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Why Weight Loss Is Losing Steam In America

Mar 27, 2017

There are less people who are trying to lose weight today than there were about 30 years ago according to a research letter published in JAMA’s March edition. The letter written by researchers at Georgia Southern University in conjunction with the CDC, found that the number of people trying to lose weight had declined by 6% since 1988. The data, drawn from three different periods of the NHANES (National Health and Nutrition Examination Survey), an ongoing survey study meant to estimate the health and nutritional standing of the general population. Data from the letter also showed that African American women showed the greatest decline in reports of trying to lose weight followed closely by white men and women, who back in 1988 showed the highest prevalence of reported efforts to lose weight (all showed about a 10% decline).

While seemingly only a slight decline, it’s worth noting that these declines are occurring as the national obesity rate continues to rise, and as there is a growing drive to incentivize weight loss. Weight loss it is know to have a much broader effect on health than simply reducing the number on a scale. Thus we witness employers, eager to improve the productivity of their employees, signing up left and right for workplace wellness programs, which have gained new life since the passing of the ACA. Additional legislation is being considered in Congress for tax breaks and other incentives for individuals to join gyms, or purchase fitness equipment, and in many areas of the country, local access to health and fitness resources is improving, especially in the D.C. metro area. So why the decline? Why are some losing interest?

The authors of the research letter put forth a theory that these declines may be partially due to the fact that weight perception in Americans is changing; fatness may be starting to lose some of its stigma in society. It is well documented that weight perception has an influence on one’s efforts to engage in weight loss, so what if someone does not perceive his or her weight in as much negative light? Accordingly, a person with this mindset will be less inclined to undertake a weight loss program, and the authors are seeming to suggest that social changes are leading to a more accepting view of overweight individuals, and that this may have something to do with how their findings panned out.

Now improving such social perception is not inherently a bad thing. The psychological effects of weight perception can be devastating to an individual’s self-esteem and can lead to high psychological stress. But let’s not forget the reality of the situation; obesity is still the single largest threat to the long-term health of our nation’s population.

The most recent examination of obesity-related healthcare costs found that from 1998-2006, the rising obesity rate has resulted in a $40 billion increase in healthcare spending. Now at first that number seems mind blowing, but our increasing grasp of obesity’s place as a comorbidity factor in various diagnoses, that number is, unfortunately, starting to make more sense. Obesity is known or suspected to have links to a whole host of diseases and impairments including metabolic diseases, degenerative cognitive diseases, cancers, musculoskeletal disorders and injuries, and digestive diseases just to name a few categories. When we factor in the role of obesity in the occurrence of these diseases, it becomes easier to see how the spending can pile up. CDC officially declared obesity an epidemic in 1999, and since then, there has been little to no improvement in the obesity rate in America; this is still a very dangerous public health crisis that needs to be taken seriously, and part of that is ensuring access to resources for those who do hold a desire to lose weight, improve their metabolic profile through exercise, and gain the health benefits thereof.

Resources for fitness improvements often go outside the gym, and in to the doctor’s office. The authors of the letter noted a 2013 study that concluded that primary care physicians are not addressing weight control in an effective manner with their patients. That absolutely astounds me personally. Weight loss could possibly crack an objective top 10 list of hardest personal accomplishments to achieve in life, and yet those who may want to take a shot at it, are often left in the dark by their healthcare providers. Conversation can often lead to increased incentive, especially if the conversation is coming from a trusted source. Now patients may or may not trust their primary physician, but it should be the job of the physician to be proactive in giving necessary health information and counsel to maintain, and build that relational trust. Leaving weight control out of the conversation is an easily corrected oversight that once remedied, could serve as a relational building block between doctor and patient, and a more comprehensive plan of care for those desiring to improve their health through weight loss.

All that is not to neglect the onus of the patient if the healthcare professional is not having that conversation. Initiating, and asking a question about your metabolic profile (i.e. levels of HDL & LDL cholesterol, tryglycerides, HbA1C) is often what is needed to get that conversation going. So don’t be afraid to ask for that one blood test if that is what seems to be necessary.

Secondly, and even more importantly, many do not undertake a weight loss effort because those individuals feel like they have little control over their situation, or don’t feel that they have the needed means to accomplish that goal. So they will either stop trying, or simply won’t try in the first place. Yes there is a certain amount of discipline required for a weight loss journey, but such an asset over time, is nothing that can’t be developed with guidance. Your health, and wellness are your most valuable possessions. There could be times where you may struggle with making health progress, but with health, there is never time for not believing in yourself.

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