Medical Providers Aren’t Learning About Obesity



When discussing weight, there’s a disconnection between the dieter and healthcare provider. Many providers find it difficult to even broach the subject, despite the escalating rise in the disease its related chronic conditions. It would seem that the importance of obesity education is more important than ever. However, the lack of obesity education in medical training is alarming.

According to a recent study conducted by Northwestern Medicine, licensing exams for medical students have a “surprisingly low” amount of questions in regards to obesity prevention and treatment. Why is this problematic?

“It’s a trickle-down effect,” said lead study author Dr. Robert Kushner. “If it’s not being tested, it won’t be taught as robustly as it should be.” Putting a finer point on it, “The inadequate testing means medical schools have less incentive to provide obesity education in their curriculum, and students have less incentive to learn about it.”

So what’s being done to remedy the situation? For starters, the National Board of Medical Examiners (NMBE) requested that a panel — the same panel of six obesity medicine specialists that reviewed test items from several United States Medical Licensing Examinations to perform the study — identified which topics weren’t adequately covered on the exams in relation to obesity. The panel also suggested that development committees consisting of obesity experts be established in order to begin adding obesity-related elements these exams.

However, something does need to be done in the intermediate. Updates to these exams will benefit future healthcare providers and their patients, but obesity is an intensifying epidemic that needs more immediate, contemporary solutions. As a provider, if treating obesity isn’t or wasn’t one of your primary objectives, maybe it’s time to change that.

Source: Northwestern University


Blog written by Marcus Miller/Robard Corporation

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How You Can Treat Arthritis – By Not Treating Arthritis



For every pound of excess weight, four pounds of extra pressure are put on the knees. Needless to say, overweight and obese people are at much higher risk of developing arthritis. In fact, an obese person has a 60 percent greater risk of getting arthritis than people who maintain a healthy body weight.

One in five Americans has been diagnosed with arthritis, but according to the Centers for Disease Control and Prevention (CDC), that number jumps to more than one in three among obese people — and two out of three Americans are either overweight or obese.

“Weight plays an important role in joint stress, so when people are very overweight, it puts stress on their joints, especially their weight-bearing joints, like the knees and the hips,” says Eric Matteson, MD, chair of the rheumatology division at the Mayo Clinic in Rochester, MN.

While many may disregard arthritis as unimportant and non-life threatening, it is in fact a chronic condition with serious impact on people’s lives. Arthritis is the leading cause of disability in the United States, and can lead to many debilitating problems for overweight people, from daily pain and discomfort, decreased mobility, and may even necessitate surgery.

One study examined the factors contributing to total knee and hip replacements in people between the ages of 18 and 50. A remarkable 72 percent of those who underwent joint replacement surgery were obese.

Weight loss has been shown to be effective in decreasing the effects, prevalence, and onset of many comorbid conditions, particularly arthritis. A study of overweight women showed that a weight loss of merely 11 pounds reduced their risk of developing knee Osteoarthritis by half.

Healthcare costs attributed to arthritis and other rheumatic conditions (AORC) in the United States in 2003 was approximately $128 billion, and is continuing to increase as obesity continues to rise.  For providers who have patients that suffer from arthritis, or who are at risk for arthritis, weight loss using a medically supervised program can mean an enhanced quality of life for their patients, as well as provide a cost effective solution to arthritis, and many other comorbid conditions.

In a quickly changing healthcare climate, providers must be quick to adopt smarter and cost-effective strategies to reduce expenditures while maximizing quality of care. Treating comorbid conditions singularly without looking at the bigger picture of what is causing these ailments will increasingly become a costly mistake for both physicians and their patients. Talk to Robard today about how to streamline your patient care efforts by starting a medical weight management program today.

Sources: CDC, John Hopkins Arthritis Center, Everyday Health, Arthritis Foundation


Blog written by Vanessa Ramalho/Robard Corporation


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Stress and Weight Gain



We all experience stress in our lives. But, did you know that stress could be a contributor to weight gain and preventing you from losing weight? Stress causes our bodies to produce increased amounts of stress hormones. These hormones cause a rush of adrenaline that is sometimes referred to as the “Fight or Flight Response.” When the brain receives a signal that the body is under stress, it releases the stress hormones to help the body endure whatever is upon it. It makes one ready for action and endurance. The human body is made to survive.

