Spring 2005

The Skinny on Obesity

One third of the people in the United States are overweight; one third are obese. The other third—those in the healthy range—are at risk because of two overriding factors: we eat more and we exercise less.

Overweight and obese people have increased risk for Type 2 diabetes, heart disease, hypertension, stroke, high blood cholesterol, gallbladder disease, cancer and osteoarthritis.

Strive for five servings a day of fruits and vegetables.

Bill West, director of the AAMC Wellness Program said, “We live in an world that praises labor saving efforts and lures us with an over-abundance of food, much of which is full with fat and calories. As a result, we eat more calories and burn fewer of them.” He pointed to figures in a Wellness Council of America (WELCOA) report that showed the trend in reduction of labor over the last 125 years. According to the report, in 1880, it took 20 man hours to harvest an acre of wheat. By 1916, it was reduced to 12.7 hours. In 1936, it was 6.1 hours, and today it can be done in a matter of minutes.

Not that many of us are harvesting wheat these days, but the philosophy is the same. Instead of climbing stairs, we use elevators, escalators and moving sidewalks. Rather than walk to school, we drive or take the bus (while often downing a quick and un-nutritious breakfast). And we sit in front of computer monitors all day and in front of the TVs all night. Is it any wonder the bathroom scales are reaching numbers we never expected to see?

The Food and Drug Administration (FDA) published a report last year that showed 15 percent of children and adolescents are overweight, almost double the rate of 20 years ago. Obesity is a contributing factor in an estimated 300,000 deaths a year. And the total economic cost of obesity in the United States is about $117 billion per year, including more than $50 billion in avoidable medical costs, more than 5 percent of total annual healthcare expenditures.

AAMC Dietitian Ann Caldwell says keeping a healthy weight is not complicated: “Just ask yourself this question: ‘How many calories are going in and how many are going out?’” said Ms. Caldwell. “What is difficult is trying to lose weight given the environment we live in, but it can be done as long as you’re willing to make lifestyle changes.”

She said that behavior modification is the key to managing your weight. And you must be patient. Losing more than two pounds a week is not effective. Diets that profess quick weight loss should be avoided. “The two components to a good weight management program are making sound nutritional choices and starting an exercise program,” she said.

Exercising with friends is better than doing it alone.

The Wellness Program has a variety of classes that address healthy weight loss. Ms. Caldwell and dietitian Maureen Shackelford also do individual nutrition counseling to set up a program that is geared to your specific needs.

One of Ms. Shackelford’s patients, Sue Ellen Sherblom, says she has “moved up and down the scale since I knew what one was.” But at 266 lbs., she got desperate. She said, “I was thinking about bariatric surgery. My doctor was supportive, but said even though I would lose weight quickly, I still wouldn’t be in control. She said I needed to learn how to eat before I attempted the surgery. She sent me to Maureen Shackelford at the hospital who has taught me that I’m not dieting, but I’m making a lifetime commitment to managing my weight.”

Since May 19, Ms. Sherblom has lost 40 lbs. She’s on what she calls “maintenance” right now. “I could never maintain the weight I lost previously, and I want to make sure I’m in control before I start losing more,” she said. “I don’t see Maureen as often as I did initially. I’m lengthening my leash and seeing if I can do it alone.”

Ms. Sherblom says she’s learned a lot, but most of all she feels freedom because she believes she is in control. “I’m exercising, too. My blood pressure is down and I’m off the medication.”

Her advice to others trying to manage their weight: “Don't give up on yourself. Get help from everyone who is out there. If I can do it, so can you.”

• See The Difference Between Overweight and Obese and more about diet and obesity

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