Obesity

Physicians writing on KevinMD about obesity: whether it is a disease, what the GLP-1 drugs from Ozempic to oral Wegovy have changed, what happens when patients stop them, who should take them and who pays, teenagers, compounded versions, bariatric surgery, and the stigma patients describe in the exam room. One maintained record draws on this archive: GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words.

The quality and quantity of calories both count

David L. Katz, MD

Conditions and Diseases

April 4, 2013

Among others, Gary Taubes has famously argued that calories don’t count. Perhaps the more nuanced version is that the quality of calories, not the quantity, is what counts. Mr. Taubes and I have discussed this, and agreed to disagree. Leaving aside Newton and laws of thermodynamics, there is the Twinkie Diet on my side: evidence that weight can be lost when calories are restricted, no matter how truly dreadful the …

Why digital health tools need to be rated

Thomas Santo, MD

Health Technology

March 23, 2013

The digital health revolution is in full swing, and there are an abundance of new mobile and web-based digital health tools that address everything from nutrition and exercise habits to disease-specific conditions and hospitalization. Consumers have embraced the new trend, and are becoming more actively involved in tracking and managing their own health.

This is an incredibly important paradigm shift on the oft-ignored side of the health care equation: the patient. …

Is Chris Christie too obese to run for president?

Jeffrey Parks, MD

Physician

March 20, 2013

chris christie

Former White House physician Connie Mariano, MD, set off a firestorm recently by stating the patently obvious fact that New Jersey governor Chris Christie ought to address his morbid obesity prior to entertaining thoughts of running for the presidency in 2016.

“It’s almost like a time bomb waiting to happen unless he addresses those issues before he runs for office,” Mariano …

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Is Chris Christie too obese to run for president?

Soft drinks and obesity: What do we want from Coca-Cola?

David L. Katz, MD

Physician

March 10, 2013

Responding to our justifiably increasing preoccupation with widespread obesity, the Coca-Cola Company has released a masterful television ad on the subject. They characterize their own efforts, and invite us all to “come together” to combat this scourge. The whole “come together” concept receives great emphasis, with evocative images from the (presumably) good old days of: “I’d like to buy the world a …

We hide behind vague words for fear of not living up to specific ones

Shara Yurkiewicz

Medical Education

March 4, 2013

“Your hands feel like velvet,” the 94-year-old woman told me as I pushed on her abdomen in the emergency department on a Friday night.

“That’s the nicest thing anyone’s said to me all day,” I told her.

“That’s pretty sad,” she said, and her abdomen quivered as she suppressed a laugh.

I walked out of the curtained room and briefly presented her findings to the resident on call. In return, he showed me …

Stop blaming patients for not doing enough to stay healthy

Bob Doherty

Physician

February 20, 2013

“Discrimination against heavy people, by the general public and medical professionals, might be a greater health and social problem than any extra pounds they may be carrying” argues UCLA Professor Abigal Saguy, PhD, in a provocative essay in the Washington Post.

“Despite the fact that body weight is largely determined by an individual’s biology, genetics and social environment, medical providers often blame patients for their weight and blame their …

My smartphone has become an ally in my weight loss program

J. Leonard Lichtenfeld, MD

Physician

February 18, 2013

Groundhog Day was on Saturday this year, and unlike the furry little beast, what I have to say each year around this time is just as good today as him looking for his shadow on Saturday.

What is all this about, you are probably asking yourself?

It is about an annual update that …

New Year’s resolution: Get healthy to improve surgical outcomes

Nina Singh-Radcliff, MD

Conditions and Diseases

January 15, 2013

Losing weight can decrease the incidence of several chronic and debilitating diseases, as well as their associated complications and risks during the surgical period. Additionally, it can facilitate recovery after surgery. Obesity increases the risk for:

Diabetes
Obstructive sleep apnea
Hypertension
Cardiovascular disease
Depression
Joint degeneration
Cancer

Additionally, obese patients may present special challenges for anesthesiologists:

Blood pressure monitoring (finding an appropriate fitting blood pressure cuff)
Locating …
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New Year’s resolution: Get healthy to improve surgical outcomes

What horses can teach us about health promotion

David L. Katz, MD

Health Policy

January 9, 2013

I think horses can teach us some things about health promotion. We invoke them routinely, although I suspect we are unaware of it much of the time.

Three of the more salient themes in modern health promotion involve incentives, disincentives, and what/how much people drink — with a particular emphasis, of course, on less soda, and more water. I hear hoofbeats in all of them.