However, after the adrenaline rush is over, the body continues to make cortisol. This is the hormone that triggers hunger or the “replenish mode.” For our ancestors, this was necessary. They may have gone long periods of time without eating and endured a harsh physical environment without knowing when they would eat again. Our ancestors needed the cortisol due to high levels of physical stress and activity. Often, they burned double the calories they consumed just looking for their food.

We can hardly say that now. However, despite the decline in physical activity, we are under as much stress today as our ancestors. Much of our stress comes in the form of mental and emotional. Even physical stress, such as chronic illness, brings with it an emotional toll.

Cortisol and the “replenish mode” are designed to allow for survival. Cortisol slows our metabolism to conserve energy and resources. This means we hang on to fat stores. This may not have been a problem for our great-great-great grandparents who hunted and gathered their food supply, however, driving to the nearest drive-through or ordering take-out is not such strenuous work. Add a slow metabolism from cortisol and you get added weight gain.

So, how can you start now to decrease your stress and prevent weight gain? Here are some tips:

1. Take your vitamins. Your B-vitamins and magnesium to be exact. The B-vitamins provide energy and nervous system function and magnesium is known to reduce anxiety. Most of us are not getting enough of these vitamins in our diets.
2. Get protein for breakfast. Breakfast is the most important meal of the day only if it is protein packed. Experts recommend 35 grams or more to get your metabolism cranked, increase your energy level, and keep you satiated longer.
3. Exercise more. Not only are you burning calories and increasing your metabolism, you are reducing your stress level. When you are on the elliptical, bike, treadmill, or in a yoga pose, you can sweat away the day’s concerns and burn off that adrenaline.
4. Get a good night’s sleep. At least 7-9 hours per night to combat cravings. Lack of sleep makes you hungry.
5. No crash diets or starving. When you drastically restrict a food group or reduce your calorie intake, you slow your metabolism further. This will not help when under stress. Instead, find a well-balanced, high protein, low carb diet plan and drink plenty of water. There are plenty of food options for quick, on-the-go nutrition and protein.
6. Eat mindfully. By eating slowly, you give your body time to realize you are full. Mindful eating makes us more aware of emotional eating and combats the cortisol levels our bodies are producing from stress.
7. Seek help. Often stress in life is more than we can handle alone. Seek out a therapist, a health care professional, a support group, or health coach. Do not be ashamed to ask assistance during a difficult time.




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You May Not Be Getting the Nutrients You Think You Are




Smart dieters often look at a product’s
nutrition facts panel to understand how much nutritional value it
contains. A label may tell you that a certain brand of cheese has eight
grams of protein or, if you rely on tech, your MyFitnessPal may tell you
that a cup of strawberries has 220mg of potassium.

By doing
this, you’re probably under the assumption you are being a responsible
dieter — and in many ways, you are. However, is what you’re seeing on
the label what you actually consume when it comes to nutrients? Do they
have the expected effect? Some researchers would say no, and have
published their findings in The American Journal of Clinical Nutrition.

According
to a May 23, 2017, article published by the Department of Nutrition,
Exercise and Sports at the University of Copenhagen, “The nutritional
value of a food should be evaluated on the basis of the foodstuff as a
whole, and not as an effect of the individual nutrients.” The
conclusion, based on the opinion of an international expert panel of
epidemiologists, physicians, food and nutrition scientists, “reshapes
our understanding of the importance of nutrients and their interaction.”

“When
we eat, we do not consume individual nutrients. We eat the whole food.
Either alone or together with other foods in a meal. It therefore seems
obvious that we should assess food products in context,” says Tanja
Kongerslev Thorning, PhD. What does this mean? Well, although the
nutrients on the label are valuable, it may more important to understand
how they combine with other food we eat as well as how our bodies
digest them to really decide how beneficial or detrimental certain foods
are to us.

