Posts Tagged ‘IOM Report’

Life in America More Precarious Than in Other Developed Countries

January 12th, 2013 at 3:49 pm by timigustafson

It shouldn’t come as a big surprise. On average, Americans are in poorer health and have shorter lifespans than the citizens of other affluent countries, including most Western European nations, Australia, Canada and Japan. Considering that close to 50 million people, almost 20 percent of the population, are without health insurance and many more with only limited access to medical services, a decline in public health would seem inevitable. Still, the findings of a recent study by the U.S. government are quite shocking.

According to the Institute of Medicine (IOM), America currently ranks at or near the bottom among the 17 richest nations in the world in terms of life expectancy and chronic diseases like heart disease, lung disease, obesity and diabetes as well as injuries and death from violence and sexually transmitted diseases.

What’s even more disturbing is that these statistics not only apply to the poor and the elderly, as experts long expected, but across all demographics, including young adults and those who can afford health care coverage.

“We are struck by the gravity of these findings,” said Dr. Steven Woolf, professor of medicine at Virginia Commonwealth University and chairman of an expert panel that was tasked with the study. “What concerns [us] is why, for decades, we have been slipping behind.”

Even first generation immigrants coming to the U.S. show negative health effects within a relatively short time due to diet and lifestyle changes. According to the National Institute of Health (NIH), obesity rates among immigrants roughly equal those of U.S.-born adults within 10 to 15 years after taking up residence here. One study found that migrants from comparatively poor countries like Mexico or Guatemala are especially prone to develop diseases like obesity, diabetes and heart problems because of dietary changes.

“If you go with the flow in America today, you will end up overweight or obese, as two-thirds of all adults do,” said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention (CDC) in an interview with USA TODAY. “Obesity is one of the few things that has gotten worse quickly. It really is a very serious health problem,” he added.

The obesity epidemic is also one of the main reasons why it is so hard to get health care costs under control in this country. It costs $1,400 more per year to treat an obese patient compared to someone who is normal-weight and $6,600 more to treat a diabetic, said Dr. Frieden.

What changed in the U.S. more profoundly than in other countries – although similar trends are now emerging worldwide – is a dramatic shift in our eating habits. We eat more conveniently prepared but highly processed foods and enjoy fewer healthy meals made from scratch. Our portion sizes have gone through the roof. We also have become more sedentary due to progressive automation in the workplace, longer commutes and lack of safe outlets for physical activity.

“What has happened is that the structure of our society has changed in ways that make it difficult to maintain a healthy weight,” said Dr. Frieden. It’s a fertile ground for the diseases we now see on an epidemic scale.

Obviously, there is not one solution that could undo all of these regrettable developments. Multiple measures will have to be put in place and made to work together. Personal responsibility is certainly part of the equation, but so are numerous other components such as better health and nutrition education for the public, further improvements to school lunch programs, reintroduction of mandatory physical education (PE), more effective safety and disclosure regulations of agricultural and food manufacturing industries, to name just a few.

The current deterioration of our public health is not irreversible. On the contrary. Most of our ailments are self-inflicted and therefore in our control if we only muster the will to address them in meaningful ways.

Timi Gustafson R.D. is a registered dietitian, newspaper columnist, blogger and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.”, and at amazon.com. You can follow Timi on Twitter and on Facebook.

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Stigmatization Makes It Harder to Overcome Obesity

May 16th, 2012 at 11:46 am by timigustafson

Obesity rates may be on the rise worldwide, but thinness continues to be the standard for physical beauty and attractiveness. Conversely, obesity is often linked with poor body image and low self-esteem, which only adds to the struggle with weight and weight-related health problems.

“Modern Western culture emphasizes thinness, denigrates excess weight and stigmatizes obese individuals, making it likely that obese people internalize these messages and feel badly about their physical presence that brands them,” said Dr. Kelly D. Brownell and Dr. Marlene B. Schwartz of the Rudd Center for Food Policy and Obesity at Yale University in a study report on obesity and body image.

Prejudices against the overweight seem to develop early. One study found that children as young as three years of age believed fat people were “mean, stupid, ugly, and had few friends.” A majority of adults responded similarly, associating obesity with self-indulgence, laziness and lack of discipline. One poll conducted by Reuters found that over 60 percent of respondents believed the current obesity epidemic was caused by personal diet and lifestyle choices alone. Half supported the idea of charging obese patients higher health care premiums.

Views like these are also reflected in the job market, where obese candidates on average fare much poorer than their slender peers, according to a report on the subject by Reuters (5/11/2012). Statistically, obese workers receive lower wages, are more often passed over for promotions, and are less perceived to have leadership potential than their slimmer colleagues.

The effects of stigmatizing obesity have not yet received wide attention in our society. Unlike discrimination based on race, gender, religion or sexual orientation, exhibiting bias against the overweight is not illegal and would in any case be difficult to prove. One of the reasons for this discrepancy may be cultural. Many of us like to think that hard work leads to success and that failure results from weakness. The same applies to our standards of health and beauty. We each are responsible for our own well-being, so the thinking goes, and if we don’t manage, we have only ourselves to blame. So it shouldn’t come as a surprise that obesity, especially when it’s seen as a self-inflicted disorder, is judged so harshly, even in moral terms.

Fat people are increasingly becoming scapegoats for all sorts of cultural ills, said Dr. Linda Bacon, a nutrition researcher and author of “Health at Every Size: The Surprising Truth About Your Weight.” “There is an atmosphere now where it’s O.K. to blame everything on weight. We have this strong believe that it’s their fault, that it’s all about gluttony,” she said.

Even health care professionals are sometimes found to have prejudicial attitudes towards heavier patients, as studies have shown. In one survey, more than half of the interviewed doctors said obese people were “less likely to comply with treatment.” Consequently, they tend to spend less time with them and, as a result of feeling embarrassed and disrespected, the patients themselves avoid seeking the care they need.

In sharp contrast to many popular views on the causes of obesity, the Institute of Medicine (IOM) has recently published a report that identified the increasingly “obesogenic” environment we live in as the root of the crisis, rather than individual behavior.

Dr. Rebecca Puhl, a psychologist at Yale’s Rudd Center, agrees with the IOM’s conclusions, but she warns that “as long as we have this belief that obese people are lazy and lacking in discipline, it will be hard to get support for policies that change the environment, which are likely to have a much larger impact than trying to change individuals.”

People suffering from emotional distress in connection with weight problems are much less likely to succeed in their efforts to improve their health. Dissatisfaction with one’s size or body type can produce great amounts of stress. The results can be eating disorders like binge eating or bulimia, social isolation, depression and other psychological dysfunctions. Comprehensive counseling and support from family members, friends and people with similar experiences can be lifesaving. For our society in general, a shift in attitude would help as well.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

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About timigustafson

Timi Gustafson, RD, LDN, FAND is a registered dietitian, health counselor, book author, syndicated newspaper columnist and blogger. She lectures on nutrition and healthy living to audiences worldwide. She is the founder and president of Solstice Publications LLC, a publishing company specializing in health and lifestyle education. Timi completed her Clinical Dietetic Internship at the University of California Medical Center, San Francisco. She is a Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Dietetic Association, a member of the Diabetes Care and Education, Healthy Aging, Vegetarian Nutrition and the Sports, Cardiovascular and Wellness Nutrition practice groups. For more information, please visit http://www.timigustafson.com

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