Tuesday, February 24, 2009

The Obesity Epidemic

There are some days when I am really taken aback by the number of our pharmacy customers who are seriously, morbidly overweight. They are young and old, male and female alike. I have to wonder what it's like for them at their doctor visits --- is the doctor laying it on the line? --as in saying, "Most of your health problems and the majority of your prescriptions could be eliminated if you JUST LOST WEIGHT." I know it's easier said than done, and doctors probably repeat it over and over (perhaps at some point they have to give up), but it is so true.

You look at the meds these people are on. A serious weight loss (and for some, we are talking 80-100 pounds that needs to go) would mean they could probably cut back or eliminate meds for blood pressure, blood sugar, joint pain, depression, breathing & wheezing, fungal skin conditions and many more. Next to quitting smoking, weight loss has to be the #1 best thing you can do for your overall state of health (that you have control over.) It seems so simple, but of course it isn't....

Most of us would love to drop 5-10 pounds anytime, but the folks I'm talking about are way past that. And you know the sad part is that exercise is out of the question -- they can barely MOVE. Where the heck do you go from there, other than into surgery? Way easier to just not let it get to that point. This kind of weight gain doesn't happen overnight and you wish these people would have looked in the mirror honestly a few years ago and said, I gotta change this.
It is a uniquely American predicament. I've been lucky enough to travel to some other parts of the world and I am struck by the fact that looking around you, you just don't see the fat like you do here.


Anonymous said...

We try to avoid going to the doctor. Sometimes, we feel so bad, we go to the Urgent Care to get something so the pain stops a little while.

Anonymous said...

It's like this. Yesterday, the son of a man that just died, came up to me as a pharmacist, and asked me a pharmacy-related question. I spoke to him at length, because I didn't feel like engaging him in a conversation related to the fact that his father passed so quickly. He asked me if he should take another Micardis dose, as he mentioned to an attentive nurse that he felt his BP was increasing, so she took several readings over 30 min. and it was elevated. He mentioned that he'd taken a job-related physical the other day and the nurse there told him to relax in another room as his BP was elevated and it came down, but he had not made the visit to his physician, yet. He was under the impression that SPB 136 - 140 over and DBP 88 - 96 was okay, not too bad, not too high. I said, well, your body is doing everything it can to get it to where it is with the help of your current prescription, and in order to avoid the deleterious effects of high blood pressure, you need to get it lower--normally, a person cannot tell if their BP is high, unless it's really high and they get a headache or eye vessels rupture.
I guess obesity is like that. Some of us 'live on the edge' just eating too much for our body habitus, and keeping our 'shape' shapely by excessive occasional exercise. Then one day, we break an ankle, suffer an asthmatic bronchitis attack, get pregnant, or contract an illness that decreases activity levels so that we can't perform our usual exercise routine and weight seems to pile on, muscle strength is lost, and there we are, definitely obese. We might find that DM2 kicks in with exposure to corticosteroids, incipient other illnesses and unhealthful conditions, and it's simply more difficult to lose the accumulated weight of expanded fat cells. Why is it suddenly an 'epidemic'? I don't know, but certainly I remember participating in very active sports in high school, biking everywhere as young adult, being able to hike or go outside for exercise almost daily and every weekend with young children, etc. (If there was more mass transit, I'd be running to catch buses, or didn't live in the city and work all the time at a job sitting or standing in front of a computer all day...or, not be confined to only one bathroom break in 12+ hrs...or, maybe it's like the BP education...'obesity = either lack of exercise or too much caloric food' hasn't sunk in, because I hadn't had to consider implications of carrying too much weight before...

mae said...

The UK has a similar problem - 1 in 4 adults is obese.

Loosing weight is hard, and the more you have to loose, the harder it is, and the more overwhelmingly difficult it appears.

If someone needs to loose 100lb and healthy dieting will allow a steady weightloss of 1lb per week, then they would have to be on a diet for two years to loose the weight.

And that doesn't begin to address why they weigh so much in the first place. Major, permanent changes of lifestyle are required for these people, and the changes are ones they do not want to make.

I'm coming from the perspective of someone who has lost 165lb over 18 months due to illness. I would not have lost this weight on my own.

Anonymous said...

If I have the chance I will always remind patients of fat children, that helping/making their child lose weight and make healthy dietary decisions early in life will help them greatly later in life.

Fat parents feeding their kids more and more fast food.

Lard intake cessation and tobacco cessation. I don't attack patients but I offer advice and resources if they feel they are at a point where they want to make a change in their life.

Apple said...

I was always a thin person until my thyroid stopped functioning. I packed on a good 50 pounds in less than a year as a result. I'm struggling to lose it, and it's harder than I thought. We can't seem to get the T3 and T4 levels to where they need to be. I went from running 4 miles a day to slugging around. It's awful. And people judge the hell out of you when you're heavy. I actually feel embarrassed to be in public now, as a sluggish form of what I used to be. I would give anything to have the energy back to exercise. :) But we do have a true problem here in this country. It's so unfortunate.

Phathead said...

Due to school and work I don't eat and work out like I used to. I used to run several miles a week, drink lots of water, lift weights and the like. Now I find myself running for the Mt Dew just to keep me awake. I look for something quick to eat between classes when I have a little time.

The thing is if I have days where I know I'm going to be eating fast food and such I do it in moderation. I don't go to BK three times a day and drink 10 bottles of Mt Dew. If I do stop at BK, I'll have just a sandwich for dinner. I alot myself one bottle of regular soda a day, two if I'm quite exhausted and need the boost.

Am I at the fitness I want to be? Of course not, but I'm trying to not overdo things as much as I can.

I think a lot could be learned from simple moderation. If you can't survive eating salads every day and must have a burger or something fine. Just don't do it for three meals a day. If you like fast food, maybe eat there just once or twice a week instead of seven or more.

If I forget a lunch for work and everyone is order junk food, I choose simply not to eat. It sucks and is hard to fight it sometimes, and I don't always succeed, but it works.

Moderation is the key, but it is something our society cannot fathom. Look at how we spend money. We dare not have a job that make us the least bit uncomfortable. It always has to be what we what, when we want. And you cannot live your life like that.