Researchers used cheese as an example. At face
value, cheese has a relatively high content of saturated fat. However,
researchers believe that cheese has a lesser effect on blood cholesterol
than what you would expect with a food containing that much saturated
fat. Another example researchers used were almonds. Almonds contain a
high amount of fat, but release less fat than expected while digesting.

Studies
and research like this shed light on the possibility that the foods we
are eating could be healthier — or worse, less healthy than we
originally thought — which could potentially shake up how we look at
nutrition as a whole. What’s more, studies like this could lead to more
personalized dietary recommendations from health care providers for
overweight patients.

“More studies are needed, but ultimately it
seems that some areas of nutrition science need to be rethought,” says
Professor of Food Chain Nutrition Ian Givens at the University of
Reading. “We cannot focus on a nutrient without looking at how it is
consumed and what else is eaten at the same time.”


Source: University of Copenhagen, Department of Nutrition, Exercise and Sports


Blog written by Marcus Miller/Robard Corporation

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Your Guide to a Diet Friendly Holiday BBQ

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You Can Change Lives

You Can Change Lives

Obesity impacts one in three adults in the United States. That’s one in three who at this moment is facing serious health problems. One in three faces losing their job. One in three faces mounting medical bills, immobility and/or disability. One in three experiences shame and social stigma. One in three is at risk for premature death. One in three doesn’t know where to turn to for help.

But you can make a difference.

We asked medical providers why they do what they do, and unanimously, the answer was to change lives. And during our more than 40 years in business, Robard customers have succeeded in doing just that. Our success stories show the difference losing the weight can have in a person’s life, and we’re proud to partner with healthcare providers to make a difference.

Whether or not you have considered treating obesity, start here: You have the power to change lives… and we can help.

What could it look like to change a life? Watch the video below, and then contact Robard to learn more.




Blog written by Vanessa Ramalho/Robard Corporation


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Weight Management and Corporate Wellness – A Win/Win for Everyone



In our recent blog on job absenteeism, we found that nationally, it is estimated that obesity costs employers more than $73 billion annually in higher healthcare costs — and that is a conservative estimate. The statistics don’t end there. Obese employees incur more than double the amount in health care, workers compensation and short-term disability costs than normal weight employees. In fact, obesity and related diseases have driven much of the increase in healthcare costs for employers. Looking toward the future, companies are beginning to look to adding weight management to their corporate wellness packages to help them reign in healthcare and HR expenses before obesity takes them under.

There’s no question that worksite wellness programs make a difference in employee health and productivity. Findings from 56 studies on worksite wellness programs that were published in the American Journal of Health Promotion showed an average 27 percent reduction in sick leave absenteeism, 26 percent reduction in health care costs, and 32 percent reduction in workers’ compensation and disability management cost claims.

Because of obesity’s well-recognized connection with the most common comorbid chronic conditions, employers have already begun to wise up about the efficiency of encouraging employees to attain a healthy weight to improve their overall health. In fact, in a study on Obesity in the Workplace, 71 percent of employers and 92 percent of jumbo employers agree that “it is an appropriate role for an employer to include a range of obesity-related services and benefits for employees.”

Ultimately, studies are showing that employers are connecting the appropriateness of weight management programs with their concern about medical claims expenses, sickness and disability expenses, and lost productivity. As offerings for corporate wellness programs continue to grow and diversify, this could soon prove to be a great market for weight loss centers. Not only is it beneficial for weight loss centers to expand their market, but employers will see significant cost savings, and employees will enjoy a healthier weight and life as a result. Certainly sounds like a win/win for all involved!

Learn more today about how easy it is for Robard customers to get started in corporate wellness. For even more information on why weight management is important for corporate wellness, watch the video below:





Sources: Inc., Health Affairs


Blog written by Vanessa Ramalho/Robard Corporation


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How I Treat Obese Patients in a Federally Qualified Health Care Clinic




Two of the most exciting parts being a
physician working in a federally qualified health care clinic are
providing medical care that I believe makes a difference and helps to
put the patient in charge of their own health care, and helping my
patients gain medical literacy. This includes discussing their weight.

