Vital Signs for the Growing Obesity Crisis

Obesity rates continue to be on the rise and affect people of all ages worldwide causing the current public health crisis and Dr. Travis Stork’s notion of “the weight gain emergency”. (9) Obesity, whether in adults or in children, needs to be treated as any other public health emergency. Since 2015, National Obesity Care Week has been in place to help end the obesity epidemic while supporting those affected by this serious disease. Because of its severity and the need to raise awareness of obesity, there are annual events such as World Obesity Day (on October 11th), Anti-Obesity Day (on November 26th), National Nutrition Month (in March), and National Childhood Obesity Awareness Month (in September). Also, during the first week of November at an annual international conference entitled “ObesityWeek”, global experts namely surgeons, physicians, researchers, and healthcare professionals meet to discuss the latest obesity treatments, scientific research, as well as new public policies that have an impact on those living with obesity; and they work together towards improving care for obesity. In addition, organizations that work hard to reverse weight bias include the American Board of Obesity Medicine (ABOM), ASMBS Foundation, Eisai US, Ethicon Inc., Medtronic, Novo Nordisk, Obesity Action Coalition, Obesity Medicine Association, and The Obesity Society. However, obesity is still not defeated and continues to be misunderstood by many people, unmanaged without professional guidance or the right educational resources, overlooked remaining untreated, and its severity is underestimated.

The Obesity Medicine Association describes obesity as a “chronic, relapsing, multi-factorial, neurobehavioral disease, wherein an increase in body fat promotes adipose tissue dysfunction and abnormal fat mass physical forces, resulting in adverse metabolic, biomechanical, and psychosocial health consequences”. (8) Therefore, obesity (and overweight) are complex health conditions, which need to be properly treated, monitored, and managed by qualified healthcare professionals using a comprehensive approach. Some questions that come to mind are: How many people really understand obesity and its negative effects on health? How many primary care doctors discuss weight management with their high risk patients or refer them to a leader in weight loss healthcare, such as CoreLife centers (1) or other medical weight loss clinics where physicians truly practice evidence-based medicine and offer a multi-disciplinary approach to weight loss, rather than encourage their patients to go see a nutritionist? Kudos to those specialists such as cardiologists, endocrinologists, obstetricians, and gynecologists who have already added the Ideal Protein protocol, a medically proven four-part protocol, to their practice so that their patients can have an effective tool to be successful with their weight loss. (3) In the “medical history questionnaire” or “patient history form”, patients are always asked whether they smoke or consume alcohol and whether they have a family history of heart disease, diabetes, or cancer. However, they are not asked whether they have unhealthy eating habits or a sedentary lifestyle and whether they have a family history of obesity. Given that obesity is such a serious health condition with a genetic predisposition just like coronary heart disease, why is it that a patient’s body fat percentage, fat mass, and lean body mass not considered as vital signs like blood pressure or pulse? And why are dietary intake & eating patterns, physical activity, and family history of obesity not part of a patient’s health history?

Many people don’t realize that obesity, like other diseases, is staged and that by seeking professional help to treat it early they can prevent it from progressing and therefore improve their overall health. In addition, they may not be aware that although obesity is not curable, it can be put into remission and it is possible to offset the “obesity genes”. This is also true for children living with obesity. Childhood obesity is on the rise and if left unmanaged it can turn into a lifelong problem. There are even cases of adolescent bariatric surgery to help teenagers living with obesity lose weight. The reality is unhealthy lifestyle habits start from a young age. How many parents and pediatricians are addressing this issue by using an online nutrition and exercise tool that is ideal, safe, evidence-based, innovative, and proven effective which targets this age group, such as MyShapers program? (6) How many people actually realize that sustainable weight loss requires a comprehensive approach and involves adopting a healthy lifestyle rather than following a fad diet or a trendy diet? How many know that it is not a “quick fix” but a process and a lifetime journey? Dr. Robert Ziltzer and Dr. Craig Primack, founders of Scottsdale Weight Loss Center and authors of the book “Chasing Diets: Stop the Endless Search and Discover the Solution”, emphasize that for a weight loss program to be successful and sustainable, it must be comprehensive having four essential components, namely medical management, nutritional or dietary change, activity plan, and education. They explain this using their chair analogy as follows, “Any time you omit any one of these four components your plan is more likely to fail. Think of it as four legs of a chair. Remove one leg, and you will have a difficult time maintaining balance on that chair”. (10) In addition, Dr. Michael Greger, Chief Scientific Officer at NutritionFacts.org, founding member and a fellow of the American College of Lifestyle Medicine and author of “How Not To Diet: The Groundbreaking Science of Healthy, Permanent Weight Loss”, concludes in his live presentation on evidence-based weight loss that “After all, permanent weight loss requires permanent dietary changes. Healthier habits just have to become a way of life. And, if it’s going to be lifelong, you want it to lead to a long life”. (7)

