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Treating Obesity as a Disease

Treating Obesity as a Disease

According to new guidelines released by the American Heart Association, American College of Cardiology and The Obesity Society in November 2013, doctors should consider obesity a disease and more actively treat obese patients for weight loss. The guidelines reflect the latest information that scientists have about weight loss to prevent heart disease and stroke, the nation’s No. 1 and No. 5 killers.

“The subsequent health problems of obesity and the risk factors in a person’s family history passed down through the generations have become increasingly more of a burden. That’s the siren sound we can no longer ignore,” said Gordon Tomaselli, M.D., past president of the American Heart Association and co-chair of the subcommittee that guided the completion of the guidelines. Tomaselli is chief of cardiology at Johns Hopkins University School of Medicine in Baltimore.
Included in the new guideline is a first-of-its-kind roadmap to help patients lose weight and keep it off.
Healthcare providers must find out who would benefit from weight loss by calculating at least once a year each of their patient’s body mass index (BMI), which is an indicator of obesity based on height and weight. Patients with a BMI of 30 or higher are considered obese and need treatment. In the U.S., nearly 78 million adults are obese. BMI in children is measured using a children’s BMI calculator from the CDC.

Patients would then participate in a medically supervised weight loss program two or three times a month for at least six months. “Telling patients they need to lose weight is not enough. We want healthcare providers to own the problem. Just like they own the problem of glycemic control in a patient with diabetes, they need to own the problem of weight management,” said Donna Ryan, M.D., co-chair of the committee that wrote the guidelines and professor emeritus at Louisiana State University’s Pennington Biomedical Research Center in Baton Rouge.

Physicians also should consider weight-loss surgery for severely obese patients who have one or more obesity-related health problem, such as diabetes, sleep apnea or high blood pressure. In the past, doctors waited until patients were struggling with two such issues. The guidelines do not endorse any one weight loss surgery. Rather, the choice of procedure should be based on the person’s age, severity of obesity, the risk of complications and other factors. In the U.S., about 200,000 adults have bariatric surgery each year. Learn more about extreme obesity.
The best strategy to lose weight and keep it off requires a three-pronged approach:

Eat fewer calories than your body needs,
Exercise more and
Change unhealthy behaviors.

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