Being overweight or obese is a gateway to an extensive variety of disease states across a multiplicity of organ systems.
Obesity is a chronic, relapsing, multi-factorial, neurobehavioral
disease, wherein an increase in body fat promotes adipose tissue
dysfunction and abnormal fat mass physical forces, resulting in adverse
metabolic, biomechanical, and psychosocial health consequences.
1

To
both prevent and treat this disease, the field of obesity medicine is
an exciting and growing field that is marrying new and evolving
sciences, cognitive behavioral therapies, and mind-body medicine
modalities.

I have made it a personal policy to discuss weight
with 100 percent of my patients. In my primary care setting, where we
have limited time per patient visit and I am seeing patients with
multiple and chronic illnesses, it is really a matter of time and
practicality. With the few minutes I have with each patient, what is the
one thing that I can do or say that will have the biggest impact on my
patients’ reduction of morbidity and mortality?

Having a conversation about weight with the patient saves me time and involves the patient in taking charge of their health. Talking to a patient about their weight and their BMI are crucial components in helping them to “buy in” and become a key player on their own healthcare team.

For
example, here’s a sample of patient BMI ranges that I observed over a
two-day period: I saw 31 patients with BMIs ranging from a high of 67.5
to a low of 15.1 with ages ranging from 18 to 66. 21/31 had BMIs of 26
(approximately 66 percent) or greater. Most of these patients were
insured through the Affordable Care Act, Medicaid or Medicare.

My
typical office visit goes something like this: My Medical Assistant
brings the patient back into the exam room where vital signs are taken.
Height and weight are entered into the electronic medical record at each
visit and the BMI is automatically calculated. The patients see their
vitals signs displayed before their eyes. When I enter the room, I
briefly explain to the patient what they are seeing on the screen. For
many patients this is a learning opportunity as I explain BMI and what
the ranges mean. The majority of patients are curious. They want to know
where they fall, how close they are to normal, etc. I then take a few
minutes to explain that losing as little as 5-10 percent of their
baseline weight can lead to exponential improvements in their health and
quality of life. This is especially motivating for my patients who are:

1) Suffering from multiple comorbidities such as hypertension, hyperlipidemia, diabetes, and joint pain;
2) Tired of taking multiple medications and or being insulin dependent;
3) Tired of looking older than their chronological age;
4) Tired of being depressed;
5) Feeling like they are a victim and want to have a sense of something that they can do to contribute to their well-being.

I
bring my patients back for more frequent office visits, generally every
week to two weeks for an initial period of 12-16 weeks to provide the
added support and accountability needed to support a patient on a weight
loss journey. I have also familiarized myself with the current
anti-obesity medications available and prescribe them for the
appropriate patient, along with eating behavior modification and
exercise prescriptions.

The other day a patient of mine returned
for a weight check, delighted with another few pounds of weight loss.
She exclaimed that her cardiologist stopped one of her anti-hypertensive
medications, and she was smiling broadly — her dental hygienist told
her earlier in the day that she looked like she was losing weight and
looked good. She was near tears. She stated that her stress incontinence
had improved so much that she was thinking about trying a beginner’s
yoga class. This kind of success story has become an everyday part of my
daily experience as a physician — and my own joy and satisfaction is
priceless.



1."The Epidemiology and Determinants of Obesity in Developed and Developing Countries." http://econtent.hogrefe.com. International Journal for Vitamin and Nutrition Research, 14 Mar. 2013. Web. 25 Mar. 2017.


Blog written by Carol Penn, D.O.



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Another Approach to Reduce Job Absenteeism



With obesity recognized as a chronic disease, the cost of obesity on one’s health, longevity, and medical expenses with comorbid conditions is slowly becoming more widely recognized. Nationally, it is estimated that obesity costs employers more than $73 billion annually in higher healthcare costs.

However, obesity carries with it additional costs that are not always publically addressed — costs that affect the day-to-day of people’s lives, as well as their livelihood. One of the lesser recognized is absenteeism and its overall impact on productivity at work.