Incentives are particularly prominent in worksite and …

The movement against obesity threatens many livelihoods

Michael Kirsch, MD

Physician

November 29, 2012

One cannot escape the issue of rising obesity rates in the United States. A current statistic predicts that by the year 2030, 42% of us will be obese. The ramifications of this ponderous eventuality could indeed weigh down and sink the nation. Some of the consequences include:

Zillions of health care dollars spent treating obesity directly.
Gazillions of health care dollars treating medical consequences of obesity.
Loss of economic productivity from a bloated …
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The movement against obesity threatens many livelihoods

Healthier menus without restrictive legislation

Sherry Pagoto, PhD

Physician

October 27, 2012

The recent New York City law restricting portion sizes of sugary beverages offered in restaurants has stirred much controversy among policy makers, scientists, the media and consumers. Opponents support the freedom of choice in selecting beverage portions and contend there is insufficient evidence that legislation will change behavior or body weight. Proponents contend that something should be done to reduce the ever-expanding receptacles in which sugar-laden beverages …

3 unexpected ways to help you lose weight

Lucy Hornstein, MD

Conditions and Diseases

October 9, 2012

After all the hullabaloo generated by my passing on the accurate but controversial information that exercise will not help you lose weight, I thought I should give equal time to the other side, and discuss several things that appear to help enhance efforts at weight loss.

Sleep

Although I’m not aware of any formal studies documenting this, I can report from personal and professional experience that the value of sufficient …

The hunger-obesity paradox: Why it’s a modern problem

Chris Rangel, MD

Health Policy

October 4, 2012

It’s a uniquely modern problem. We have the most obese impoverished population in the history of the planet and its been called the “hunger-obesity paradox.” Even the homeless are now more than likely to be overweight with over 32% being officially obese. Think about that.

Then think about every single picture you have ever seen from the Great Depression when 1 of every 4 Americans were out of work …

Medical residents need to be accountable for their own well-being

Brian J. Secemsky, MD

Medical Education

September 28, 2012

I am three months into my medical residency, and I am getting fat. Not the noticeable change-in-pant-size fat, not yet. But I am most certain that what was once muscle is now just “padding,” and I can no longer solely attribute the words “muffin top” to the anatomy of the snacks that I scrounge to stay alive during the long hours in the hospital.

I am three months into my medical …

Would you accept obesity advice from a fat doctor?

Joyce Ho, MD

Conditions and Diseases

September 7, 2012

Something that has been on my mind recently is obesity, specifically obesity in doctors. This may be because we cover obesity in a high percentage of our stories (1 in 3 Americans is obese, after all) or because I recently discovered that I gained ten pounds since moving to New York City. Either way, after watching Dr. Snyderman speak her mind on national television about how obese leaders are unfit …

Why weight loss advice may be unethical

Arya M. Sharma, MD

Physician

September 4, 2012

And issue of Newsweek quotes me as saying, “A lot of our weight-loss recommendations are unethical because we shouldn’t be saying lose weight when there is no chance people will keep it off.“

This quote appears in the context of a lengthy article by Daniel Heimpel that examines whether or not the obesity epidemic is being oversold.

While I personally do not think that the obesity epidemic is being oversold, I do …

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Why weight loss advice may be unethical

Fat cells are factories of inflammation

John Mandrola, MD

Conditions and Diseases

August 1, 2012

The headline called it “the new” science behind America’s deadliest diseases. Wall Street Journal reporter Laura Landro was talking about inflammation and its role in causing human disease.

Now, you all know my reaction when a prestigious newspaper features a founding principle of this blog. Well, let’s just say it felt awfully nice.

A brief Mandrola review of inflammation is in order.

First, acute inflammation is normal, and required for life. …

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Fat cells are factories of inflammation

When it comes to exercise, stating the obvious is really important

Claire McCarthy, MD

Conditions and Diseases

August 1, 2012

If we want to fight childhood obesity, we need to get kids moving.

Sounds incredibly obvious. And that was my reaction when I first read the study just released in the journal Pediatrics—in it, the authors said that high school students were less likely to be overweight or obese if they played at least two sports during the school year, or if they walked or biked to school. Really? Next we …

Is measuring Body Mass Index (BMI) obsolete?

James Haddad

Conditions and Diseases

July 15, 2012

I’ve been interested in health and nutrition since I started playing high school sports. During my 3 year stint as a personal trainer, I developed a distinct opinion of the Body Mass Index (or BMI – the most widely used anthropomorphic measurement in medicine): it’s not a very good tool.

My issue with BMI began here – it doesn’t actually measure a person’s body fat or lean mass, but rather is …

Health promotion needs to start in medical school

Rich Joseph

Medical Education

July 13, 2012

I recently took an exam focused on the pathophysiology and clinical risks factors of cardiovascular disease, the number one cause of morbidity and mortality in the developed world. Atherosclerosis, hypertension, and smoking were all there, front and center. Ironically enough, since it was the final exam of our first year of medical school, the instructors decided to reward us with dozens of Krispy Kreme donuts to enjoy during the exam. …

Obesity

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