From the Editor: The STOP Obesity Alliance recently announced a new director, Scott Kahan, MD, MPH, following founding director Christine Ferguson's move to lead the state of Rhode Island's health insurance exchange. While many Alliance members and partners have worked with Dr. Kahan in his role as Clinical Advisor or in his other capacities as an obesity expert, his expanded role as Alliance Director seems a good time to re-introduce him to our readers. The following is an excerpt from an interview Alliance newsletter editors held with Dr. Kahan earlier this month.
Alliance Editors: Tell us how you see your role as a clinician intersecting with leading the STOP Obesity Alliance.
Dr. Kahan: First and foremost, I am a doctor. And up until I began my public policy work, and especially my involvement with the Alliance, I had rarely considered how my view from the exam room, might actually be valuable from a public affairs or advocacy perspective. Today, however, I see things much differently. I see how important being in the trenches with people who are struggling with obesity and weight-related chronic disease can be to finding pathways to overcome and prevent these serious and debilitating health conditions. As Clinical Advisor, I offered patient insights when the Alliance developed tools like the Essential Health Benefits Task Force recommendations and our updated policy recommendations. Together with our coalition members who represent consumers and health care professionals, we ensured our work was sensitive to the systemic or cultural barriers that may be preventing long term weight-loss success. In my role as Director, I expect to continue bringing this perspective to the table. I look forward to deepening our research into the evolving field of obesity science and finding ways to communicate - really translate - what we're learning into practical and actionable steps that can help both national decision makers and individuals alike.
Alliance Editors: In what area do you see the greatest chances for positive change in the near term?
Dr. Kahan: Our understanding of the complex nature of obesity, just how multi-faceted a condition it is and how interrelated it is to other chronic, long-term diseases, has been a major development. Thanks in large part to the work of the Alliance, our national conversation surrounding obesity has shifted to a more responsible, health-focused dialogue. In the media and in policy discussions, we are seeing references to obesity in terms of health, not appearance; we're moving to a more health-focused definition of success; and there is growing acceptance for the fact that addressing obesity requires successfully integrating both prevention and intervention. Positive behavior change plus other support systems are required.
The evolution of addressing obesity as a matter of health has been the area where we've seen the most progress. It's also the place where I think we have the greatest chances to see even more positive changes in the near term. New recommendations from the United States Preventive Services Task Force state that primary care physicians should screen their adult patients for obesity are just one example. While most doctors are still in need of training for weight-related health issues - both in terms of building specific clinical skills and an informed, non-stigmatizing attitude - we can at least motivate physicians to offer their patients valuable resources to get the help they may need.
Alliance Editors: How about the challenges? What obstacles are particularly vexing?
Dr. Kahan: There's one thing about being in the trenches...you really see what works and what doesn't, on a practical level. While there is a huge amount to be done to bring obesity further along the research continuum, I have also seen that there are limits to what we can learn from randomized controlled trials, especially in terms of what we can broadly apply across those who are affected. Not to understate the importance of these studies. They are invaluable. But they do need to be put into perspective. In practice, we often see many things that are evidence-based and supposed to work, but end up not working all that well. Then there are other approaches that may not show up in the peer-reviewed literature, but have been really valuable in practice. We have to be open to both.
"Operator dependence" is an important consideration, as well. The best treatment in the hands of an untrained provider can backfire. So we need to work in policy and practice to offer appropriate obesity-related education.
There are lots of smart, passionate people in public health, and lots of smart, passionate clinicians. But I have seen a disconnect between these groups, and that means we are not yet seeing the whole picture of how to address this issue - both as a matter of population health and how we might achieve success one person at a time. With 1 in 3 Americans affected by obesity and another third with overweight, we're going to have to recognize that one size will not fit all. And that is a high mountain to climb.
Alliance Editors: What excites you the most about the work of the STOP Obesity Alliance this year?
Dr. Kahan: Both our work with the states and expanding our research to help families who are struggling to help a child affected by obesity are really important. The Alliance has a great track record of helping to shift the dialogue around obesity and weight-related chronic disease to one that is research-based and responsible. From my work in both public health and clinical practice, I know that the dialogue tool we are developing will be an enormous resource for families.
As a clinician, one of the things I've learned many times over is that the way we develop obesity, or overcome it, rarely resides solely with the individual. Many of the ways we interact with the world, including our habits, are shaped by our families, schools, homes and communities. So in addition to seeking help from physicians, there is great opportunity for both parents and children with obesity to find ways to achieve better health as a family - together! |
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Alliance & Member News
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Several Alliance Steering Committee and Associate Members were featured in news stories this month including: |
- Alliance Director Dr. Scott Kahan in Associated Press, "Know Your BMI: Docs Urged to Screen for Obesity," and HealthDay, "Obesity, Depression Blamed for Daytime Sleepiness Epidemic" and "Docs Aren't Coaching Overweight Kids on How to Slim Down: Study."
- Academy of Nutrition and Dietetics in FOXBusiness, "Banning Large Sodas: Who Loses, Who Wins."
- American Heart Association in USA Today, "Youth Diabetes, Pre-Diabetes Rates Soar."
- American Society for Metabolic and Bariatric Surgery in ABC News, "Bariatric Surgery for More Than Just Weight Loss?"
- Binge Eating Disorder Association in PsychiatryOnline, "Many Mysteries Unsolved in Binge-Eating Disorder."
