Our topic this week is weight loss resistance which addresses the many causes of our inability to lose weight. But let's discuss the issue of the “Obesity Epidemic.” We've all heard the staggering statistics that nearly two thirds of adult Americans are overweight or obese—and nearly one third of our children are now suffering from obesity. Pardon the pun, but the cost of obesity to our society is huge.
On the cover of the June issue of The Texas Medicine Magazine from the Texas Medical Association (TMA) is a man holding a giant hamburger while he is stepping off the roof of a building. The title of the article is “Eating Ourselves to Death, The Cost Of Obesity."
Texas State Comptroller Susan Combs issued a frightening report on the worsening obesity crisis in Texas. The projected trends show that by 2025, nearly 50% of adults will be obese and only 12% will have normal weight. All you have to do is go the mall or other public area to witness these statistics.
Even more sobering is the cost of obesity to businesses. Texas businesses spent an estimated $3.3 billion in 2005 on costs related to obesity. These costs were reflected in disability, decreased productivity, absenteeism and health care. Additional estimates place the total health care expenditures for the state of Texas in the neighborhood of $114 billion, with private health insurance for adults accounting for 25.7 percent of that amount, or $29.3 billion, with obesity driving those costs. To download the full report, visit the Texas Comptroller of Public Accounts website, www.window.state.tx.us. Click on Obesity: A Crisis in Texas.
Now let's talk about the children. According to the Counting Costs and Calories report in 2005, 42 percent of Texas fourth graders, 39 percent of eighth graders and 36 percent of 11th graders were overweight or at risk of becoming overweight. The report projects that 70 percent of overweight children will become overweight or obese as adults.
I do not know if the general public is aware of the health consequences which develop from obesity. Just a small list of those illnesses include: hypertension, heart disease, diabetes, arthritis, sleep apnea, hernias, surgical complications, pregnancy complications, and cancer.
Just look at the diseases that could be managed and even prevented if we could get control of the obesity epidemic.
What steps can we take to get this epidemic under control? First of all, we have free will. No one is force feeding us the foods that contribute to obesity. But we are influenced by the commercials in the media. We all know the foods that we should be avoiding; it's just easier and less expensive to eat the “fast foods.” But you will pay a price farther down the road. We have to start taking responsibility for our health and the health of our children.
The first advice I give to patients is “Don't bring the enemy into your house.” If the junk is not sitting in your kitchen, then you won't be tempted to eat it. And until your children are old enough to drive and shop for themselves, you can control the foods that are served at home and when you go out to eat. There are certain aisles in the grocery store that you shouldn't even walk down. You know what I'm talking about.
The Texas Medical Association is addressing the childhood obesity by focusing on advocacy, community education, public policy initiatives and physician education. The Texas Pediatric Society formed an obesity task force in 2003 to help pediatricians manage obesity in their patients. The TMA is urging U.S. Sen. John Cornyn (R-Texas) to cosponsor S771, the Child Nutrition Promotion and School Lunch Act. The TMA is backing four additional obesity related bills in the Texas Legislature for 2007. I think every PTA should have improved nutrition and physical education on the top of their agendas. Remember when you were a child in school and you had a balanced meal for lunch and only needed a quarter for a carton of milk. I'm dating myself, but at least we were given a healthy start on life. It's time to make a difference.
The MedicalMinute™ is where I address current and news worthy medical topics and add my own personal comments and opinions.
The controversy really began in April 2004 when the results from the Women's Health Initiative (WHI) became public. The purpose of this study was to evaluate the long term benefits and risks of hormone replacement therapy. The hormone replacement used in the study consisted of conjugated equine estrogen (CEE), in other words, conjugated estrogens from horse mare urine, and medroxyprogesterone acetate (MPA), which is a synthetic progestin. The estrogen-progestin portion of the clinical trial was stopped in 2002 after results showed that a synthetic hormone combination containing conjugated equine estrogen (CEE) plus medroxyprogesterone acetate (MPA) increase a woman's risk of developing invasive breast cancer, heart disease, stroke and pulmonary embolism. The “estrogen–only” portion of the WHI study was halted in March 2004 after analysis of data suggested that synthetic CEE alone had no impact either on heart disease, which was the main focus of the study, but may increase the risk of stroke.
