Philosophy and Oath
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OBESITY EPIDEMIC IN THE US
|If you weigh
less than the range given on this chart, you are in good shape. If you
are significantly above the ranges given, consider that over 300,000
deaths per year are caused by obesity and diseases linked to obesity,
and that a BMI of 30 or over is the point at which risk of death
increases from excess weight. Also worth noting, and easily measured, is
a waist circumference of 40 inches or more in males, and 35 inches or
more in females significantly increases risk of obesity-related
For those of you reading this who are in shape, here is another chart, more detailed for the lower ranges of BMI:
| Obesity Now Considered a "Disease" and|
Public Health Problem #1
The American Obesity Association states that obesity is a "chronic disease," and it could also most certainly be classified as a nutritional / metabolic disease, although it is closely related to behavior, whether a person is eating more than is needed for daily energy needs, or leads a sedentary lifestyle, or both. Just as other diseases result from the behaviors that lead to them, such as problem drinking, a behavior, leading to the disease of alcoholism; smoking, a behavior, leading to cancer or emphysema; or sunbathing without sunscreen, a behavior, potentially leading to skin cancer; overeating and lack of exercise, both behaviors, can and do lead to the disease of obesity. But the problem is not that simple. Once obesity takes hold, a myriad of other problems and diseases can develop much more quickly such as arthritis, heart disease, hypertension, stroke, cancers of all kinds, insulin resistance / diabetes, gallstones, liver disease, low back pain, and decreased life expectancy, not to mention the psychological impact of the obese person being a victim of disdain and discrimination.
The National Academy of Sciences Institute of Medicine states that obesity is "one of the most pervasive public health problems in this country, a complex, multi-factorial disease of appetite regulation and energy metabolism involving genetics, physiology, biochemistry, and the neurosciences, as well as environmental, psychological and cultural factors. Unfortunately, the lay public and health-care providers, as well as insurance companies, often view it simply as a problem of willful misconduct - eating too much and exercising too little. Obesity is a remarkable disease in terms of the effort required by an individual for its management and the extent of discrimination its victims suffer."
The American Society of Bariatric Physicians states that: "Recognized since 1985 as a chronic disease, obesity is the second leading cause of preventable death, exceeded only by cigarette smoking." And the American Academy of Family Physicians has adopted a policy on obesity, stating: "The AAFP recognizes obesity as a disease and a national health risk for premature death; will support CME programs on childhood obesity; and promotes nutritionally balanced meals, decreased TV viewing and increased physical activities for obese children."
Children are especially at risk for developing serious problems, both
physical and emotional, if obesity develops in younger years.
The reality about the obesity epidemic is that medical professionals need to get more involved with their patients, educating them about good nutrition and eating habits on a much more widespread basis. Although surgeons have been the main providers of care for the morbidly obese patients, providing stomach stapling gastric bypass procedures, or the new electroshock therapy for the stomach, in which a pacemaker type device is implanted in the patient's body and shocks the stomach to create a sensation of fullness (and it should be noted that these are extreme cases, people who weigh 300 lbs. and higher), the family physician is in the best position to teach and counsel the obese patient. If nothing else, a doctor could and should strongly recommend that the obese patient eat more fiber, in the form of vegetables, and even a fiber supplement, because fiber is a natural way to feel more full and encourages proper elimination. Some people may need a special dietary menu to follow, because they cannot seem to make those healthier choices for themselves for whatever reasons, but the healthiest and medically sound method of weight loss is a calorie restricted diet which provides adequate protein, carbohydrates, fats, minerals and vitamins, and NOT from a fad diet.
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