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Inspiring Story About A Man Making Changes To Transform His Life

It isn’t easy to get rid of a harmful habit like drinking too much, or to make healthy changes like losing weight and exercising more. Media stories about people who run marathons a year after surgery to bypass cholesterol-clogged arteries or who climb Mt. McKinley after being diagnosed with diabetes are interesting, but they don’t resonate with me. Mostly it’s because they often leave out the hard work needed to change and the backtracking that invariably accompanies it.

I ran across a truly inspiring story the other day in the American Journal of Health Promotion—one that shows how most of us ultimately manage to make changes that improve our lives. The journal’s founder and editor, Michael P. O’Donnell, wrote a moving essay about his father, Kevin O’Donnell. Once an overweight workaholic who smoked and drank heavily, ate mostly meat and potatoes, and didn’t exercise—and who eventually needed a double bypass—Kevin O’Donnell gradually made changes to improve his health. Now, at age 85, he has the cardiovascular system of a 65 year old and is working on a house-building project in North Korea.

How did Kevin O’Donnell engineer such a remarkable transformation? Read more »

*This blog post was originally published at Harvard Health Blog*

More Bad News About The Obesity Epidemic In America

A report released recently by the Robert Wood Johnson Foundation and the Trust for America’s Health issued some grim warnings about the current and future state of the U.S.’s obesity epidemic.

Bluntly titled “F is for fat: How obesity threatens America’s future 2011,” the report found that obesity rates rose in 16 states since 2010 and that more than 30% of people are obese in 12 states, compared with one state just four years ago. The South is still the worst-faring region—nine out of 10 states with the highest obesity rates are located there.

The report compared today’s data with data from 20 years ago, when no state’s obesity rate exceeded 15%. Now, only one state—Colorado—has a rate below 20%. The report also points out that despite the increased attention paid to obesity by government (not to mention the media), no states posted a decrease in rates over the past year. Diabetes and hypertension rates have also risen sharply over the past two decades, the report said.

Recommendations to address the problem include preserving and in some cases restoring federal funding for obesity prevention and implementing legislation to improve nutrition in schools, among others.

Meanwhile, two researchers are making headlines for proposing a more extreme solution: Read more »

*This blog post was originally published at ACP Internist*

Good Health Requires People To Help Themselves

Not every Friday brings doctoring bliss. Sorry.

Some Fridays, the wrongness of our healthcare approach squeezes you like a vice-grip.

The medical news of the week can hit you hard.

–This highly tweeted report on how Overweight is the new normal speaks to the futility of asking people to help themselves. That our strong, vibrant, and proud citizenry is succumbing to fatness saddens me deeply. Building wider doors, heavier toilets and restaurant seats without armrests is the wrong approach to fighting obesity.

–We also learned this week that the advancing fury of medical therapeutics cannot counter high rates of obesity, smoking and inactivity. The WSJ health blog reports life expectancy in some Southern US counties trails that of El Salvador and Latvia.

–The nation’s chief doctor prescribes prevention over treatment, and no one retweets her. Silence.

–And the final egg on the face of wellness was this warning from the FDA: Read more »

*This blog post was originally published at Dr John M*

Doctors Refuse To Treat Obese Patients in Florida

In a nation with 93 million obese people, a few ob-gyn doctors in South Florida now refuse to see otherwise healthy women solely because they are overweight. Fifteen obstetrics-gynecology practices out of 105 polled by the Sun Sentinel said they have set weight cut-offs for new patients starting at 200 pounds or based on measures of obesity — and turn down women who are heavier. Some of the doctors said the main reason was their exam tables or other equipment can’t handle people over a certain weight. But at least six said they were trying to avoid obese patients because they have a higher risk of complications.
Source: visiontoamerica.org/719/report-doctors-refusing-to-treat-overweight-patients/

While I have not specifically “refused to treat” obese patients, I have in a few cases recommended against surgery or recommended weight loss and re-evaluation later. Than again I am not in primary care and do understand what these OB/GYNs are saying. Obese patients do represent more risk when it comes to surgery and that would of course cover pregnancy and child bearing.

Take into account that Read more »

*This blog post was originally published at Truth in Cosmetic Surgery*

Obesity Beats Adiposity For Cardiovascular Risk

Obesity contributes to cardiovascular risk no matter where a person carries the weight, concluded researchers after looking at outcomes for nearly a quarter-million people worldwide.

Body mass index, (BMI) waist circumference, and waist-to-hip ratio do not predict cardiovascular disease risk any better when physicians recorded systolic blood pressure, history of diabetes and cholesterol levels, researchers reported in The Lancet.

The research group used individual records from 58 prospective studies with at least one year of follow up. In each study, participants were not selected on the basis of having previous vascular disease. Each study provided baseline for weight, height, and waist and hip circumference. Cause-specific mortality or vascular morbidity were recorded according to well defined criteria.

Individual records included 221,934 people in 17 countries. In people with BMI of 20 kg/m2 or higher, hazard ratios for cardiovascular disease were 1.23 (95 percent CI, 1.17 to 1.29) with BMI, 1.27 (95 percent CI, 1.20 to 1.33) with waist circumference, and 1.25 (95 percent CI, 1.19 to 1.31) with waist-to-hip ratio, after adjustment for age, sex, and smoking status. After adjusting for baseline systolic blood pressure, history of diabetes, and total and HDL cholesterol, corresponding hazard rations were 1.07 (95 percent CI, 1.03 to 1.11) with BMI, 1.10 (95 percent CI, 1.05 to 1.14) with waist circumference, and 1.12 (95 percent CI, 1.08 to 1.15) with waist-to-hip ratio.

BMI, waist circumference, or waist-to-hip ratio did not importantly improve risk discrimination or predicted 10-year risk, and the findings remained the same when adiposity — the carrying of adipose tissue (fat) — measures were considered. Read more »

*This blog post was originally published at ACP Internist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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