Obesity and Related Conditions

by Dr. Kenneth Hahn
February 16, 2012

    Obesity is an epidemic in this country and Colorado is no exception, although it does have one of the lowest rates of obesity in the country. Mississippi has one of the highest prevalence rates where 34% of adults are obese. Colorado has approximately 3.7 million adults of which 36% are considered overweight and another 20% are considered obese. About 10% of children between 12 and 18 years old living in Colorado are overweight and another 10% are obese. Just 10 years ago, the prevalence of obesity in Colorado was half of today's estimates.

    Obesity plays a major role in the development and worsening of many diseases encountered every day in family practice. These include type 2 diabetes, coronary heart disease, high blood pressure, stroke, certain cancers (colon, breast, endometrial), gallbladder and liver disease, and osteoarthritis. The incidence of these conditions increases with obesity and lower levels of physical activity. There are many theories as to how obesity plays a role in these diseases. I think about it as a vicious cycle where inactivity and poor diet cause weight gain which increases insulin resistance and fatty infiltration of the liver. These conditions in turn cause an increased appetite which causes further weight gain.

    What is a primary care physician to do? We don't treat populations, we treat patients on an individual basis. It is critical that we make an impact on an individual's behavior in order to help the whole country get healthier. This is the heart of primary prevention! Start with the basics: recommending regular exercise and a balanced diet help with all of the conditions previously mentioned. Patients need to continue these behaviors for the rest of their lives. This needs to be reinforced often. When they slip up, that is OK, but they just need to get back on track as soon as possible.

    The hard part is getting people motivated to change. Change is difficult for a multitude of reasons. I have had several patients change their diet and lose weight just to avoid paying a higher premium for their health insurance. This short term achievement can actually have a positive impact their health, as long as they continue those behaviors long term. I encourage patients to think about their fight against obesity like they do about their retirement savings. The investment, sacrifice and hard work now will pay off down the road. One of the most rewarding parts of my job is watching patients transform to a healthier lifestyle and succeed!