Feature | June 22, 2006 | Kim Phelan

Preaching to the Choir

You’ve Heard it Before, but the Obesity Crisis in Critical Care is Getting Bleaker

Kim Phelan, Editor

About 10 years ago a close friend received some very bad news, but, oddly, she was happy about it.
My friend was diagnosed with diabetes — she was also perhaps as much as 100 pounds overweight. She viewed the news as a wake-up call and a turning point in her struggle with weight: Diabetes, she reasoned, was going to be the catalyst for lifestyle changes that would force her to reign in her problem. Unfortunately, this did not happen — there was no long-term weight loss, and I sadly expect that complications from her diabetes will create some very serious problems for her in the near future.
Acute care professionals, of course, know the tie between obesity and diabetes, so the findings of a just-released paper in the American Journal of Preventive Medicine are probably not surprising. Authored by experts from the Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention in Atlanta, and titled “Changes in Incidence of Diabetes in U.S. Adults, 1997-2003,” the article outlines a study that reviewed data about diabetes diagnoses and examined sociodemographic characteristics, risk factors and indicators of health status.
The conclusions are in line with what healthcare professionals would expect: “Obesity was a major factor in the recent increase of newly diagnosed diabetes. Lifestyle interventions that reduce or prevent the prevalence of obesity among persons at risk for diabetes are needed to halt the increasing incidence of diabetes.”
And perhaps acute care providers everywhere collectively reply: “So tell us something we don’t already know.”
The clear and confirmed link between obesity and diabetes is serious, and hangs yet another severe outcome on a growing list of obesity-related consequences. According to the Surgeon General, heart disease, cancer, breathing problems, arthritis, reproductive complications, gall bladder disease and depression are all associated with being overweight or obese. And the risk of premature death from all causes is 50 to 100 percent higher among obese individuals (body mass index > 30) compared to those with a healthy weight.
“Even moderate weight excess (10 to 20 pounds for a person of average height) increases the risk of death, particularly among adults 30 to 64 years,” states a Surgeon General’s Call to Action. (www.surgeongeneral.gov/topics/obesity)
In this issue, tucked between informative articles about mechanical ventilation, wireless blood glucose monitoring, handheld technologies and single-use devices, is a Spotlight on Bariatric Products. This market of products is, I’m sorry to say, a black eye for our culture. Equipment designed to help hospital personnel safely care for the morbidly obese is a sad testament to our utter complacency about dying from preventable diseases we have all been warned about. Hospital caregivers absolutely need this equipment, but I hope they don’t in 20 years.
Obesity is a borderline PI (politically incorrect) subject, but healthcare providers have got to keep preachin’ with words, and actions too. It’s gone from bad to worse — how much more can our hospitals and healthcare dollars sustain?
Thanks for reading.

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