Blog | Friday, July 15, 2011

QD: News Every Day---The latest bad news on obesity

A report released recently by the Robert Wood Johnson Foundation and the Trust for America's Health issued some grim warnings about the current and future state of the U.S.'s obesity epidemic.

Bluntly titled "F is for fat: How obesity threatens America's future 2011," the report found that obesity rates rose in 16 states since 2010 and that more than 30% of people are obese in 12 states, compared with one state just four years ago. The South is still the worst-faring region---nine out of 10 states with the highest obesity rates are located there.

The report compared today's data with data from 20 years ago, when no state's obesity rate exceeded 15%. Now, only one state---Colorado---has a rate below 20%. The report also points out that despite the increased attention paid to obesity by government (not to mention the media), no states posted a decrease in rates over the past year. Diabetes and hypertension rates have also risen sharply over the past two decades, the report said.

Recommendations to address the problem include preserving and in some cases restoring federal funding for obesity prevention and implementing legislation to improve nutrition in schools, among others.

Meanwhile, two researchers are making headlines for proposing a more extreme solution: removing dangerously obese children from their parents' custody. In the most recent Journal of the American Medical Association, Lindsey Murtagh, JD, MPH, and David S. Ludwig, MD, PhD, from the Harvard School of Public Health and the Optimal Weight for Life Program at Children’s Hospital in Boston, respectively, wrote that state intervention, including such options as counseling and financial assistance, could be the "only realistic way" to help children with life-threatening obesity. But in cases where support services aren't enough, they wrote, foster care and bariatric surgery may be the only remaining options. Although the former can be painful for the child and his or her family, it doesn't carry the physical risks of bariatric surgery. "Family reunification can occur when conditions warrant, whereas the most common bariatric procedure. . . is generally irreversible," they said.

The writers make clear that such a step should be considered only in the most severe cases---but that they suggest it at all seems to be yet another indication of just how bad the problem is, and how much worse things could get.

An article in ACP Internist's July/August issue discusses tips on talking to patients about obesity.