This might be a story you have heard before: a husband and wife go on a diet. They eat the same meals, take in the same calories, exercise at the same time… but then somehow, hubby drops 10 pounds in two weeks while wifey loses maybe half of that. What gives? Well, as it turns out, a recent study shows that there does seem to be a gender component when it comes to weight loss that gives men an edge.
By now, the need to prioritize obesity treatment in health care is widely accepted. Not a single state met the 2010 Healthy People goal of a 15% obesity rate. Instead, obesity rates have steadily climbed, with over one-third of American adults being obese, and with the United States ranking as one of the most obese countries in the world. And with obesity rates rising, so do the rates of comorbid conditions, such as diabetes, hypertension and heart disease.
Why should a busy healthcare provider take time out of their day to treat obesity when their patients are dealing with so many other health issues? This seems to be the prevailing question among many providers, despite obesity’s 2013 designation as a disease. There are so many other diseases and ailments that need to be treated, so why obesity?
The answer: Because we can’t afford not to! And that applies to time, money and the health of your patients.
It’s true that chronic diseases suck up the majority of healthcare resources; 75 percent of all health care costs are linked to chronic conditions. People with chronic conditions are the most frequent users of health care in the U.S., and they account for 81 percent of hospital admissions; 91 percent of all prescriptions filled; and 76 percent of all physician visits. Chronic disease is widespread, and it’s only getting worse. By 2025, chronic diseases will affect an estimated 164 million Americans — nearly half (49 percent) of the population
In response to the growing concern over chronic disease, many healthcare providers and hospitals are investing thousands of dollars in resources and time to implement multi-level treatment plans targeting chronic conditions. But the question many advocates are forgetting to ask is: What is one of the most common links between many chronic conditions?
The answer: OBESITY.
Obesity is associated with significantly increased risk of more than 20 chronic diseases and health conditions that cause devastating consequences and increased mortality. Consider the following statistics:
• In the often-cited Framingham Offspring Study, obesity was responsible for 78 percent of cases of hypertension in men and 64 percent in women
• The well-known Nurses’ Health Study of more than 44,000 women found high waist circumference resulted in a two-fold increase in coronary heart disease
• More than 85 percent of people who have type 2 diabetes are overweight, and more than 50 percent are obese
• Overweight and obesity are associated with increased mortality from diabetes and kidney disease, resulting in over 60,000 excess deaths per year
And this is just the tip of the iceberg. Obesity, in many cases, is the direct cause of many of the chronic conditions that we are spending so much time and money treating. Many of these conditions can be prevented, delayed, or alleviated by simply treating the cause, not just the symptoms. Research shows that modest weight loss (five to 10 percent of body weight) can reduce the risk of developing chronic conditions dramatically, and this amount of weight loss is achievable through various evidence-based medical obesity treatment models.
Not only can obesity treatment save physicians time and money by decreasing healthcare costs associated with comorbid chronic conditions, it has also been shown to be a proven revenue generating model, with real financial benefits. In a climate when we’re unsure about where we will stand with insurance and Medicare, it is imperative for healthcare providers to proactively look for new and innovative models to save time and money, and ultimately, to save lives.
Are you still asking yourself, “Why treat obesity?”
Sources: Partnership to Fight Chronic Disease, Hospitals & Health Networks, Stop Obesity Alliance
Blog written by Vanessa Ramalho/Robard Corporation
According to a recent article by CNN, 2 billion adults and children worldwide – the equivalent of one-third of the world’s population -- is overweight, and the U.S. is among the countries most severely affected.
The article reflected the results of a study published in the New England Journal of Medicine that included 195 countries and territories. The study also notes that an increasing number of people globally are dying from comorbid conditions related to obesity, such as cardiovascular disease.
“People who shrug off weight gain do so at their own risk -- risk of cardiovascular disease, diabetes, cancer, and other life-threatening conditions,” said Dr. Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington, who worked on the study. “Those half-serious New Year’s resolutions to lose weight should become year-round commitments to lose weight and prevent future weight gain,” he said in a statement.
The conclusions of the study do important work in highlighting obesity as a growing concern in global public health as a chronic condition in and of itself; however, researchers also hope to educate the public at large about the link between obesity and other diseases in the hopes that preventative measures and treatment can help people avert early mortality. Almost 70 percent of deaths related to an elevated BMI in the analysis were due to cardiovascular disease, killing 2.7 million people in 2015, with diabetes being the second leading cause of death.
The study notes that obesity rates rose in all countries studied, irrespective of the country’s income level. “Changes in the food environment and food systems are probably major drivers,” they write. “Increased availability, accessibility, and affordability of energy dense foods, along with intense marketing of such foods, could explain excess energy intake and weight gain among different populations.”
