Beating Obesity: Getting to HEALTHY and Feeling Good!
Getting to HEALTHY and Feeling Good!
In our last conversation, we learned that being overweight and actually obese (as measured by the Body Mass Index (BMI))* has a direct connection to poor health in the sense of conditions like diabetes and high blood pressure. What this means, in turn, when it is all put together, is a poorer quality of life and a shorter life expectancy for individuals with obesity.
Obesity is responsible for most cases of Type 2 diabetes; 40% of cardiovascular disease diagnoses; 41% of cancers of the uterus; and more than 10% of cancers of the gallbladder, kidney, liver, and colon cancers. Currently obesity is a key risk factor for serious illness or death from a COVID-19 infection with data from the World Obesity Forum showing that coronavirus death tolls were more than 10x higher where over half the adults were overweight or obese! What is happening with health in East New York today is strongly associated with the overweight/obesity problem. Some data specifically for East New York (Community Board 5 as defined above) are provided below:
As I said in my last blog, this is not the “leadership” East New York should have. We are far too good for that. We need to be the example of what can be done to change the current situation. In so doing, we can be the ones to set a path to better health and life for all our brothers and sisters – for ALL Americans, including our too-often forgotten Native-American fellow citizens. While we are healing “overweight,” we can do much to heal our ailing nation!
Again, from the last blog, we set the following goals:
- Reduce overweight/obesity from its current level in East New York adults of 35% to 15% by December 31, 2022.
- Reduce overweight/obesity in children (ages 2-15) from 25% to 15% by December 31, 2022.
SO, HOW ARE WE GOING TO DO IT?
As I said in the last blog, the last thirty years have seen multiple governmental (such as those of the Centers for Disease Control Michelle Obama’s, Let’s Move program and other White House efforts), semi-governmental, and private efforts, including “intensive behavioral therapy,” try with limited success to reduce the problem. The answers at first seem to be simple: maintain an ideal/normal weight (BMI = 18.5-24.9) depending principally on nutrition (“fuel” or calories in the form of nutritionally health foods – generally more fruits and green vegetables) and physical exercise (to burn off calories, tone muscles, promote body flexibility). However, being overweight and obese are not simply problems of eating too much and eating less healthy foods and sugary beverages, for example. Lack of a place to exercise, lack of access to affordable fresh vegetables (for example bodegas outnumber supermarkets 13:1 in East New York) and stress all contribute to the problem. Beyond that, however, there is still more: medical science has come to realize that excess weight may actually provide a baseline for the body such that when weight is lost, the body tries to get back to the baseline of what it considers normal, which includes the excess weight. In other words, weight loss and overweight/obesity represent competing body processes. Finally, long-established excess weight and true obesity can actually represent an abnormal or “disease” process, which require treatment with drugs (pharmacotherapy) or surgery (bariatric surgery).
Our focus in this blog is on what we can all do to achieve body weights in the normal range – and, most importantly, healthy behaviors and a healthy style of living. The community of East New York can, and should, be the one to show the rest of America how to beat the weight problem. Individual efforts can certainly help, but East New York also needs to Rise Up together. This is what the Rise Up East New York Campaign for Better Health and Quality of Life is all about. – TOGETHER, we can beat overweight and obesity, chronic illnesses, and the other health problems (like back and knee-joint pain) that come with weight problems.
It is hard to lose weight all ALONE, and especially to keep the weight off, so let’s do it together…
HERE’S THE PLAN:
- Recruit 50 weight “coaches” in the East New York Community (BMI 25-29; ages 20-50) to weight loss (BMI 20-24)/healthy-living program; weekly (in-person or virtual) classes on weight control with good nutrition and calorie counting, physical activity/exercise, and monitoring plan. April to June 2021;
- Simultaneously with 1) above, launch a public body-weight awareness/healthy living/weight-loss (nutrition, physical activity) campaign – store, residence, ambulatory care centers flyers, social media, Channel 12, etc; April, 2021 and ongoing;
- 50 weight coaches form groups of at least 20 (maximum 30) adults (18 to 65) to reach a total of approximately 1,200 ENY people that have a minimum 5-pound weight loss goal (weight-loss goal set by BMI at baseline and pounds required to lost to reach BMI< 24) over the next 3 months; weekly nutrition teaching and weekly 45-minute group exercise events (with 30-minutes individual physical activity every other day between group sessions); July to September, 2021);
- Add 150 weight coaches from those just trained plus original weight coaches (total now: 200 weight coaches; repeat 3x) with each group now consisting of 40 ENY persons for a total of 8,000 people now undergoing weight-, nutrition-, and exercise -training and activities (18-70 years of age; weight-loss goal per reaching BMI < 24); group now called the Rise Up East New York Better-Health Force; October, 2021-January, 2022;
- Repeat of 4) now with a total of 1,000 coaches reaching 40,000 ENY people (ages 13-70); February-July, 2022
- Weight-loss recheck (individual and program weights); refresher classes and activities: August-December, 2022. Data collection and formal report. Publication in recognized journal (e.g. Journal of American Medical Association)
*Note: Throughout the above process, individuals identified as at special medical risk (clinical judgment, via formal risk stratification) will be referred to the One Brooklyn Heath System (OBHS) or other ambulatory clinics.
We can do it EAST NEW YORK!!!
LET’S DO IT TOGETHER!!!
This is your program. All suggestions for how to do it better are welcome!
Send them in!
Barry H. Smith, MD, PhD