Treatment for Obesity Calls for Lifestyle and Cultural Changes

Jul 1, 2013

Following the American Medical Association’s reclassification of obesity as a disease, physicians are hopeful about the slew of positive opportunities that could come to the one in three Americans classified as “obese.

Dr. Esa Davis, a practicing physician with UPMC Division of General Internal Medicine, notes that this change will allow for primary care offices to have more discussions with patients about obesity and hopefully allow for “broader insurance coverage for weight loss programs and nutritional services” as well as “increased funding for research and intervention programs.”

But why are there more obese people in 2013 than ever before? Davis points to the increased availability of nutrient-dense food and a decrease in physical activity.  This decrease has extended to schoolchildren where exercise is not always part of the daily routine.

Treatment for those classified as obese generally begins with programs that address eating habits and physical activity.  Patients will take classes on nutrition and focus on calorie restriction while slowly starting to increase physical activity. Davis suggests, “it’s about getting back to the basics of eating” and “if we could get back to cooking again, where you’re controlling the amount of salt, sugar, fat…that’s a step in the right direction.”

In her experience, habits can typically be put in place after about three weeks. During that time, it’s important to take small steps to change your diet or exercise habits.  “Cutting out soda” and “increasing water intake” are two things Davis says people can do to avoid “bad diets that people are drawn to” but never result in true, healthy weight loss.

Surgery is a last resort for physicians dealing with obese patients.  The most popular procedure, bariatric surgery, is done by completing a bypass in the stomach area to make it smaller.

“This is recommended for people with sever obesity,” Davis warns, “where their body mass index is greater than 40 and diabetes, hypertension, and cardiovascular disease are accompanying risks.”  In order to receive this surgery, patients must go through a six month prescreening process, demonstrating that they have attempted lifestyle changes, intense dietary counseling, and psychological evaluations.

Obesity Treatment Must Focus on Cultural Changes

Through the lens of dietitian Judy Dodd, obesity is an issue best tackled by changing the atmosphere and the culture surrounding the obese individual.  For adults, she maintains, it may come down to “clean your plate vs. not enough food.” 

“If you grow up in a family where food is at risk, the idea is to get to it fast and eat it down because you may starve” and some adults grew up in more affluent households and were raised with the notion that people are “starving in a third world country” so they should eat all on their plate.

For children, Dodd insists that treatment for obesity must begin with an observation of the child’s caregivers and the role-modeling that happens in school, daycare and home.  

“Children are pretty much a captive audience until they get to that point where they can buy their own food or access their own,” she says and tackling an issue such as childhood obesity must begin with lifestyle changes for the entire family.