While obesity rates continue to rise in the U.S., with approximately one-third of our own adult population being overweight or obese, we are luckier than other countries to have access to medical resources that can help curb this epidemic. Now more than ever, the need to begin treating obesity is becoming a public health imperative and medical providers are being called on to lead the charge. (Interested in learning how obesity treatment affects population health? Register for this free webcast!)
Treating obesity is easier than you may think, especially when you work with an experienced partner. Robard takes all the guess work out of treating obesity, and provides all the tools and resources to get you started within 60 days. Join in the conversation that’s happening, not just around the country, but around the world, and learn more about medical weight management today.
Blog written by Vanessa Ramalho/Robard Corporation
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
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
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.
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.
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.
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
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
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.
So fat is fat, and all fat is bad, right?
“Not all fat is equal,” says Professor Alexander Pfeifer from the Institute of Pharmacology and Toxicology of the University Hospital Bonn. Apparently, according to recent research out of University of Bonn, researchers have found a way to use what is called “brown fat” to burn energy from food and stimulate weight loss.
Humans actually have two different kinds of fat: white fat (which is the bad fat that makes our “love handles” that we want to get rid of) and brown fat which acts like a desirable heater to convert excess energy into heat. In essence, white fat stores energy, while brown fat helps the body burn energy through heat. In adults, people with higher amounts of brown fat have lower body mass, and according to studies, increasing brown fat by as little as 50 grams could lead up to a 10 to 20 pound weight loss in one year.
Using adenosine, a new signaling molecule typically released during stress, researchers at University of Bonn have discovered a way to activate these brown fat cells, and even turn white fat cells into brown fat cells, a process called “browning.”
More recently, scientists at the Gladstone Institutes identified an FDA-approved drug that can help create more of this brown fat. “Introducing brown fat is an exciting new approach to treating obesity and associated metabolic diseases, such as diabetes,” said study first author Baoming Nie, PhD, a former postdoctoral scholar at Gladstone.
Such a method of treating obesity is still in the research phase, and may not likely become a commonly accepted practice for some time yet. There are several potential side effects that may arise from taking the drug, and more development is necessary before human trials can be explored. Nonetheless, it is an exciting direction in the field of obesity treatment that healthcare professionals should keep a close eye on.
In the meantime, weight management is still an urgent need for so many across the country. For healthcare providers, there are already many effective ways to begin treating obesity. Learn more about how to start a weight management program, or if you are a dieter, connect with a provider who can get you started on your weight loss journey today. Need more inspiration? Listen to some success stories of dieters who have lost more than 200 pounds by starting a medically supervised program.
Blog written by Vanessa Ramalho/Robard Corporation
Eat an apple a day? What about eat a pear a day? A North Dakota State University study examined the benefits of Bartlett and Starkrimson pears and found that “pears as part of a healthy diet could play a role in helping to manage type 2 diabetes and diabetes-induced hypertension.”
Yo-Yos go up and down… but your weight isn’t supposed to! Nonetheless, many dieters find themselves in an endless cycle of losing a portion of pounds, only to gain it back all over again — and then some. When you get stuck in what seems like an endless cycle of weight loss and regain, losing weight can become a frustrating and unachievable pursuit. How do you keep up the motivation to lose weight when you can’t seem to keep it off?
Don’t feel alone. Most dieters will experience weight regain at some point, and it is definitely frustrating. "People go on diets over and over again - and keep failing," says professor Eran Segal of the Weizmann Institute of Science in Israel. "It's a very common problem. Up to 50 percent of obese people suffer this relapsing pattern.” Such a pattern can lead to a lot of mental and emotional anguish, making dieters more likely to give up on their dreams of achieving a healthy weight.
But in addition to being emotionally and mentally draining, Yo-Yo dieting can actually come with health risks. Due to an increase in the stress hormone cortisol, consistently losing and gaining weight can increase your risk of developing heart disease, cancer and diabetes. Naturopathic doctor Natasha Turner claims that Yo-Yo dieting can also damage arteries and cause an increase in LDL cholesterol — both of which increase the risk of heart disease. And, there are many other health risks associated with being overweight and/or obese.
Additionally, Yo-Yo dieting is often associated with rapid weight loss in a short amount of time by limiting calorie intake. When you are undergoing low calorie diets without the supervision of a doctor or dietician, you can actually be depriving yourself of important nutrients and healthy calories. This type of dieting can slow your metabolism, lead to low energy levels, tiredness, fatigue and irritability. Not fun!
Step one of losing weight healthily and keeping it off in the long-term is to find support. Working with a weight loss professional who can provide you with proven tools and resources can be a far greater investment than any fad diet out there. Also consider these additional tips on how to avoid the endless cycle of Yo-Yo dieting:
Be realistic: A weight loss professional can help you set achievable goals. Make sure your goals come with a realistic time frame and can fit reasonably into your life, and that are aligned with health objectives. Having a goal to lose 20 pounds for a wedding two months from now can set you up for failure, and promote unhealthy habits. As a starting point, commit to goals that can be achieved with moderate effort.
