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Obesity

Health Attitude Book CoverOne of the topics in Health Attitude is obesity, a chronic condition which has become a pandemic. In 2013 at the annual meeting of the American Medical Association, physicians voted overwhelmingly to categorize obesity as “a disease that requires a range of interventions to advance treatment and prevention”. In the United States, 36.5% of adults are obese. Morbid obesity is a condition of weighing double or more a person’s ideal weight. It is called morbidly obese because it correlates with numerous serious and life-threatening conditions. Obesity is a significant inhibitor to America’s positive growth and development. Three percent of the population are considered morbidly obese, but the treatment of the condition and related healthcare costs represent 21% of healthcare spending. Obesity is a serious problem beyond the condition itself.

Obesity causes serious related diseases including diabetes, cancer, sleep apnea, osteoarthritis, and cardiovascular disease, including myocardial infarction (heart attack). The quality of life for an obese person is reduced significantly. Unfortunately, there is no simple procedure or medication to eliminate the negative conditions. There are three main approaches to managing obesity; lifestyle modification, pharmacological treatment, and bariatric surgery. Each has significant economic and ethical implications. The most effective treatment for obesity is a combination of behavior modification and bariatric surgery. However, a new study suggests that the surgical route is often better.

The causes of obesity are complex and include socioeconomic factors such as household income, median earned income, employment, poverty status, and welfare participation. These factors influence lifestyle changes through clinics, counseling, and home healthcare. A bariatric surgeon told me the surgery is just one small encounter with a lifelong obese patient. She said patients understand they have to change their lifestyle or surgery won’t solve the problem, but often they do not make the required changes. She went on to tell me bariatric surgery could help people achieve an improved level of health.

The impact of obesity is extraordinary and growing. Fortunately, research is advancing on multiple fronts. Diabetes has traditionally been classified as Type 1 or 2. New research is showing it is not so simple. There are at least four types. The World Community Grid is busy sequencing the genes of the microbiome (our gut). This could be quite revealing and may show some people gain weight not just because they eat too much but because of how their gut handles the digestion. New research in Singapore has shown promise in laboratory trials. A new type of skin patch contains hundreds of micro-needles, each thinner than a human hair. The needles are coated with the drugs which are known to turn energy-storing white fat into energy-burning brown fat. The trials on mice show  reduced weight gain on a high fat diet and reduced fat mass by more than 30 per cent over four weeks.