Reality check on state of our weight

The state of our weight in the U.S. is flat-out frightening, according to an MUSC Health expert. The Centers for Disease Control and Prevention published a pair of reports that show more than a third of American men are obese and more than 40 percent of women are in the same unhealthy boat.

Here, the director of the MUSC Health Weight Management Center, Patrick O’Neil, Ph.D., answers some key questions about the research and what’s being done to try to end the obesity epidemic.

Q: CDC reports show that a stunning 40 percent of American women and 35 percent of American men aren’t just a little overweight – they’re clinically obese. What’s your reaction to that?

It’s frightening. That’s a very disturbing prevalence rate for each gender. What’s really discouraging is that the time period covered (2005-2014) probably had the most public attention focused on obesity of any time in history, and yet the obesity rate increased for women and stayed the same for men.

Q: While the obesity rate for men has stayed the same, the obesity rate for women rose 5 percent. Why do you think that is?

It’s hard to know what to make of that. Actually, the investigators looked at prevalence estimates from 5 points over that 10-year period, and that greater increase for women was seen only at the last point (data for 2013-2014). It indicates a remarkably large rise over just 2 to 3 years, which is very unusual. So it’s too early to tell if that increase will be maintained or not. Over the 4 to 5 years before the period studied here, the rates for men had increased but those for women had not.

But even if that most recent increase is just a temporary blip, the more important issue is that women have had a higher obesity rate than men for some time. That’s not new. 

And to sadly continue another longstanding trend, for even more frightening numbers, consider non-Hispanic black women (57 percent) and Hispanic women (47 percent).

Q: What are the implications for people’s health?

In a word, dire. Obesity increases the risk of myriad diseases and conditions, literally from head to toe. In particular, these levels of obesity portend increased rates of diabetes, hypertension and heart disease, as well as, for example, encouraging osteoarthritis of the hip and knee while presenting a complication for the joint replacement surgery they may necessitate. Obesity impairs health, shortens life and diminishes the quality of the lifespan that remains.

Q: What is being done at MUSC to address obesity?

There is a wide range of weight-related programs and initiatives at MUSC, including the following:

• The Office of Health Promotion offers Lunch ‘n Learn and other seminars for employees and others, including wellness nutrition programs and the Healthy Charleston Business Challenge.
• The Boeing Center for Children’s Wellness offers community and school programs promoting child wellness, with a significant focus on childhood obesity.
• The MUSC Heart Health program offers clinical weight loss programs for children and adolescents.
• The Healthy Charleston Challenge has been a very successful and popular weight loss program offered by the MUSC Wellness Center.
• The MUSC Weight Loss Surgery program offers surgical interventions for obesity.
• Our MUSC Weight Management Center has been a university resource for clinical services and research in the area of obesity since 1974. We offer a wide array of services for people with a little or a lot to lose, including dietitian consultations, obesity medications, comprehensive 15-to-30-week lifestyle change programs (many of which include the use of meal replacement products), “Lunchtime Losers” 8-week classes for MUSC employees and worksite weight loss programs for local employers such as Boeing and the City of Charleston. Recently we have incorporated telemedicine technology to allow us to offer some of our programs to people across the state. Using wireless scales, activity trackers and diet tracking apps, we also offer a remote weight monitoring program for maintenance or continued loss. In the last few years several new obesity medications have been approved which can be an important assist to weight loss efforts for many people. There are also numerous apps and monitoring devices that can be used alone or in conjunction with structured weight loss programs.

What, if anything, is new when it comes to helping  people lose weight?

In the last few years several new obesity medications have been approved which can be an important asset to weight loss efforts for many people. There are also numerous apps and monitoring devices that can be used alone or in conjunction with structured weight loss programs.

Q: A recent report about the “Biggest Loser” contestants was pretty discouraging – it found that it was almost impossible for them to avoid regaining weight. How do you encourage people to try to lose weight in the face of such disheartening news?

There are too many issues with that study to address here in other than superficial fashion, but in a nutshell it is important to note that the group of people studied were highly unusual in the amount of weight they lost and the exceedingly intense intervention they went through. 

It is perfectly natural to see some reduction in resting metabolic rate when you go on a diet and lose weight. The amount of reduction for these people was greater than is usually seen but the rate and amount of their weight loss was greater than usual as well. Regarding the weight regain, when significant weight is lost there are a number of physiological mechanisms that come into play to encourage return to the former weight, which is why it is important to make long-term lifestyle changes to preserve the lower weight. 

I don’t know what type of maintenance support was offered to these participants after their season was over, if any, but certainly they no longer had the support, scrutiny and social pressure that they had during their intense active weight loss.

For more information about the MUSC Health Weight Management Center, check out its website or call 843-792-2273. You can also visit its main campus in downtown Charleston or its satellite clinic in North Charleston at 8471 Resolute Way.