When Life Happens

The other day while seeing a patient our discussion focused on how life can take many turns and that just when we think we have things figured out suddenly there is a changing life event that changes everything. Sometimes I think life just gets in the way because learning to put change into perspective and learning to deal with ups and downs can be difficult even if the change could be a positive thing. Life happens to all of us and actually most of the time it is good, but too often it can be a little rocky and difficult to navigate.

For the past 30 years I have worked as a nurse educator for those suffering with the disease of obesity who have chosen to have surgery. As strange as it seems it has only been just recently that I believe I finally know what I am doing in this business. Perhaps it is that my focus has been revolving too much around the surgical aspect of obesity all of these years. I love working with our patients and do feel I have listened to their concerns but perhaps I have not responded to their needs adequately. I have seen the good and bad of life happen to most of them. What I haven’t done is to see how life-events have correlated with their ups and downs, not only emotionally but also physically in regards to their weight loss and or weight regain as well as their overall health status. Now I get it. Now I have to really listen and I have to see that the professionals who are more knowledgeable than I am will be working closely with me so that we might get the ‘real picture’ and the patients receive the real help they need for a healthy life long recovery. I must learn more about the disease.

Because of this recent revelation I decided to look into the disease of obesity in regards to current statistics and in particular has there been an increase in the disease. I first went to the Centers of Disease Control (CDC) to find out if obesity is still increasing. The title of the report read: “Obesity is common, serious and costly”

The actual report indicated:

  • More than one-third (34.9% or 78.6 million) of U.S. adults are obese.

  • Non-Hispanic blacks have the highest age-adjusted rates of obesity (47.8%) followed by Hispanics (42.5%), non-Hispanic whites (32.6%), and non-Hispanic Asians (10.8%)

  • Obesity is higher among middle age adults, 40-59 years old (39.5%) than among younger adults, age 20-39 (30.3%) or adults over 60 or above (35.4%) adults.

  • The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight.

To see how various states are affected by the disease it is actually interesting to go to the prevalence of obesity maps at: cdc.gov/obesity/data/prevalence-maps.html

In my investigation process I had to once again review the health consequences of obesity. To name just a few they are: hypertension (high blood pressure) ,osteoarthritis (a degeneration of cartilage and its underlying bone within a joint) ,Dyslipidemia (for example, high total cholesterol or high levels of triglycerides), Type 2 diabetes, coronary heart disease, stroke, gallbladder disease, sleep apnea and respiratory problems and some cancers (endometrial, breast, and colon). These are just a few, there are many more physical, emotional and economical consequences of the disease that are too long to mention here. All of the above makes the disease of obesity as the CDC stated, common, serious and costly.

After reviewing the most recent statistics and health issues I realize what we knew 30 years ago and still know today is that we are talking about a disease which involves all ages as well as people from all socio-economic walks of life. Obesity takes a toll on our society in many ways to include but not limited to, employment, the medical industry, the insurance industry but most important, human life. To decrease the current high statistics regarding percentage of obesity in this country we must all take a stand. Catherine Hambley, Ph.D., a psychologist who I have known to counsel candidates before and after weight loss surgery states, “Obesity is not merely the result of a psychological problem, nor is it simply the manifestation of an eating disorder. Like so many diseases in America today, it calls for a multifaceted approach to understanding the condition, including but not limited to social status, heredity, financial situation, emotional stability, activity level, and even time.”

In April, 2014 Patrick Luciani wrote an article for the Globe titled, ‘Don’t expect government to win the war on obesity’. He explains, “We discovered pretty quickly (in their research) that obesity was far more complex than we had imagined, the cause and effect more tangled. We started with the notion that the causes were simple: consume too many calories and you’re bound to get fat.” They found out the cause was not simple. “In other words, external factors are the main drivers of obesity. Here is a partial list: genetics, changing sleep patterns, air-conditioning, heated homes, chemicals in the atmosphere, viruses, processed foods, junk foods, food deserts, capitalism, the design of our cities, the automobile, food technology, depression, stress, less exercise in and out of schools, computer games, sugary drinks, the friends we keep, declining cost of calories, too many carbohydrates, food addictions, poverty, race, gender, corporate manipulation of our taste buds, microwave ovens, lost cooking skills and now some say an over-use of antibiotics.”

Are we fighting a losing battle? We may be winning a few small battles but overall losing the war against the disease. The weight loss methods being done by the hundreds/thousands of diets, diet pills and bariatric surgeries seem to only slightly be diminishing the disease rather than resolving it. Perhaps we are not focusing enough on the external factors that are the main drivers of obesity?

For the number of years I have been in the field of bariatric surgery I often wonder if we will ever win the war. If we even think we can it will require all medical professionals, multidisciplinary teams, even business professionals and lay people alike, working diligently together to overcome the overwhelming odds we face. It will take all of us to come to the revelation that we finally get it. For those living with the disease of obesity life can take many unfair turns but how do we turn this around? For those suffering with the disease life is not happening. We have to seriously look into what is really happening to their lives and understand how it radiates out to all of society. Perhaps we might then realize the statistics are changing in favor of a healthier country.

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