You're "Obese"- Now What?

Yesterday's WAKE UP blog entry referred to the USPSTF recommendation that all patients who have a BMI >30 should be referred to an "intensive, multicomponent behavioral intervention" in order to lose weight and therefore decrease their health risk. These recommendations are evidence-based, focusing on patient outcomes (disease states, not purely lab numbers).

What is "intensive"? 

• 12-26 sessions per year (often weekly to begin, then monthly.)

What is "multicomponent"?

• Individual or group sessions with physicians, dietitians, and other trained providers
• Include physical activity
• Address issues that keep people from changing behaviors
• Encourage self-monitering of nutrition and exercise

What results can be expected? 

• Weight loss typically ranges from 8.8-15.4 pounds in the first year
• Glucose tolerance is greatly improved- in fact,  that there is a 50% decrease in new diabetes diagnoses in only 2-3 years 
• Cardiovascular risk factors are improved (lower cholesterol & lower blood pressures)

If your BMI is >30, you are more likely to develop heart disease, strokes, high blood pressure, diabetes, certain cancers (esophagus, breast, uterine, colon, kidney, thyroid,  and gall bladder). It doesn't matter if you LOOK "okay"- this is NOT a cosmetic issue! While 15 pounds may not be all you need to lose, often that is enough weight loss to make a very significant positive impact on your health

BOTTOM LINE: Talk with your doctor about your BMI at this year's annual physical, and prioritize a healthier lifestyle starting today.

WAKE UP America- Courtesy of Colorado!

This summer I had the pleasure of spending some time in the gorgeous mountains of Colorado, a state which has long been one of the "healthiest" state in the nation- especially as measured by weight. Colorado has "only" 20.7% of the population with a BMI (body mass index) that indicates obesity, compared with 35.7% of overall American adults who are obese. That's ONE in THREE American adults who are obese! But I digress...my point was going to be that as our family watched some of the Olympics on tv, we saw a Colorado health-awareness commercial that I thought was extremely well done. The commercial shows people waking up in bed, challenging the Colorado population to actually "WAKE UP" and look in the mirror and see their true reflection- not the image in their head. The point is that obesity is "not as extreme as you think", and certainly my clinical experience echoes that thought.

Most adults are so comfortable with the notion that they "will never look like/ weigh what they did in high school" to the point that as they carry around an extra 20-30 pounds, it doesn't occur to them that they are jeopardizing their health in any way. And their physicians (who are not immune to the same beliefs for both themselves AND their patients) are along for that joy ride.

In June of this year, the  United States Preventative Service Task Force issued an update to physicians regarding screening for obesity. We are called to screen EVERY adult (which means get a weight & height & determine a BMI) and then for every patient who is obese- meaning a BMI >30- we should direct them to an "intensive, multi-component behavioral intervention". What is that and why? More on this tomorrow...

BOTTOM LINE: "WAKE UP", step on a scale & check your BMI today- don't assume weight is not an issue if you don't "look" or "feel" obese. 

PS. It's the FIRST of the month- change those air filters!

Recharge your battery!

What do I do to recharge my battery? My favorite vacation is summer or fall in Colorado. I believe our children summed it up beautifully when one of them said, "Mom, how can ANYONE be bored here?" Nature provides all the entertainment I could ever desire. Hiking, biking, kayaking, and rafting are ever-present. Want a slower pace? Grab your camera and shoot pictures of all the beauty.

Yesterday I took an amazing bike ride up here in Crested Butte. The views alone are enough to lighten my spirits, but the heart pounding you get at 9000 feet above sea level riding a bike will clearly up your adrenaline and pump up those "happy neurotransmitters" in your brain!

Remember that thirty minutes a day of aerobic activity (anything that significantly raises your heart-rate- you don't have to travel to Colorado!) is equivalent to taking a low dose of an anti-depressant.

BOTTOM LINE: Jump on your bike, go for a walk, or pick your favorite exercise and recharge your battery!