The total economic cost of obesity in the U.S. includes indirect costs, such as missed time from work, lost productivity at work, and premature death due to obesity-related health problems. Obesity can cause exhaustion, inability to focus, decreased confidence, and an increase in stress. Comorbid conditions caused by obesity can also result in unscheduled call outs and extended medical leave, leading to low morale, disciplinary action, and even the loss of one’s job.

While there are limited studies that have looked closely at this issue, one group of researchers at the University of Michigan Weight Management Program tackled this issue head on with a study they recently presented at Endocrine Society's 99th annual meeting in Orlando. The study revealed compelling evidence that participation in a weight management program can reduce job absenteeism.

The weight management program in the study utilized a Very Low Calorie Diet (VLCD) and followed participants through a six-month time period. The participants lost an average of 41 pounds through the program. Before the program, participants reported that they worked, on average, 5.2 fewer hours per month than what their employers expected. After six months in the program, they described working 6.4 hours more than expected.

According to Jennifer Iyengar, M.D., the study's lead author and an endocrinology fellow at the University of Michigan, the findings “suggest that, through favorable effects on work attendance, participation in a weight management program may be mutually beneficial for workers and their employers.”

While more research needs to be done on what impact medical weight management programs can have on work productivity, the hidden cost of obesity is still fairly clear, and it takes a toll. Obese workers on average are absent one more week each year than other employees. While concern for health should of course be a prime focus, concern for the livelihoods of job security of obese individuals should also be taken into consideration.

With Robard Corporation’s evidence-based weight management programs and products, you can launch or enhance a current wellness program by providing your employees with an effective weight management solution that helps them achieve their health and lifestyle goals. Our time-tested, multidisciplinary programs can help alleviate unscheduled absenteeism, increase productivity and reduce employee turnover. Click here to get some free information today.

Sources: Science Daily


Blog written by Vanessa Ramalho/Robard Corporation

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Sweeteners: The Inside Scoop



In an effort to better our diets, we often look for healthier choices — especially when it comes to sugar alternatives. Instead of sugar, a large number of shoppers reach for low calorie artificial sweeteners, believing that doing so will offer a similar taste without the guilt and adverse health effects. According to preliminary research, however, artificial sweeteners can do more harm than good. Study results recently presented at ENDO 2017, the Endocrine Society’s 99th Annual Meeting in Orlando, Florida, showed that low calorie, artificial sweeteners could be detrimental to the body’s metabolism.

Results showed that “large consumption of these sugar substitutes could promote fat accumulation, especially in people who are already obese.” Researchers found that there was an increase in glucose transport into cell and overexpression of fat-producing genes, as well as an overexpression of sweet taste receptors in fat tissue.

“We believe that low calorie sweeteners promote additional fat formation by allowing more glucose to enter the cells, and promotes inflammation, which may be more detrimental in obese individuals,” says Sabyasachi Sen, MD, an Associate Professor of Medicine and Endocrinology at George Washington University in Washington, D.C., and the study’s principal investigator.

Researchers believe that the findings signify metabolic dysregulation causing cellular mechanisms to make more fat. The effects were most apparent in “obese individuals who consumed low-calorie sweeteners, rather than individuals of normal weight.”

So how do we educate ourselves more about these sweeteners and how it affects obese and overweight patients? For starters, join us on Wednesday, June 14 at 3:00 p.m. (Eastern Time) for a complementary webcast featuring Registered Dietitian Laurie Shank entitled, How Sweet it is:  Navigating the World of Natural and Artificial Sweeteners. During the webcast, Laurie will discuss commonly used types of natural, caloric sweeteners in the U.S. food supply, as well as the types of artificial, non-nutritive sweeteners approved by the FDA for use in the U.S. while identifying the health risks and benefits of caloric and non-caloric sweetening agents as they relate to health and weight management.

If you want to learn more about artificial sweeteners and the effects on the body this is a presentation you don’t want to miss! To register and find out more, click here.

Source: Endocrine Society


Blog written by Marcus Miller/Robard Corporation

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