How many people are ready to work on weight management goals by discussing their weight issues with their primary care physician or by visiting a nearby medical weight loss center that offers evidence-based treatment? Or how many know that obesity should be treated, monitored, and managed by a board-certified obesity medicine specialist who uses FDA-approved medication/treatment or by experts in weight management? Dr. Ryan Morgan, president and co-founder at Vitalis Metabolic Health explains “an Obesity Medicine Specialist is a physician that has gone through rigorous training and board testing in the field of Obesity. We learn how to help patients with nutrition, behavior, and activity, all while using our medical degree to treat the medical components. We use motivational interviewing instead of the normal authoritative approach. Simple fact is one does not know what one does not know. That’s why it’s important providers refer patients to see someone that is specialized and especially focused in an area geared toward improving weight and toward nurturing a healthy lifestyle”. (5) Dr. Craig Primack, president of the Obesity Medicine Association, emphasizes that “most people who have tried dieting have not been successful. What we’ve learned over the years of treating many patients is that when you start putting together a medical approach, people do well. When we think about other diseases, we don’t go on the internet and say ‘what is the next chemotherapy?’ and just do it ourselves. We go see a specialist. We see a physician. The idea is not to find the next diet. It is to use the techniques that have been proven medically to work for weight”. (2) As a nurse who is passionate about helping clients lead a healthy sustainable lifestyle, along with other health professionals and obesity experts out there, I hope that more people would understand what obesity really means and be aware of its serious threat to one’s health. I also hope one day obesity will be conceptualized like other chronic diseases and that more people would see the right specialist for it namely one who is certified in Obesity Medicine.

Dr. Greger explains, “It may take up to seventeen years before research findings make it into day to day clinical practice” in terms of finding “some safe, simple, side-effect-free solution to the obesity epidemic”. (7) However, every day we can start taking practical steps towards ending this growing obesity crisis. Hence, to help end the current obesity epidemic we need to take action today for a healthier tomorrow. For physicians, it means to consider their patients’ body fat percentage, fat mass, and lean body mass as vital signs; to include dietary intake & eating patterns and physical activity as part of their patients’ health history; to ask about any family history of obesity; and to discuss weight issues or refer their patients to nearby CoreLife centers or other medical weight loss clinics that offer effective, proven, and safe treatments to maximize patient outcomes. More specialists need to incorporate a medically developed protocol for weight loss in their practice such as the Ideal Protein Protocol. In addition, pediatricians need to offer solutions for unhealthy lifestyle behaviors that target and involve children as well as their parents, such as the use of MyShapers online platform tool. Dr. Farshad Marvasti (Dr. Shad), a Stanford-trained physician leader and medical educator as well as the Chief Medical Officer of MyShapers emphasizes “When we think about solutions, we have to think about involving the entire family. As a practicing Family Medicine physician, as a Clinical Associate Professor of Family Community and Preventive Medicine, I can see how MyShapers can be a novel innovative solution to the needs of our time. And we have to do this not just for us, but for our children and for the next generation”. (4) Lastly, for patients, it means to seek professional help for their weight goal from a board-certified obesity medicine specialist who can prescribe FDA-approved medication/treatment regimen, or from a compassionate healthcare team who have the expertise in weight management and can create a personalized and an individually tailored care plan for a healthy lifestyle. So let’s take action now by working together to help control and end the current obesity epidemic!

References

1. CoreLife Healthcare. Retrieved from https://corelifemd.com/our-program/
2. DoctorPrimack. (2019, Feb 6). Arizona family chasing diets book launch interview from feb 2 2019 Craig Primack MD. Retrieved from https://www.youtube.com/watch?v=l156rwN5bSk
3. Ideal Protein. Retrieved from https://idealprotein.com/
4. Laura Conrad. (2018, Oct 8). MyShapers childhood obesity prevention. Retrieved from https://www.youtube.com/watch?v=CMFMrMhG_HA&t=2s
5. Morgan, R. (2019, Oct). What is an obesity medicine specialist? Retrieved from https://www.linkedin.com/posts/ryanmorgan1_health-vitalis-obesity-activity-6588407426414891008-aVf-/
6. MyShapers Online Nutrition and Activity Program. Retrieved from https://myshapers.com/home/
7. NutritionFacts.org. (2019, Nov 20). Evidence-based weight loss: live presentation. Retrieved from https://www.youtube.com/watch?v=EpRrD58Ah3Q&feature=youtu.be
8. Obesity Medicine Association. Retrieved from https://obesitymedicine.org/definition-of-obesity/
9. Stork, T. (2015) The doctor’s diet. New York, NY: Grand Central Life & Style
10. Ziltzer, R. & Primack, C. (2019) Chasing diets: stop the endless search and discover the solution. Dublin, OH: Telemachus Press, LLC