Health Risks of Obesity Dismissed by Overweight Americans

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Are you overweight? If you are, chances are good that you understand the health risks of obesity, but you don’t think the dangers of death from heart disease and other weight-related illness threaten you personally. And your doctor is reluctant to discuss your weight with you.

This is the principal finding of new research on overweight Americans sponsored by Shape Up America!, a national non-profit organization founded by former Surgeon General C. Everett Koop, to educate the public about the escalating health crisis of obesity.

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The national “Talk to Your Doctor” survey found that the doctors of overweight Americans are failing to bring up the topic of weight loss with their patients and if they do, they fail to recommend comprehensive treatment programs of diet, exercise, behavioral modification, and medication, when appropriate. This finding is particularly important in light of a study released last week of more than one million Americans published in the New England Journal of Medicine. The NEJM study conclusively shows that overweight people run a higher rate of premature death from all causes, but especially from heart disease and cancer.

“Overweight Americans may see the threat as real, but they don’t believe it applies to them personally,” said Barbara J. Moore, Ph.D., president and chief executive officer of Shape Up America! “We are failing to personalize the serious health threats people face when they carry excess weight as fat. It is similar to smokers who know that cigarettes can kill, but are sure they will never get sick.”

Dr. Moore was also dismayed by the finding that the medical community “appears to be in denial” about treating obesity. “Two out of three doctors are failing to bring the topic up with their overweight patients. Health professionals need practical information to help them assess obesity, gauge the associated health risks, and offer treatment options that are appropriate for that level of risk.”

As founder of Shape Up America!, Dr. C. Everett Koop, the anti-smoking advocate, has taken on the growing epidemic of obesity in America: “Obesity-related illness kills more than 300,000 Americans annually and is the second leading cause of preventable death after smoking. Obesity is killing us and costing us: the annual health care costs of treating obese Americans were recently estimated at $238 billion.”

“The results of the ‘Talk to Your Doctor’ survey are important for millions of Americans who are afraid to face the reality of being obese. I know this only too well, because I had that fear, too,” said Delta Burke, best known for her role in TV’s Designing Women. “I always thought I was dieting to build my self esteem or keep my job, and that perspective immediately changed when my doctor said I had developed type 2 diabetes as a result of my weight,” she added.

Ms. Burke is helping to announce the Shape Up America! data, collected by Roper Starch Worldwide, which surveyed 1,651 U.S. adults between the ages of 18 and 65. Of these, the survey focused on 547 respondents with Body Mass Index (BMI) scores of 27 or above. Because it correlates with total body fat, BMI is the medical standard for measuring obesity and is calculated by dividing your weight (in kilograms) by the square of your height (in meters). By focusing on those with a BMI of 27 or higher, the survey polled significantly overweight Americans who are at high risk for obesity-related illnesses and premature death. Government data estimate that 60 million Americans have a BMI above 27, which for a woman 5’5″ tall means that she weighs 160 pounds or more.

Among the study’s highlights:

Almost 7 out of 10 seriously overweight Americans believe that there health is not at risk because of their excess weight.

Of the 44% who have discussed weight loss with their physician, 2 out of 3 had to bring the topic up first.

Most doctors (82%) did little more than suggest their patients get more exercise to manage their weight. Only 17% of respondents indicated that their physicians recommended drug therapy to help them lose weight, 80% of the time without explaining the differences between FDA-approved prescription medications.

“These findings are very disturbing,” said John Foreyt, Ph.D., Director of the Behavioral Medicine Research Center at Baylor College of Medicine in Houston, TX, “because the physician should be the leading advocate for the overweight patient, and should take the lead in devising a comprehensive weight loss or weight management program that includes, when necessary, appropriate drug treatment.”

Source: New England Journal of Medicine. October, 1999

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