Meadville Tribune

July 17, 2012

Is our obesity problem a biohazard?

By Rosanne Rust
CNHI

MEADVILLE — According to a new study published in the U.K. (BMC Public Health), the level of national fatness is what should be taken into account when planning how to deal with increases in food demands. Data from the United Nations and World Health Organization estimates that the adult human population in 2005 weighed about 287 million tons (15 million tons of which is due to overweight, and 3.5 million tons due to obesity).

Crunching the numbers in this manner is quite interesting. Asia, for example, has 61 percent of the world’s population, but only 13 percent of its biomass. North America, however, has only 6 percent of the world population but accounts for 34 percent of its biomass due to overweight and obesity.

One ton of human biomass corresponds to about 12 adults in North America but 17 adults in Asia. These researchers note that if all countries had the same average body mass index (BMI) as the United States, the total human body mass would increase by 58 million tons. This is equivalent to an additional 935 million people!

It’s challenging enough to grasp the public health issues of obesity in our own country, let alone the mark it makes on world population and health. You have to come to your own decisions about being overweight or obese. Whatever may motivate you to lose weight — it’s easy for me or your doctor to say: Lose weight. But finding the tools and support to do so is a challenge, and I know from years of counseling patients that many do need individual support — at least to get started on a new path to wellness.

There is no question that comprehensive programs, led by registered dietitians, work, but the number of appropriate weight-loss programs or counseling availability (and insurance reimbursement for these services) is limited.

A recent recommendation by the United States Preventive Services Task Force stated that physicians should be screening every patient in his or her office for obesity (that is, measuring and recording BMI). Identifying the patients is doable, however, the task force recommends that all obese patients be referred to appropriate weight-loss programs — whether one-on-one counseling with a registered dietitian, or in a group weight-loss program setting.

Ideally, the task force recommends that patients be involved in comprehensive programs (those that include 12 to 26 sessions) that include both group and individual counseling sessions. But where are these programs?

The absurdity here is that while this task force made these recommendations, the Center for Medicare and Medicaid Services recently passed a bill excluding registered dietitians from billing for obesity, allowing only physicians to bill for intensive obesity therapy services. (I’d wager that most physicians do not have the time nor interest in providing intensive obesity therapy.)

So how are we to deliver “comprehensive” obesity treatment to those who need it?

Until there is better coverage for such services, I guess you’re on your own. Do speak to your physician about the programs offered locally. Read books, subscribe to magazines or free e-newsletters, or sign up for my Balance Program online at rosannerust.com.



IT’S YOUR TURN

Start today with these five easy steps:

- Eat a healthy breakfast (see examples in other sidebar story) — part carbohydrate, part protein.

- Skip snacks unless you are truly hungry, then choose a snack that includes some fiber and protein in about a 100- to 200-calorie portion (such as a few nuts and an apple).

- Keep a food and exercise journal — set new goals to move more in daily living.

- Include a fruit and/or vegetable at lunch.

- Eat less bread at dinner, and more vegetables. Grill veggies in summer for excellent flavors and easy side-dishes



HEALTHY BREAKFAST IDEAS

n 1 cup oatmeal with 3 to 4 spoons of fresh raspberries or blueberries, 1 tablespoon chopped pecans or walnuts 1 teaspoon of sugar, honey or maple syrup.

- One whole wheat English Muffin with 1/2 ounce cheese, banana.

- 1 cup shredded wheat-type cereal with 4 to 8 ounces 1 percent milk, fresh fruit.

- One egg, two slices whole grain toast with 2 teaspoons margarine or butter spread, fresh fruit (such as sliced cantaloupe or kiwifruit).

- Scrambled egg wrap: one to two scrambled eggs placed into small wrap (100-calorie, such as Flat-Out), add salsa and 2 tablespoons cheese; 8 ounces 1 percent milk.



Rust is a licensed, registered dietitian, nutrition communications consultant, and author. She’s co-authored several books in the “For Dummies” series including “Calorie Counter Journal For Dummies.” Visit rustnutrition.com.