Featured at the 2021 ACOG Annual Clinical and Scientific Meeting, here’s what we know about the obesity epidemic and what we can be doing to stop it.
Presented by Dr. Sarah White, Maternal-Fetal Medicine Fellow in the Department of Obstetrics and Gynecology at the Wake Forest School of Medicine, the session led us through the different factors that play a role in obesity, including dietary changes, work, social responsibility, food swamps, recreation, and processed foods. These complex factors have led to an increase in obesity and morbidity throughout the country.
Here’s a look at those factors:
- Work & Recreation: As of 2010, according to the U.S. Bureau of Labor Statistics, manual labor makes up 10 percent of the workforce, and while many Americans believe they’re getting the recommended amount of exercise, research has shown that only 5 percent meet that requirement. Physical activity has a clear association with reducing obesity.
- Dietary Changes & Processed Food: Increased caloric consumption, sugared beverages, and dietary changes can all lead to an increase in obesity and diabetes. Over the past fifty years, an increase in products with corn sweeteners and ultra-processed foods have played a role in the obesity epidemic.
- Food Swamps: Food deserts refer to areas around the country with limited access to healthy food options, often related to socioeconomic status. Food swamps, on the other hand, have a high density of fast food and convenience store retail, and they’re more predictive of obesity than food deserts are.
- Social Responsibility: Nearly half of America’s overweight patients do not realize they’re overweight. The role of social networks and socioeconomic status play a role in a patient’s risk of obesity.
Confronting the Epidemic One Step at a Time
Dr. White recommends a few different strategies clinicians can implement to help encourage a healthy lifestyle, reduce the risk of diabetes or other co-morbid conditions, and propose means of expansion to provide improved care for female patients with obesity.
- Counseling: According to Dr. White, we should be counseling from adolescence. Talk to patients about their diet, caloric intake, and activity; counsel them on the risks of obesity in pregnancy; and help develop goals to meet to reduce the risk of obesity. Counseling plays a significant role in reducing the risk of obesity, and currently, patients are often given little to no information on obesity. Code G0447 allows for a 15-minute session to counsel patients on weight loss and obesity.
- Target Different Metrics: Metrics other than BMI are critical to assessing a patient’s risk of obesity. BMI does not take into consideration levels of activity or health conditions, and waist circumference or hip to waist ration can be a better measure of obesity.
- Different Interventions: Taking a tailored approach to weight management can help reduce the risk of obesity in female patients. Optimizing mobile health platforms such as Noom and MyFitnessPal and offering health and wellness coaching have also been shown to improve health outcomes and reduce the risk of obesity.
- Improved Civic Response: Several national programs, such as SNAP and the Let’s Move program, can be helpful in reducing the risk of obesity. Studies show that increasing coverage for obesity has been extremely beneficial.
Obesity is complex, and there’s no way of knowing if our approach to treating our patients is correct. As clinical trials continue and new research is released, we can continue shifting our way of thinking and find improved ways to reduce the risk of diabetes and obesity in our female patients.
But according to Dr. White, what we’re currently doing is not working, and an entire paradigm shift is needed in order to make any progress in ending the obesity epidemic.
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