Unraveling Obesity’s Screening Tool: A Step Towards Obesity Prevention
By Nermeen Asham, BScN, RN & Craig Primack, MD, FACP, FAAP, FOMA, Dipl. ABOM
Pre-obesity (BMI 25.0 kg/m² — 30.0 kg/m²) and obesity (BMI ≥ 30.0 kg/m²) are still not defeated and continue to be on the rise. “Results from the 2017–2018 National Health and Nutrition Examination Survey (NHANES), using measured heights and weights, indicate that an estimated 42.5% of U.S. adults aged 20 and over have obesity, including 9.0% with severe obesity, and another 31.1% are overweight.” (1) Pre-obesity and obesity are chronic, complex, and multifactorial medical conditions that are treatable using a comprehensive approach (medication, nutrition, physical activity, and behavior). Excess adiposity and adipose tissue dysfunction are due to an increase in body fat.
You can unravel the mystery of obesity and crack your personal code only when you understand the science of obesity management and use the four-pillar approach as the treatment protocol. Dr. Kushner & Dr. Primack underscore the importance of screening for overweight early by discussing lifestyle and other nonpharmacological treatments as means of obesity prevention. “Without comprehensive treatment, adults with overweight continue to gain weight, moving steadily into the obesity (BMI 30–39.9 kg/m² ) and severe obesity (BMI ≥ 40.0 kg/m²) categories”…….Evidence indicates that the detrimental effects of excess weight on morbidity and mortality begin at lower BMI categories. Therefore, identifying at-risk patients who have overweight (BMI from 25.0 to < 30.0 kg/m²) and initiating treatment earlier may interrupt the progression toward further weight gain and the development of obesity-related comorbidities”. (3)
It’s imperative that we take a prevention approach to overcome pre-obesity and obesity. Before treatment, whether of obesity or other medical conditions, there is health promotion and disease prevention. Benjamin Franklin’s axiom that “an ounce of prevention is worth a pound of cure” still has relevance today. Any disease has five preventive stages, namely [1] primordial, [2] primary, [3] secondary, [4] tertiary, and [5] quaternary. “Primordial prevention consists of risk factor reduction targeted towards an entire population through a focus on social and environmental conditions…such measures typically get promoted through laws and national policy.” This includes access to safe sidewalks to encourage a healthy lifestyle through physical activity. “Primary prevention consists of measures aimed at a susceptible population or individual…to prevent a disease from ever occurring.” This includes immunization as a means to increase immunity. “Secondary prevention emphasizes early disease detection, and its target is healthy-appearing individuals with subclinical forms of the disease.” This includes yearly health screenings such as blood pressure monitoring, colonoscopy, pap smear, and mammogram. “Tertiary prevention targets both the clinical and outcome stages of a disease. It is implemented in symptomatic patients and aims to reduce the severity of the disease as well as of any associated sequelae.” This includes diabetic foot care in patients with diabetes and cardiac rehab in those with post-myocardial infarction. “Quaternary prevention is an action taken to protect individuals (persons/patients) from medical interventions that are likely to cause more harm than good.” This includes decreasing non-validated medical practices that can lead to mortality such as hormone replacement therapy that increases the risk of strokes and breast cancers. (2)
An obesity screening tool in addition to body fat percentage, fat mass, and lean body mass monitoring would be considered as a secondary prevention strategy just like other health screenings, namely blood pressure/blood sugar/cholesterol monitoring, colonoscopy, pap smear, and mammogram. A comprehensive obesity screening tool is necessary for early detection of pre-obesity and obesity to [1] help reduce or eliminate the risk of developing other chronic medical conditions or [2] treat obesity early before it progresses.
Unraveling Obesity Inc., which is based on science, truth, and compassion, created this valuable screening tool that can be used by patients and physicians. It is considered secondary prevention to obesity because it helps to identify at-risk patients who have pre-obesity or are overweight and whose condition can progress to obesity. It will lead to early identification and education for both patients and their providers. In addition, it will encourage them to be more proactive in the weight loss journey.
To help curb the current obesity epidemic, our team of obesity medicine leaders created an app designed for obesity prevention that will decode weight loss and obesity to get to the cause of weight gain. Our obesity-specific app is based on science and the Obesity Medicine Association’s (OMA’s) 4 pillars of clinical obesity treatment. There are many benefits to using this obesity screening tool whether you are a patient, primary care physician, or a specialist.
Our goals include: to [1] share the truth about obesity and underscore the importance of this medical condition that needs to be treated by primary care physicians (PCPs) and/or obesity medicine specialists; [2] reinforce the fact that obesity is a chronic disease yet treatable using a 4 pillar medical framework; [3] encourage patients who are struggling with pre-obesity or obesity to seek professional help; [4] help patients have a healthy relationship with food, break the cycle of emotional eating, and overcome obesity; [5] help PCPs treat weight or refer their patients with pre-obesity and those who are at “high-risk for obesity” to obesity-certified specialists; and [6] provide PCPs with educational material from credible sources about obesity medicine and management to help them with their patients who are suffering from pre-obesity or obesity. The Unraveling Obesity team strongly believes that pre-obesity/obesity screening is an important step for disease prevention and healthy living because it leads to early diagnosis and prompt treatment, reduces obesity-related comorbidities, and improves one’s quality of life.
In a nutshell, there are five preventive stages of any disease and we need to consider disease prevention even before diagnosis or treatment. Hence, a comprehensive approach to obesity prevention is vital because it is a complex multifactorial disease. Pre-obesity and obesity, like other medical conditions, need to have a routine preventive screening that is more than one’s BMI or number on the scale. Excess adiposity is a chronic and progressive disorder that requires lifelong prevention and management. This underscores the importance of using Unraveling Obesity Inc.’s screening tool whether you are a patient, primary care physician, or a specialist.
References
- Fryar, C. D., Carroll, M. D., & Afful, J. (2020). Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960–1962 through 2017–2018. NCHS Health E-Stats.
- Kisling, L. A., & Das, J. M. (2020). Prevention strategies. StatPearls [Internet].
- Kushner, R. F., & Primack, C. (2020). Overweight: The Overlooked Risk Factor. The Journal of family practice, 69(7 Suppl), S51-S56.