So, of course, the major headlines and media reports of the day announced that “estrogen and progesterone” are terrible for you and every woman needs to stop her hormone therapy. And many women did stop hormone therapy. They went “cold turkey” and suffered with their menopausal symptoms not knowing that they had an alternative.
In reality, the news media should have reported that taking conjugated horse mare urine and synthetic progestins for hormone replacement increases your risk for side effects and complications. Personally, I don't think we were ever intended to consume estrogens from pregnant horse mare urine. So, the results of that study make sense. But what doesn't make sense is to continue to promote synthetic and artificial hormones for hormone replacement therapy.
What does make sense is to replace the hormones that identically match what your body makes. Hormones are little messengers that travel around the body. The attachment of a hormone to a cell is similar to inserting a key into a lock. The bio-identical hormones are the perfect match. The synthetic hormones may fit the lock, but they won't open the lock. Because the synthetics do not fit perfectly, side effects develop. And you can read the potential list of side effects from these drugs in the PDR (Physician's Desk Reference).
Now the politics enters into the equation. Bio-identical hormones are specifically produced in compounding pharmacies. Bio-identical substances cannot be patented. Only patented drugs can be mass produced and be profitable to the pharmaceutical companies.
Wyeth Pharmaceuticals, makers of the conjugated horse estrogen and the synthetic progestin used in the WHI study, filed a Citizen's Petition with the Food and Drug Administration (FDA) asking the FDA to impose harmful restrictions on the compounding and dispensing of bio-identical hormone replacement therapy (BHRT). Then Senators Kennedy (D-MA), Burr (R-NC) and Roberts (R-KS) among others were considering legislation (Safe Compounding Drug Act of 2007) that would severely restrict and possibly deny access to critical medications. On the download page of my web site I have a copy of the testimony of T.S. Wiley before the Special Committee on Aging in United States Senate on April 19, 2007. Many experts testified and along with a grass roots efforts, that bill died in commitee.
Please, members of Congress, with all the issues we have to face in our nation and the world, restricting a person's choice in medical therapy should not be on your list of priorities. Haven't you heard the saying “If Mama ain't happy, then nobody's happy”. Please continue to allow women and men a choice in hormone replacement therapy. As we struggle to achieve peace in the world let's, at least, allow a little peace at home.
LEGAL DISCLAIMER: The Living Well Hour is designed to be informative and educational, not to diagnose or manage medical conditions. Consult your private physician for diagnosis, treatment and management of any medical condition.
Let me describe my general point of view. I consider myself a conservative and a patriot. I love my country. I am proud to have served in the United States Air Force. I usually have tears in my eyes when I sing the “The Star Spangled Banner” or watch our American flag marching by in a parade. I tend to support policies that I believe are good for the country ...as well as the individual.
That being said, I saw the new movie by Michael Moore, “Sicko,” at the Angelika Theater. Now, I'm not a huge Michael Moore fan (I have not seen his previous four films), but I was very curious to see his illustration of the problems that exist in our health care system. I think he did an excellent job in revealing a few of the inequities and frustrations in obtaining health care within our current system. And I can tell you that, after working in our health care system for 22 years, I believe that Michael Moore's movie illustrates only the tip of the iceberg.
Nearly 50 million Americans do not have health insurance— and do not have the means to pay for health care. Even having health insurance these days is no guarantee that you are going to receive your needed care and treatment. Health care in America has become all about the money. Insurance companies, hospitals, pharmaceutical companies and medical equipment companies are making millions — and for some, billions — of dollars at the expense of the American public. We have the most expensive health care in the world but we are far from being the best.
Our health care system is headed for the intensive care unit. With our expanding population and aging “Baby Boomers,” the access to care is going to become a growing issue.
I even emphasize to my patients that you, literally, cannot afford to be sick anymore. You cannot afford the insurance premiums, $5,000.00 to $10,000.00 insurance deductibles, prescription medications or the time off work.
For these reasons and many more, “The Living Well Hour” will emphasize preventative health care and provide you with information to improve and maintain your health each week.