August 15, 2007

 

 Waging war on obesity - August 15, 2007

 

Personal accountability, education are the most powerful weapons in the arsenal

posted August 1, 2007

 

Obesity is an American epidemic that has stubbornly resisted efforts to rein it in. Despite high-profile awareness campaigns and a multibillion-dollar weight loss industry, the incidence of obesity continues to increase.

The statistics are alarming. A study by RAND Corp. found that 66 percent of the U.S. population is overweight, which is defined as a body mass index of 25 to 29.9; moderately obese, a BMI of 30 to 35; or morbidly obese, a BMI greater than 40.

That includes 3 percent (6.8 million) who, at 90 pounds or more overweight, are morbidly obese, up from 2 percent in 2000. Another 24.6 percent are obese at 30 pounds or more overweight, up from 20 percent in 2000.

Annual average health care costs for moderately obese people were 20 percent to 30 percent higher than costs for people at a healthy weight, and more than 60 percent higher for those with a BMI greater than 35. A BMI of at least 40 doubled health care expenditures.

Among the moderately obese, 11 percent reported limitations in daily living activities and 27 percent reported limitations in their ability to work. These figures more than doubled for those with a BMI greater than 35.

The health and financial implications are far-reaching. The obese are at increased risk for chronic diseases and health problems, including diabetes, heart disease, stroke, certain cancers, osteoarthritis, back and joint problems, gallbladder and fatty liver disease, and sleep apnea.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, obesity carries a price tag of $117 billion in direct medical care and indirect costs.

The National Institutes of Health breaks that down into an itemized accounting of the economic impact of obesity. Costs, based on 1995 figures updated to 2001 dollars, include the following:

  • breast cancer: $2.9 billion
  • endometrial cancer: $933 million
  • colon cancer: $3.5 billion
  • type 2 diabetes: $98 billion
  • osteoarthritis: $21.2 billion
  • hypertension: $4.1 billion (direct costs only)
  • gallbladder disease: $3.4 billion

The AVMA Group Health and Life Insurance Trust has seen firsthand the impact of the nation's obesity problem. Diabetes is a prime example. The Centers for Disease Control and Prevention reports that the prevalence of diabetes has risen by 5 percent annually since 1990, and nearly nine of 10 patients diagnosed with the disease are classified as overweight.

The GHLIT benefits payments related to the treatment of diabetes rose by 35 percent in less than two years, from approximately $653,000 in May 2004 to April 2005, to nearly $878,000 from January 2006 to December 2006. During the same two 12-month periods, GHLIT also paid in excess of $4 million for claims related to back problems, another common adverse effect of obesity.

The increased prevalence of diabetes is also seen in the results of blood tests conducted each year at the GHLIT Wellness Center during the AVMA Annual Convention. In 2005, 13.6 percent of those screened had glucose concentrations greater than the reference range. By 2006, that figure jumped to 15.6 percent.

One of the underlying challenges in the war against obesity is the disconnect between perception and reality. Even veterinarians can see this disconnect between pet owners and their pets.

According to a 2006 study by Pfizer Animal Health, 47 percent of veterinarians felt their canine patients were obese, while only 17 percent of dog owners agreed.

A similar disconnect can be seen in the way humans perceive their own weight. A National Consumers League study conducted by Harris Interactive found that while just 12 percent of participants considered themselves obese, BMI calculations found that actually 34 percent were obese.

The study also found that just 12 percent had been told by health care professionals that they were obese.

Those findings prompted NCL to launch "Choose to lose," a consumer education campaign to help individuals honestly evaluate their weight and work with their doctor to do something about it. Information about the campaign is available online at www.nclnet.org/obesity.

Similarly, the Trust offers veterinarians access to tools that will help them take control of their weight. In addition to the Wellness Center, the enhanced Wellness Benefit of many GHLIT medical plans encourages participants to undergo routine physicals, and to consult with their physicians to safely change their diet and exercise habits.

A personal commitment to making the necessary lifestyle changes, however, remains the most critical aspect of achieving and maintaining a healthy weight.

Happily, those changes do not have to be drastic, and the resulting benefits go far beyond an improved physique.

In addition to controlling weight, regular physical activity contributes to healthy bones, muscles, and joints; helps relieve arthritis pain; and reduces symptoms of anxiety and depression. It is also associated with fewer hospitalizations, physician visits, and medications. Best of all, it can be as simple as a brisk, 30-minute walk most days of the week.

Proper nutrition can help lower the risk for many chronic diseases, including heart disease, stroke, some cancers, diabetes, and osteoporosis. The dietary guidelines published by the Department of Health and Human Services and the Department of Agriculture are a great resource and are available at www.health.gov/dietaryguidelines/.

In short, despite the gloomy predictions about the war on obesity, it is a battle that can be won by taking personal responsibility, using the support tools available through the Trust and other organizations, and committing to some basic lifestyle changes.

There is no better time than now to get started on a healthier life.