American adults just keep getting fatter. Obesity has been a growing challenge for health professionals and society for almost 40 years. But according to a new study published yesterday in JAMA, we are not making any progress.
The study utilized data from the National Health and Nutrition Examination Survey (NHANES). This survey is one of oldest and most sophisticated surveys that the country utilizes. The survey divides the country up into 15 blocks and each block has one county selected. Within the county, segments of groups of households are formed. Within each group, individual households are selected. Then a computer randomly selects some, all, or none of the members. Each year approximately 5,000 people are interviewed in person by trained surveyors.
The main results from the new data analysis revealed that the prevalence of obesity (BMI ≥ 30) increased from 33.7% in 2007-2008 to 39.6% in 2015-2016. This means that the number of obese adults in American increased by 15 million in just a decade.
When I was first learning about the obesity rates in my undergraduate schooling, I remember that the statistic was that about 1 in 3 Americans are obese. Now, that number is creeping up toward 1 in 2.
Perhaps most troublingly the researchers found that this increase in obesity is a linear trend. This means that the rate of obesity is probably going to continue rising at this rate unless something changes.
The authors also found that the rate of severe obesity ((BMI ≥ 40) increased from 5.7% to 7.7%. This increase was in men and women from 20-59 years old. Again, the authors found a significant linear trend indicating that this rise in severe obesity may continue into the future.
The one somewhat better result was that youth obesity rose a small amount from 16.8% to 18.5%. There was not a linear trend to this result.
Clearly, what the healthcare industry is doing is not working. With the costs of obesity estimated to be as high as $210 billion each year in our country, we owe society a better way forward. This can start in a few ways.
If a patient is obese, start the conversation. There are many ways to go about this, but it can sound as simple as: “I want to talk about a trend I have noticed with your weight. Is this something we can discuss today?”
Some follow up questions might be:
- How do you feel about your weight?
- Are you considering/planning any weight loss now?
I have been incorporating questions like these into my practice for several years now and have seen some amazing results. I have had patients who have been desperately ready to change but haven’t felt supported to take the first step. Several have reversed symptoms of conditions such as diabetes and hypertension. One patient had a drastic reduction in arthritic pain following transitioning to a plant-based diet. Others report increased mood, improved energy, and a feeling of health. The bottom line is that we are responsible to our patients to use all the means at our disposal to help them achieve their goals.
I’m sure that we all KNOW what a problem obesity is. But clearly there is a gap between knowing and doing.
Where do we get started with doing? Here are some tips:
Motivation – It starts with understanding what motivates us. Spend some time asking yourself what your values are. For me, I want to be able to maintain a healthy weight so that I can go on adventures with my 1 year old daughter.
Start small – It can be easy to feel overwhelmed when trying to make changes in our lives. But there is some research suggesting that a single positive change in a behavior makes you two and a half times more likely to change another behavior. In light of this, what is a single change that can be made to improve your weight this next week?
Focus on the pros – The pros for losing weight or changing your diet are your why. This is what drives the decisions beneath the decisions. The more you can think about the positives of changing, the easier it will be. One question to get you thinking in this direction is: what would be some benefits of eating more plants/eating less processed food/etc?
Enlist others – who we are is primarily shaped by our social community – the people with whom we eat, play, converse, and study. None of us are ‘lone rangers.’ Because of this, it is natural that we should need the help of other to make significant changes in our lives. Just telling someone about your planned change can make you more likely to be able to stick to it.
The staggering problem of obesity will not be tackled by more research, as useful as it is. Only through actually engaging in behavior change can we begin to reverse these trends. Obviously individual behavior change is only one small component of what will need to change in order to see progress. But it is a place that all of us can start.