Dr. Francisco Enriquez, Sixteenth Street Pediatrician, sheds light on the current conversation around obesity and what providers should really be talking about with their patients.
Obesity is a problem, we all know it. Nationally nearly 38% of adults are obese and the childhood obesity rates have stayed at around 17% for nearly a decade[i]. But the bigger problem is the conversation swirling around it. If we know the serious health concerns that come with obesity – diabetes, hypertension, lower life expectancy, etc. – and we communicate this with our patients, why have we seen so little progress? What can we do better?
Before we can ask patients to make behavioral changes, we first have to help them to understand the obstacles they, and all of us, face. Providers need to refocus the conversation and help our patients become aware of our role as consumers in today’s society, and how that role makes us vulnerable to obesity.
Our economic system depends on people being non-informed consumers that will purchase and consume starchy and low-nutrition food items. We are constantly being bombarded with messages to do so. The media encourages unhealthy eating with constant fast food and quick-eating promotions. “Normal” portion sizes have grown to enormous amounts. Low prices align with low nutrition options. Most school lunches lack nutrition policy or nutritional requirements. All these influences to eat poorly feed into and maintain the food delivery system as we know it. And if you live in poverty – eating healthy is even more of a challenge.
“Food desert” is a term thrown around in the population health world to talk about neighborhoods, often low-income, that don’t have convenient access to affordable, healthy food. Millions of Americans live in these neighborhoods. The stores that do exist in those neighborhoods often have less fresh and healthy food, and when they do they are often more expensive. So even if people are informed consumers, motivated and want to make good nutritional decisions, they are encouraged not to by social and economic forces. We also can’t forget about other stressors that add to obesity, like not feeling safe or not knowing if you will have a steady income or a place to stay night after night. It is an uphill battle no matter which way you slice it.
So the question remains – how do we expect individuals to improve in an environment that feeds itself?
We first have to help inform people of the obesity driven environment in which they live. As providers, we need to have open conversations with our patients and increase awareness around these challenges in a patient-provider context. It is essential that we talk with our patients and educate them about the challenges they face. To battle obesity, we as consumers have to understand that we are vulnerable to it – because we are constantly encouraged to maintain an economic system that depends on it.
We then need to empower our patients to overcome it through education and support. I’m not saying this is an easy feat, or an easy solution – but it’s the start of a solution. Until we first bridge that gap of awareness – it’s going to be really hard to move towards improvement.
As health care providers we also need to raise our voices not only with individual patients, but in the community, via media outlets and with our representatives, so that this holistic discussion on obesity may take place at all levels. Eventually it has to reach the food industry and the government regulatory agencies.
[i] http://stateofobesity.org/fastfacts/
Author: Dr.Francisco Enriquez, Sixteenth Street Pediatrician