A Community Approach to Obesity


www.spcms.org

Spokane County Medical Society

Obesity – say the word and most of us want to ignore it… it is frustrating to deal with and we have had little success with our patients.  We cannot ignore that obesity is creating an increasing toll on our patients and the health care system. The statistics from the NHANES database paint a grim picture of the demographics of the disease. The numbers – 34% of US adults are obese, and 68% are either overweight or obese.   The cost of obesity in medically related health care costs – $150 billion dollars annually. The hidden costs of obesity are more obvious to those of us who work in the hospital and have seen the altered environment. Larger beds, more durable wheel chairs, cath tables structurally reinforced to support increased weight, and enlarged MRI scanners, all to accommodate larger individuals are now common place.

As physicians, we may believe we all have the discussion in the office regarding patients’ obesity. However, a 2006 survey revealed that only 65% of obese patients were advised by their physician to lose weight. Health care individuals playing a role in this interaction recognize a lack of skills, knowledge and practical tools to deal with obesity.  But, is the office the only battleground to attempt to wage war on this disease? As mentioned in the August Circulation article regarding cardiovascular health and obesity –  “Preventing a disorder makes more sense than treating one; this concept holds especially true for obesity”.   We also have an obligation to think about our children. A recent study from US National Longitudinal Study of Adolescents Health found that obese adolescents were 16 times more likely to develop severe obesity than normal weight or overweight adolescents.

How do we as physicians respond to the crisis?  There are two settings to deal with the problem. One is the office, in face-to-face contact with the patients. It is challenging and as an article in Circulation, August 8, 2011 points out in a review of the critical elements to improve success.  The other setting is the public arena, which warrants a change in the culture. This is a bold concept, but it has potential for the largest impact.  There is evidence through the CDC that population based approaches to weight loss and improved medical outcomes have been cost effective.

Oklahoma City launched such a campaign several years ago when the Mayor challenged the city (ranked the fattest in the nation) to lose a million pounds. To date they are almost there at nearly 950,000 pounds lost and more than a million miles of movement logged on the campaign’s website. Recognizing this success, a core group of individuals representing organizations vested in the health care of Spokane, worked together to develop an organization, Step UP Spokane, committed to address this issue.

Step UP’s mission is to promote healthy lifestyles by encouraging people to engage in daily physical activity and healthy eating with a web based resource. The Step UP website, stepupspokane.org, has engaging physical activity trackers, helpful health information, healthy recipes, a local activities calendar, an active social networking element, and more. There is no shortage of web based activity trackers and programs. The ones that are successful in helping people change behavior have something more. They provide a sense of community, a place for people to connect with other local people, and are supported by organizations with proven track records of caring for their communities. Step UP provides all the above!

Launched October 2010, there have been a number of successes during the first year. There are more than 1,900 people registered on the web site, many of whom have completed exercise challenges. Step UP Spokane served as the web site for Bloomsday training tools for 2011 and will again in 2012.  We are part of a WSU study to compare the success of internet based exercise training vs. the latter plus coach based training. Future developments will include group/team exercise and nutrition challenges that can be used by corporations or individuals and cooperative efforts with local restaurants to develop menus with tasty items that are healthy and have fewer calories.

Step UP Spokane is a community based effort to forge an initiative to improve community health. The Surgeon General, Dr. Regina Benjamin in January 2010 stated, “Our nation is at a crossroads. Today’s epidemic of overweight and obesity threatens the historic progress we have made in increasing America’s quality and years of healthy life. The future is unacceptable. I ask you to join me in combating this crisis.”  We ask you to join in Spokane’s effort to combat this crisis. You don’t need to be a large company to help out. Our hope is individuals will also see Step UP as a worthwhile non-profit to support. We are seeking financial support to cover the costs of additional program development. These donations are tax deductible through the Spokane Area Business Foundation of GSI.  For more information, please contact the Step UP Director, Julie Humphreys at julie@stepupspokane.org.

Hal Goldberg, M.D.
Julie Humphreys, Director Step Up Spokane

Thank you to our generous 2012 “building momentum” and “making it happen” sponsors; Premera Blue Cross, Family Home Care, Inland Northwest Health Services, Spokane Cardiology, Spokane County Medical Society, Spokane Regional Health District, Providence Health Care, and YMCA of the Inland Northwest.

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