Reward yourself: But not with food. When you reach a weight milestone, treat yourself to a massage. Or start a change jar and add the equivalent of what you would spend on junk food. At the end of every month, use the money accumulated to go on a shopping spree.
Identify your motivation: Motivation is key to success. “That is the number one most important thing,” says Judy Caplan, a registered dietitian and spokeswoman for the American Dietetic Association. List out why you want to get healthy, and refer to those reasons during moments of weakness.
Don’t give up: “One of the most important tips for being a successful weight loser is not to let past failed attempts keep you from trying again,” says Michael Dansinger, M.D., weight loss and nutrition advisor for “The Biggest Loser” and assistant professor at Tufts School of Medicine in Boston. “Every time you fail, you get more insight about what to do differently next time.”
Sources: Livestrong, U.S. News
Blog written by Vanessa Ramalho/Robard Corporation
People that smoke cigarettes know the risk they are taking when doing it. Aside from the commercials they may see on television or their friends telling them about smoking’s pitfalls, they also see the warnings every time they buy a pack with the Surgeon General Warning on the side.
It looks like some want to have similar labels on sugar-sweetened drinks. Researchers from the University of Pennsylvania School of Medicine feel that such labels will have a positive effect on deterring parents from purchasing these drinks for their children. Sugar-sweetened drinks such as sodas and sugary juices have been found to have as much as seven teaspoons of sugar per 6.5 ounces. With the newest eating guidelines proclaiming that added sugar shouldn’t exceed 10 percent of a person’s daily calorie intake, that amount is almost double the dietary recommendation, making it a factor in the children obesity rate.
The main reason researchers are advocating for such a label is to better inform parents of the health risks that are included in the over-consumption of such beverages. Obesity, diabetes, and tooth decay are only a few things that children can be exposed to if they are to drink too many of these sugary drinks, dangers that the parent may not necessarily know about or consider when purchasing for their child.
Researchers put this theory to the test by surveying over 2,300 parents that have children between the ages of 6 and 11. They divided the parents into several groups, including: parents that saw no labels on beverages, parents that only saw how many calories were in the beverages, and several groups that saw different alterations of warning labels on the beverages.
When the parents were asked if they would buy sugar-sweetened drinks for their child, 40 percent of the parents that saw the warning labels said they would buy the drink for their child, compared to 60 percent who saw no labels on the beverages, and 53 percent who had calorie labels.
The labels did prove to have positive effects on parents, but there are other questions that arise. Such as will the parents choose healthy alternatives to these sugary drinks? Will they do it on a consistent basis? Will they make sure there isn’t over-consumption regardless of the beverage? But maybe warning labels is a step in the right direction particularly with reversing the increasing trend of childhood obesity. What effect do you think such labels will have on the purchase of sugary drinks?
Source: University of Pennsylvania School of Medicine
Blog written by Marcus Miller/Robard Corporation
According to the National Diabetes Education Program, “National Diabetes Month is observed every November to draw attention to diabetes and its effects on millions of Americans.” The NDEP’s 2015 theme, Diabetes Education and Support: Everyone Has a Role. What’s Yours?, “highlights the need for ongoing diabetes education and support among people with diabetes and those who care for them.”
Obesity is a major risk factor for the development of type 2 diabetes; therefore, prevention and treatment of obesity is of utmost importance to help control or minimize the effects of type 2 diabetes. Studies show that metabolic control of diabetes can reduce the associated complications.
According to a medical protocol written by Robard Medical Advisory Panel member Christopher Case, MD, “Recent research has elucidated the pathophysiology of diabetes, suggesting that insulin resistance and beta-cell dysfunction as key components. Weight loss can address the underlying pathophysiology of type 2 diabetes, even within one week on a Very Low Calorie Diet (VLCD). Diet-induced weight loss through a VLCD removes stores of ectopic fat outside the fat cell, improving beta-cell function, as well as blood pressure and cholesterol. This is often associated with a reduction in medications to treat type 2 diabetes and an improved quality of life.
Robard offers a suite of materials related to type 2 diabetes for you and your patients. In addition to our extensive Diabetes Medical Protocol, we offer patient education modules, patient brochures, and more, to assist you with explaining the correlation between type 2 diabetes and obesity. Our medical protocols are also available on our website. To view the protocols, login to www.Robard.com, and visit “Medical Protocols” under the “Education” tab in the top navigation. By using Robard’s frequently asked questions and patient handout on type 2 diabetes, you can further educate your patients on recommendations for suggested initial testing, ongoing monitoring, and contraindications/risks.