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    Medical Association Urges Attention to Issues of Obesity in America

    In the hopes of drawing the nation’s attention to the rapidly increasing number of overweight and obese Americans, the American Medical Association hosted a media briefing in New York City on Thursday, July 12. Experts on various aspects of obesity-related health issues spoke at the conference, which was moderated by Dr. Susan Adelman, a member of the AMA Board of Trustees, Dr. Cheryl Renz from Abbott Laboratories, and Dr Charles Billington, president of the North American Association for the Study of Obesity.

    At present, according to Dr. Adelman, one-half of U.S. adults are overweight, and one quarter are obese. “The number of obese adolescents and children is also increasing” she continued. William H. Dietz, M.D. from the Centers for Disease Control and Prevention (CDC) in Atlanta stated that many physicians and consumers overlook the health dangers of obesity. Both tend to view obesity more as a cosmetic than a health concern. Less than one-third of Americans surveyed in a recent AMA study knew that obesity is associated with cardiovascular disease, according to Dr. Dietz.

    He went on to explain that obesity is second only to tobacco use as a public health issue in the United States, as it is associated with high blood pressure, diabetes, gallbladder disease, some types of cancer, pregnancy-related problems, and arthritis and other joint-related ills. Further, the fact that obesity is on the rise in children as well as adults does not bode well for public health in the future. In a press release on the conference, Dr. Dietz cited data that “demonstrates that type 2 diabetes, which was a rare disease in children and teenagers, is now much more common, and in some clinics young people account for half of the new cases of type 2 diabetes.”

    Dr. Dietz warned, “The complications of childhood are the risk factors that actually become the diseases of adulthood.” He urged physicians to educate their patients about the health consequences of obesity and to encourage them to view excess body fat as a serious health problem. Further, he noted that often only a five to ten percent loss of body weight could achieve a remission of some obesity-associated complications.

    Robert I. Berkowitz M.D. of the Weight and Eating Disorders Program at the University of Pennsylvania pointed out that overweight children who become obese adults are more likely to develop early diabetes and heart disease.

    Successfully dealing with childhood obesity requires that the family be committed to making any weight management program work. This may require family participation in more physical activities, as well as modification of types and amounts of food ingested.

    Other speakers at the conference emphasized the fact that an obese person does not necessarily have to become thin in order to avoid or even reverse some of the health consequences of obesity. Susan Yanovski, M.D. from the National Institutes of Health, stated in a press briefing that “Weight loss and exercise can help overweight people at risk for diabetes redefine their odds.”

    Similarly, Robert H. Eckel, M.D. from the University of Colorado Health Science Center, explained that losing only 5 to 10 percent of body weight can be enough to improve an obese person’s health prospects. According to Dr. Eckel, “obese people are three times more likely to have high blood pressure -- a significant risk factor for heart disease -- than are normal weight people of the same age and gender.” In addition, he noted that prevention of weight gain is also a valuable health message to pass along to consumers.

    James O. Hill, Ph.D., also from the University of Colorado Health Science Center, has studied people who have successfully lost large amounts of weight and maintained the loss for long periods. “Participants in the National Weight Control Registry” stated Dr. Hill, “have lost an average of 66 pounds, and have maintained the loss for an average of 6 and one-half years. Thus, contrary to popular belief,” he continued, “it is possible to lose substantial amounts of weight and maintain the loss.”

    Dr. Hill identified four behaviors that were common among these people. The behaviors included:
    eating a low-fat, high-carbohydrate diet

    eating breakfast almost every day

    self-monitoring (keeping track of body weight and food intake); and 4) being very active (about an hour each day -- though not necessarily at one time)

    According to Dr. Hill, maintenance of weight loss is much more difficult than losing weight -- he feels that more attention should be focused on this aspect of body weight control.

    All participants in the press briefing emphasized the importance of educating physicians and the general population about the potential health impacts of overweight and obesity. They agreed that the increasing prevalence of obesity in young people should sound an alarm about future challenges to public health. George Bray, M.D., professor at Louisiana State University in Baton Rouge, another conference participant, concluded, “obesity is a time bomb that must be defused.”



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