Changing Behavior to Conquer Obesity

According to a recent Bipartisan Policy Center report, Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future, two-thirds of Americans are overweight or obese.  In addition, one in three children meet this definition, putting them at risk for chronic diseases such as diabetes, hypertension, asthma, heart disease and cancer.  With escalating health care costs now acting as the main driver of our spiraling national debt, obesity has become a preeminent public healt

According to a recent Bipartisan Policy Center report, Lots to Lose: How America’s Health and Obesity Crisis Threatens our Economic Future, two-thirds of Americans are overweight or obese.  In addition, one in three children meet this definition, putting them at risk for chronic diseases such as diabetes, hypertension, asthma, heart disease and cancer.  With escalating health care costs now acting as the main driver of our spiraling national debt, obesity has become a preeminent public health issue.  Recognizing this plight, the Bipartisan Policy Center (BPC) launched its Nutrition and Physical Activity Initiative based in large part on concern about the national debt and the clear role that escalating healthcare costs play in our nation’s looming fiscal emergency.  As noted in the report, a number of recommendations must be implemented across individual, family and organizations in order for, “success (to be) possible if all these entities work together and bring creativity, innovation and focused commitment to the effort.”

In response to the report, Kaid Baifield highlighted a number of recommendations regarding how cities can help fight obesity.  Specifically, the author outlines ways in which the community can help prevent the situation:

1. Train health care professionals in nutrition and physical activity
2. Expand a “prevention-workforce” by providing training also to non-clinical, community health workers
3. Provide incentives for community health services such as diabetes or weight loss education
4. Improve menu options at large institutions, shifting food supply chains towards healthier options and better prices
5. Promote positive nutrition and fitness examples at public institutions
6. Use existing infrastructure assets to promote more local opportunities for physical activity
7. Make creative use of technology, such as games, pedometers, or apps locating walking and recreation spots
8. Incorporate physical activity and healthy transportation guidelines into construction codes and planning policies

As a wise mentor once taught me, our mission, as healthcare leaders, is to improve the health of the people in the communities we serve.  In reviewing the list above, there are a number of recommendations for interventions with health professionals and services that serve this purpose.  And while it is commendable to note these general statements about improving health, perhaps the real crux of the problem is how we influence individuals to change the way they think, and more importantly, act, about their health?  Further complicating the debate, researchers at the University of Florida have also noted that forty percent of rural residents, versus thirty percent of their urban counterparts, remain obese, underscoring the lack of access to health professionals and services continuing to fuel this potential epidemic.

Noting my previous interest in healthcare providers engaging their patients, I continue to believe this strategy offers a potential key to the solution.  First and foremost, providers must be given tools and reimbursed appropriately in order to succeed at this endeavor.  And by incorporating tools – concisely written ‘cue’ cards, texts, videos, apps (games, weight loss programs), pedometers, e-health visits, follow-up phone calls with traditional office visits, providers are able to reinforce their message via a variety of formats that are most relevant to the patient.  And it is through these channels – incorporating the use of ubiquitous technology, theory-informed, but user-relevant interventions, high degree of tailoring, and continuous interventions –  that Dr. Karen Calfas believes that healthcare providers can drive successful maintenance of behavior change.