care teams in our state and across the nation need evidence-based tools to help their patients identify risks and provide treatment.
The good news is that there are resources available to clinicians.
The STOP Obesity Alliance’s Why Weight Guide (whyweightguide.org) provides information on how to guide the conversation with your patient. The Obesity Medicine Association has developed adult and pediatric clinical guidelines and obesity algorithms that are available for free online and provide information to support clinicians in the treatment of obesity.
Toward a healthier America
The U.S. has spent decades focused on preventing obesity — and yet the number of obese Americans continues to grow. The strategy of focusing only on prevention has contributed to our failures to reverse this trend.
We must focus our efforts on treatment. Childhood obesity begins in the womb, so treating adult obesity also prevents childhood obesity.
It is time to target reversing the chronic diseases associated with excess weight. The Trust for America’s Health determined that the U.S. could save $29.8 billion in five years, $150 billion in 10 years, and $611 billion in 20 years if it reduced its obesity rates by only 5 percent. While the economic impact is compelling, treating obesity is at the heart of what we as physicians have pledged to do — care adequately for the sick.
We cannot afford to fail our patients — or our profession. The true burden is on each of us to care for the sick and reverse the trend of obesity.
Wendy Scinta, M.D. is medical director of Medical Weight Loss of New York in Syracuse, and a nationally recognized expert in adult and childhood obesity. She is founder of the BOUNCE pediatric obesity program, president-elect of the Obesity Medicine Association, assistant professor of family medicine at SUNY Upstate Medical University, and chief medical officer at One Stone Technology.