Treating people, not conditions

More than one-third (35.7 percent) of adults are considered to be obese. More than 1 in 20 (6.3 percent) have extreme obesity. Almost 3 in 4 men (74 percent) are considered to be overweight or obese. The prevalence of obesity is similar for both men and women (about 36 percent).  In order to address this problem we need to treat the reasons behind obesity.

Currently, estimates for healthcare costs of obesity range from $147 billion to nearly $210 billion per year . In addition, obesity is associated with job absenteeism, costing approximately $4.3 billion annually and with lower productivity while at work, costing employers $506 per obese worker per year.

If obesity is as much a psychological as a physical problem, why aren’t more obese people being evaluated for issues that can lead to weight gain and health decline? The Journal of Lancaster General Health says ” psychological issues can not only foreshadow the development of obesity, but they can also follow ongoing struggles to control weight. Because the psychological aspects of obesity are so important, psychological assessments and interventions have become an integral part of a multidisciplinary approach to treating obesity, which includes the use of bariatric surgery.”

However, perhaps the biggest reason is that HCP’s are taught to treat conditions not patients and insurers prefer to hold down the costs per patient.  If, for example, an obese patient was referred to a registered dietician it might strategically lower health costs but would increase short term care.

Obesity is also frequently accompanied by depression and the two can trigger and influence each other leading to more health problems.  Although women are slightly more at risk for having an unhealthy BMI than men, they are much more vulnerable to the obesity-depression cycle. In one study, obesity in women was associated with a 37 percent increase in major depression. There is also a strong relationship between women with a high BMI and more frequent thoughts of suicide.


Depression can both cause and result from stress, which, in turn, may cause you to change your eating and activity habits. Many people who have difficulty recovering from sudden or emotionally draining events (e.g., loss of a close friend or family member, relationship difficulties, losing a job or facing a serious medical problem) unknowingly begin eating too much of the wrong foods or forgoing exercise. Before long, these become habits and difficult to change.
HCP’s need to treat the whole patient and that means going beyond telling a patient to lose weight.  They need to try and address the root causes of obesity before our healthcare system goes broke.

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