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5 Things to Know About Obesity in the United States

Jaime Rosenberg
As the country continues to grapple with best practices for combating the high prevalence of obesity, here are 5 things to know.
Both short-term and long-term effects of obesity, such as type 2 diabetes and various types of cancer, are well-documented. However, more than  35% of men and 40% of women in the United States are obese. As the country continues to grapple with best practices for combatting the high prevalence, here are 5 things to know:

1. Obesity rates are on the rise

According to 2017 CDC data, 7 states have obesity rates of at least 35%, up from 0 states in 2012, and all states have more than 20% of adults with obesity. The 7 states with obesity rates of at least 35% are Arkansas, Alabama, Iowa, Louisiana, Mississippi, Oklahoma, and West Virginia.

Colorado and Hawaii are joined by Washington, DC, as the only places with rates under 25% The south (32.4%) and midwest (32.3%) had the highest prevalence of obesity, followed by the northeast (27.7%) and the west (26.1%). As levels of education increase, rates of obesity decrease.

2. USPSTF recommends intensive behavioral interventions

The US Preventive Services Task Force (USPSTF) has updated its recommendation on screening for obesity in adults, recommending intensive, multicomponent behavioral interventions for obesity.

According to USPSTF, they have found adequate evidence that these behavioral interventions in adults with obesity can lead to clinically significant improvements in weight and incidence of type 2 diabetes. Most behavioral interventions encourage self-monitoring of weight and provide tools to support weight loss or weight loss maintenance through dietary changes and increased physical activity.

3. Patient engagement in addressing obesity falls short

The latest New England Journal of Medicine Insights Council Survey on addressing obesity revealed that although providers consider obesity an epidemic and include it as a high priority for their organizations, patient engagement is insufficient.

Among the 700 providers who responded to the survey, 90% believe that patients hold primary responsibility for addressing obesity, yet 44% indicate that their patients with obesity are not engaged in addressing their weight. Respondents reported that the biggest barriers to engaging patients in treatment are difficulty of sustained weight loss, as well as lack of patient perception of obesity as a problem or health issue. The most common approaches to treating these patients include referrals to nutritional counselors, individual counseling, and bariatric surgery.

4. Physician education is also lacking

Only 5 fellowship programs in obesity medicine exist today, even though 50 are needed. To address this gap, Novo Nordisk is working with the Obesity Society and the Obesity Medicine Association to launch the Obesity Medicine Fellowship Development Program, which will eventually increase the number of fellowship programs in the country to 20.

In an interview with The American Journal of Managed Care®, Caroline M. Apovian, MS, president of the Obesity Society and a professor at Boston University, explained that traditional physician education relies on addressing complications arising from obesity, rather than obesity itself. To evolve the standard of care, educating young physicians on interpersonal skills and nonjudgmental communication, patient care focused on eliciting an obesity-focused medical history, and personalized obesity management plans, among other things, is needed.

5. Interventions for childhood obesity

September marks National Childhood Obesity Month, and as 1 in 5 school age children has obesity, strategies for reducing rates of childhood obesity have popped up around the nation, targeting both the home and public forums.

Researchers at the University of Alabama at Birmingham are assessing whether simple targeted interventions, focused on forming good habits within home, can successfully reduce the number of children who are overweight and obese. The effort will implement a federally funded home visitation program where underserved mothers will be taught healthy habits in their home, such as putting more fruits and vegetables into a diet and weighing each day.

In California, efforts are being taken outside of the home. Starting in 2019, the default beverages for restaurants that sell special meals for children will be milk or water. Sodas and sugary drinks will be available only be request.

 
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