- The Obesity Society in USA Today, "FDA OKs First New Prescription Diet Drug in a Decade," and CBS New York, "City Lawmaker Calls Big Drink Ban Proposal Pointless and Silly."
- Rebecca Puhl, PhD in TIME Healthland, "Women May Suffer Fat Stigma Even After Losing Weight."
Welcome Medicaid Health Plans of America - Center for Best Practices
STOP's new Associate Member, Medicaid Health Plans of America (MHPA) - Center for Best Practices, represents over 100 urban and rural health plans dedicated to serving the low income population's medical, health and social and economic needs. The MHPA's Center was created in 2010 to provide research, information and evaluation on important issues facing Medicaid health plans and their members. Prevention and treatment of obesity is a high priority for state Medicaid programs and health plans and as such is also a top priority of the Center for Best Practices. Click here to learn more about MPHA and follow the organization on Twitter at @MHPA.
OAC Announces New Webinar Series
Obesity Action Coalition (OAC) and Obesity Prevention, Policy and Management launched a free online 14-part webinar series focusing on the complexities of obesity. The next webinar, titled "Obesity, Hormones & Metabolism: Everything You Ever Wanted to Know but Were Afraid to Ask," will take place July 19 and focus on the relationship between obesity, hormones and metabolism. Click here to register.
AADE to Host Annual Meeting
American Association of Diabetes Educators (AADE) will hold its annual meeting August 1-4 in Indianapolis, Ind. This year's theme, "Power of Partnership," reinforces how empowerment and teamwork extends to everyone involved with diabetes education and care, from the patients themselves, to diabetes educators, to physicians and other health care professionals. Presentation topics will include the current state of the U.S. health care system and the potential impact on diabetes educators as well as reversing mindless eating. Click here for more information.
CDC Holds National Conference on Health Communication; CRI to Present Details of Life Enhancement Program
The Centers for Disease Control and Prevention, National Public Health Information Coalition and Substance Abuse and Mental Health Services Administration will hold the sixth annual National Conference on Health Communication, Marketing, and Media August 7-9, in Atlanta, Ga. Canyon Ranch Institute (CRI) Life Enhancement Program Manager Chuck Palm, MPH, will present outreach and implementation approaches, individual outcomes and information on the community impact of the CRI Life Enhancement Program at the conference. Click here to learn more about the conference.
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News Round-Up
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The Supreme Court upheld the central component of the Affordable Care Act, agreeing that the requirement for nearly all Americans to secure health insurance is permissible under Congress's taxing authority. The court modified another key provision of the law, ruling that the federal government cannot withdraw existing Medicaid funding from states that decide not to participate in a broad expansions of Medicaid eligibility.
U.S. Task Force Recommends Obesity Screening, Counseling for Obese Patients
June 26, 2012
CBS News
By Michelle Castillo
The United States Preventative Services Task Force (USPSTF) issued new recommendations that advise health professionals to screen their adult patients for obesity. If a patient is determined to be obese with a body mass index of 30 or more, the USPSTF recommended that those patients be referred to a comprehensive weight loss and behavior management program.
Long Commute Takes Away From Healthy Activities, Study Suggests
June 18, 2012
The Huffington Post
By Amanda L. Chan
Brown University researchers found that people who spend an hour every day commuting have less time for several healthy activities. They have 30.6 percent less time for sleep, 16.1 percent less time for exercise, 5.8 percent less time to eat with their families and 4.1 percent less time to prepare food. The study was published in the Journal of Urban Health.
Global Weight Gain More Damaging Than Rising Numbers
June 17, 2012
BBC News
By Matt McGrath
A study published in the journal BMC Public Health projects that increasing rates of obesity around the world could have the same impact on global resources as an extra billion people. Study researchers reported that North America had the highest average weight of any other population on the globe. The article notes that while only 6 percent of the global population lives in North America, it accounts for more than a third of the world's obesity.
Bill Frist Says Coaching Can Help Reverse Obesity Epidemic
June 16, 2012
The Tennessean
By Heidi Hall
At a Partnership for a Healthy America roundtable discussion on childhood obesity, former Senate Majority Leader Bill Frist, the group's honorary vice chair, said that doctors have a role in connecting patients to lifestyle and behavior change coaches for weight loss even if they are not personally prepared to coach patients. He noted that doctors are the most trusted source of information for patients.
Study: Couch Potatoes Are Thriving Around World, Not Just U.S.
June 14, 2012
Los Angeles Times
By David Zucchino
A study to be published in Obesity Reviews reports that people in China and Brazil are becoming more sedentary as they continue to modernize, and people in the United Kingdom are more inactive than Americans. Study researchers attribute these outcomes to modern conveniences like microwaves and dishwashers which have reduced laborious household chores, an increased reliance on cars and the popularity of the Internet, computer games and television.
Lots to Lose - How Obesity Is Costing America
June 6, 2012
The Hill
By Dan Glickman, Ann M. Veneman, Donna E. Shalala and Mike Leavitt
The Bipartisan Policy Center released a report, "Lots to Lose," outlining recommendations to combat the obesity crisis including: encouraging large public- and private-sector institutions to purchase and serve healthier foods, increasing training for health care professionals to help prevent obesity and related chronic diseases and creating workforce wellness programs throughout public and private businesses. |
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