Obesity – Prevention or Treatment

Almost every province and state across North America is struggling with this exact question. In fact for western and developed nations, it’s a worldwide problem. Even in counties like India which has in very recent years made dramatic strides both sociologically  and economically. They too are experiencing sky rocketing levels of obesity.  It seems that the price of “westernized” economic success in our world also includes obesity.

In a short span of 25 years, North Americans have  leaped from a semi reasonable 20% of our population being overweight  to an outrageous 60%! We all know that there are other critical challenges we face in our world today, but few will impact as many people’s quality of life, longevity and literally $10s of billions of dollars in cost as obesity will during the next 50 years.

Those $ billions will for the most part be paid by tax payers and individuals to supplement health care systems treating all the recognized co-diseases that obese patients end up with and usually cause their actual deaths. High blood pressure, heart disease, diabetes, COPD, kidney disease – the list goes on! All their death certificates will state one of these co-diseases as cause of death, but the real reason will be obesity.

You’re probably wondering how we got to such a horrendous obesity epidemic. Here’s a short overview of some of the major contributing factors:

• the invention and prolific distribution of junk food. This includes sugar laden pop, all chips, super burgers, take out pizzas and fast food restaurants.
• the insidious creation of “quick meals” found in the centre aisles of your grocery store. These include boxed pre-cooked pastas, boxed meals of any sort, cheese spreads, peanut butters with added sugars, frozen food diners, hamburger helpers and just about everything else that cooks in less than 5 minutes.
• “fillers” and “additives” including taste and appetite enhancers that are added to most of these quick foods.
• the marketing price points of these foods being cheaper than healthy foods. It obviously costs less to manufacture refined processed foods with additives and fillers. The savings get passed onto the consumer, making “quick meals” super attractive to shoppers both in convenience and price.
• social/economic changes that require most family units to have both partners in the work force
  • either for economic reasons – families living near or below the poverty line
  • social reasons – because we expect personal self worth can only be achieved outside the home. It seems that prime care giving for rearing children is no longer seen by many people as a way to achieve self-fulfillment.
  • both of these concepts result in parents that are too tired to cook or teach and monitor healthy food intake of children. In fact the majority of people rely heavily on fast foods or complete meals in a box for many of their weekly meal choices.
  • heredity
  • addiction and psychological predisposition

We’ve only touched on a myriad of complexities that surround obesity in our world. Let’s leave causes and look at solutions.

Prevention:

Since the 50′s when obesity statistics were seen to be rising, most governments invested in prevention strategies of some sort. The Canada Food Guide and ParticipACTION program are great examples of prevention and reduction strategies. Healthy Food Choice programs for schools is another example. The US and other countries have equivalent programs in their jurisdictions.

Unfortunately all the prevention programs to date have done little to stem the rising obesity epidemic. Should we throw them all out and consider other options? No, these programs do help. If anything we need to increase their presence and effectiveness. We’ll talk about that in a minute.

Treatment:

Well we do have hundreds of diet books of all types and flavours, we have the Jenny C program, WWers of the World, the “For Sure Slim” program – if those don’t worked for you, we have dozens of “exercise your fat away in 8 weeks or less” gym businesses. You can buy a rowing or exercise bike, also known as the new bedroom “clothes hanging butler”. If you actually go to your doctor, you can get diet pills of all forms and shapes AND a medically approved diet sheet.

All of these will work for the person who has 15 or 20 lbs to lose. If you’re in this category, consider yourself blessed. With a small amount of will power, slight reduction of foods, a small shift to healthy  foods and a tiny increase in exercise, you’ll be back to your normal trim self in no time.  If you lose 2 lbs a week, you’ll be back to your healthy weight in less than 3 months! Easy as falling off a log!

But what about those who are more than 30% above their normal weight? (officially obese and heading towards morbidly obese) Somewhere between 15 and 20 % of us  ( 1 in 5 ) are classed as obese or worse – morbidly obese.  When you finally get the wake up call, usually the result of a catastrophic health crisis, you’ll be faced with losing at least a 100 lbs or more. Often in today’s world it’s not uncommon for a morbidly obese person to be more than double their normal or healthy weight. Let’s see … hmmmmm, at 2 lbs a week for 150 lbs, it should take about a year and a half!

• Chances of staying on your diet for 18  months – probably less than 1 %
• Chances of achieving your goal weight -probably less than 1 %
• Chances of regaining weight lost -at least 95%
• Chances of rebounding and actually gaining more weight than you lost – at least 95%

We have one other weapon in our arsenal when dealing with obese and morbidly obese patients. It’s called weight loss surgery. Extreme – yes! It’s not for the faint of heart, but it is proven effective – especially the gastric bypass versions of the surgery which have a success rate after 5 years of more than 70%.

Seems simple enough – why don’t we treat more people with weight loss surgery? The answer lies in our perception of obesity. For most of the world, obesity isn’t classed as a disease. Health Authorities and the majority of the traditional medical community consider it a condition brought on by poor food choices and a sedentary life style. Strangely, this writer is ok with this view – as long as an obese person doesn’t have any co-diseases of obesity. Then it becomes really very simple. Morbidly obese + life treating co-diseases = equals treatment by any means that the patient agrees to including weight loss surgery.

Quality of life for the patient AND extended family members is significantly improved. (remember – that where you find one obese adult, you usually find obese children, spouses and pets). A very BIG plus factor for governments and health authorities is the reduction of medical care costs,  medications and future health care. Weight loss surgery gives a positive “return on assets” usually within 2 years.

“Out of the Box” Thoughts:

Obviously obesity is out of control and our tools to fight it, including weight loss surgery are not working. We know that all our present policies, management and solutions for both prevention and treatment are at the very best, completely ineffective. Seems like a good time to reflect on possible extreme solutions that might actually turn the tide on our out of control obesity epidemic.

(Note: Brain storming and innovative thinking takes us “out of the box”. All of these ideas need to be investigated and dare I say – validated through community input groups/sessions arranged and hosted by our Health Authorities. In BC, that would be the PHSA – Provincial Heath Services Authority or our Provincial Government. Community engagement, especially with those that are most affected – existing morbidly obese and those that have fought and won the battle.)

Ideas:

• Officially classify morbid obesity as a disease – this would create appropriate funding options for prevention and most importantly, treatment.
• Tax manufactures a graduated production tax that cannot be passed on to consumers in the final product price by the amount sugar and fat content in “quick meals” and “junk food, including pop”. The higher the sugar and fat, the more the tax.
• Create tax breaks for large corporations and businesses that provide free ongoing nutritional and exercise programs for their employees  and families. – let’s say a 20% participation rate has to happen before they receive the tax break.
• Free community centre memberships for all citizens over 30% of their normal body weight.
• Legislate “Healthy” alternatives must be offered on the menus of all fast food restaurants AND they must be listed 1st on menus AND pictures must be larger than other menu choices.
• In fact, let’s make it so all restaurants must list their menu choices by calorie content, ordered lowest to highest and all menu choices that don’t meet Canada Health Guide standards must be listed in “red”
• Red warning labels on foods in our super markets that don’t meet Canada Health Guide standards
• Free yearly nutritional courses for parents with children in grades 1 through 6.

OK, – you get the idea. Now let’s hear from you. No idea is bad in “brain storming”. Use the comment field below and add your idea to the list.

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