Obesity is on the rise in the United States and across the world. More than two-thirds of adult Americans are overweight and half of those are obese. An analysis in the New England Journal of Medicine predicts that half of Americans (49%) will be obese by 2030. Although higher in some states than others it will be more than one-third of state residents (35%) in the lowest state. Nearly one-in-four adults are projected to be severely obese by 2030. What is the root cause of obesity? That is a discussion in and of itself but by most accounts it is related to: (1) inactivity and (2) unhealthy diet.
Work no longer requires physical labor for most Americans and foods are highly processed and calorie dense. Human bodies did not evolve to eat processed foods high in calories and sugar with little physical activity required to acquire food. Sugar came from the New World. Prior to sugar processed from sugar cane the only sweetener was honey, which was too expensive for all but the richest households.
Obesity leads to heart disease and diabetes, the latter which exacerbates heart disease. So where can people get good advice on diet and nutrition? Don’t try asking your doctor. He or she is not
trained in nutrition.
University of Georgia researchers believe the way health and nutrition are taught to medical students is not the best approach. Medical science focuses mostly on weight rather than a more holistic approach. Critics argue BMI and weight alone are not good measures of health More about the University of Georgia study:
Nutrition is a key determinant of health. But American physicians aren’t receiving effective training to counsel patients on the topic, according to a new paper from University of Georgia researchers.
Current medical training focuses on weight and body mass index (BMI), exacerbating anti-obesity bias and increasing the risk of eating disorders, the authors said. And it doesn’t give future doctors adequate education on how to encourage healthier eating habits.
Physicians who limit health and nutrition advice to “just lose weight” are missing much of what their patients need, according to researchers.
Medical education on nutrition should instead focus on objective measures of cardiometabolic health. Cardiometabolic health includes things like blood pressure, insulin resistance, cholesterol levels and more. And it is a much stronger predictor of overall health.
Previous research demonstrated that almost half of Americans deemed overweight by BMI standards are actually metabolically healthy. About one in three whose BMI is in the “healthy” range are actually unhealthy when assessed by more comprehensive measures.
Researchers at the University of Georgia claim that because weight by itself is not an indicator of health status doctors should focus on teaching their patients healthier lifestyles.
Reframing the conversations between doctor and patient to focus on healthful behaviors, such as moving more and avoiding labeling foods as inherently “good” or “bad,” can go a long way in encouraging individuals to move toward health.
Those negative interactions where health concerns are dismissed with a simple “just lose weight” demoralizes patients and can make them less likely to share problems going forward. Shaming patients for their weight can sour patients on the health care system in general, prompting them to stop seeking medical care even when they really need it, the researchers said.
The University of Georgia researchers are ignoring the elephant in the room. During a 10- or 15-minute office visit physicians have little time to discuss eating healthy and beneficial lifestyle behaviors. Another problem that appears lost on these researchers is that primary care physicians do not have any extra time for patient education. One could argue patient education is a poor use of physicians’ time. Furthermore, is there so little information on diet that doctors need to spend more time studying nutrition?
Should doctors coddle patients and tell them to eat fruits and vegetables when they clearly are 100 pounds above their ideal weight? Is it fat shaming to explain excess weight can lead to hypertension, diabetes, and other problems? Or maybe we should admit doctors are not lifestyle coaches and another counselor is needed.
Which nutrition doctrine should the doctors push? It seems that nutrition experts are like economists– you can always find one who holds any imaginable point of view.