According to research in 2013 at the Cleveland Clinic, “more than 30 co-morbid conditions are associated with severe obesity,” like Type-2 diabetes, the metabolic syndrome, obstructive sleep apnea, atherosclerosis, heart disease, hypertension, strokes and degenerative arthritis, among others. These are the swords that strike down thousands of Americans and tens of thousands of the world’s inhabitants each day. And what do we do? We treat them. We diagnose them. We manage them.
What are we not doing? We are not preventing them.
Most physicians will agree that since they were in medical school, medicine has advanced significantly in the diagnosis and management of many common and chronic, life-threatening illnesses and diseases. We have many forms of specialized imaging techniques of every description, new procedures to arrest or cure some diseases, new surgical techniques to correct CAD. Yes, we have the goods.
What do we not have? We lack the forethought, the will, and the desire to really delve into what we must do to seriously attack through prevention the epidemic of obesity and all of the related diseases that are destroying lives, our economy and our personal wealth.
Please remember the Hippocratic Oath; it even speaks of diet:
“I swear by Apollo the physician, and Aesculapius the surgeon, likewise Hygeia and Panacea, and call all the gods and goddesses to witness, that I will observe and keep this underwritten oath, to the utmost of my power and judgment. I will reverence my master who taught me the art. Equally with my parents, will I allow him things necessary for his support, and will consider his sons as brothers. I will teach them my art without reward or agreement; and I will impart all my acquirement, instructions, and whatever I know, to my master’s children, as to my own; and likewise to all my pupils, who shall bind and tie themselves by a professional oath, but to none else. With regard to healing the sick, I will devise and order for them the best diet, according to my judgment and means; and I will take care that they suffer no hurt or damage.”
The practice of medicine is a very difficult path to follow. In 1985, about 35 percent of adults were overweight or obese, and now, it is closer to 69 percent. Some physicians have not done enough to help solve and direct their patients in the correct manner to assist in the prevention of obesity. Some of this is due to following older concepts that have failed, while others are over worked from putting out fires during each office visit. The average family physician is expected to manage three separate problems for each patient scheduled for a 15 minute office visit. Specialists are often working on
one problem per visit though the complexity of the problem may be daunting. We cannot wait any longer to deal with obesity.
“In 1985, about 35 percent of adults were overweight or obese, and now, it is closer to 69 percent”
How big is this problem?
Total deaths from the wars in Iraq and Afghanistan as of April 2014: 6,848
Total deaths of American soldiers from the Vietnam War: 58,209
Total American deaths from diabetes in 2013: 78,831
Total number of obese Americans that die annually from obesity: 300,000+
Total number of obese children from 6- to 18-years-old: 9,000,000
Total number of Americans with pre-diabetes 20-years-old and older: 86,000,000
Total number of overweight or obese Americans: about 190,000,000
By reading this you will decide for yourself that the truth is lurking somewhere between these words and your own thoughts and conclusions. As physicians we must think for ourselves, for the practice of medicine is more of an art than a science because we deal with humanity, and we all practice differently.
So there it is: the shock and awe, the problems and the challenge. Due to the immensity of these problems, we have deflected them for too long. It is time to take a stand, to show up and make a difference. My new book, Weight No Longer, educates the reader on how to solve the problem of obesity if they follow the prescriptions. It focuses on the real cause, which is a sedentary lifestyle more than it is a poor diet. With the advent of the horseless carriage, mechanized assembly lines and power equipment, men and women are expending less energy to perform heavy tasks. Men and women have all kinds of automatic home appliances to “make their life easier,” but they shortcut their chances of burning calories through physical labor. What happened to the push-reel lawn mower, the snow shovel, the pick and ax?
In the 1860s, women ate an estimated 3000 calories per day and were normal weight. Look at photographs online from that era. Lumberjacks who cut down trees by hand with axes and saws were believed to eat approximately 8,500 calories per day. Olympic champion Michael Phelps joked on Saturday Night Live, “You can eat whatever you like as long as it adds up to 12,000 calories a day.” He worked out about six hours per day, swimming laps to earn his eight gold medals at the Beijing Olympics.
During my early career, I preached adjusting diet, eating low-fat foods, avoiding processed carbohydrates, reducing snacking, skipping late-evening treats and reducing overall calorie intake, thinking, as most, that obesity is a dietary problem. It is less of a dietary problem and more of a lack of exercise and fitness. If one only reduces calories to lose weight they will also reduce muscle mass, bone mass, tendon and ligament strength. Therefore, they are losing fat and fat-free mass. The healthy way to lose weight is by improving nutrition and participating in frequent exercise to lose fat while maintaining fat-free mass. Thus we maintain power, strength and the body’s integrity while losing weight. This is not rocket science. It is actually more difficult. Obesity escalates while our space achievements shine.
I throw the gauntlet down. Please pick it up. Learn what it takes to prevent obesity. Educate your patients in daily exercise and fitness. Fitness strengthens us, lengthens life, delays dementia, prevents many diseases and reduces mobility disability. Everyone must work out five to seven days per week to solve the disease of obesity and its related consequences. Eating a natural and preferably organic diet will help. Patients must give up their dependence on processed foods and begin to consume what was available to us as hunters and gatherers. Exercise shows its worth by remembering that a less than ideal diet may be overcome with additional exercise.
Let’s stop the epidemics of obesity, Type-2 diabetes and all related disorders. Every physician must attack this problem with spirit.