Kevin Eberly's Blog | Confronting America's Obesity Epidemic

A patient’s experience starts the moment he or she steps foot in the office. It starts with the greeting from the assistant at the front desk, followed by the amount of paperwork to fill out, followed by the interaction with the nurse, and then, finally, the doctor.

It’s often a long process, not exactly a patient’s idea of fun, and a physician’s communication skills play an important role in whether a patient is willing to be receptive of the information provided. Today, the physician’s role goes beyond writing a prescription and sending a patient on the way.

America’s obesity crisis is affecting workers’ productivity and overall health of the nation, and physicians have a say in prevention, which starts a ripple effect. Prevention means fewer people are obese, fewer people driving up healthcare costs, fewer employees taking sick days. So, you can see why communication skills play a critical role.

You may not be able to teach empathy, but specific care models can set patients up for success. The Center for Medical Weight Loss, for example, focuses on a team atmosphere, one where the physician provides support and gets to know the patient on a deeper level, where the doctor really understands the underlying causes of unhealthy habits. It’s a personalized experience where each treatment plan is different. The model allows doctors to form a unique bond with each patient who steps through the door.

The more welcoming the office, the more likely a patient will be open to suggested treatment. Our healthcare system puts physicians in a powerful position. It puts physicians in the primary prevention role, and like all diseases, the sooner the problem is detected, the easier it is to treat.

By taking advantage of this role, we can significantly lower healthcare costs in this country. One overweight employee can add $1,500 in health costs per year, and with two-thirds of Americans overweight, the costs add up quickly.  Part of the solution to these startling costs is the evolution of the physician role to a more patient-centered approach, one where weight loss becomes a team effort. 

Everything is at our fingertips. With a touch to our smartphones we can have food delivered to our door in minutes, get the latest updates on our favorite sports teams, read a book, and surf the Internet without leaving the couch.

On one hand it sounds like the perfect setup for a sedentary lifestyle, but on another hand, technology can help us reach our fitness and weight loss goals. And according to a study conducted at the Jean Mayer USDA Human Nutrition Research Center on Aging (HNRCA) at Tufts University, the workplace environment combined with technology is a successful strategy.

The study found workplace programs that include behavioral counseling coupled with supportive emails are effective in managing weight long term. During the study, program participants received professional counseling during their lunch hour, which focused on strategies for menu planning, managing hunger, portion control, and ways to deal with emotional eating. They also received email support from their counselor.

After six months, results showed that employees who participated in the program significantly reduced their risk for cardiovascular disease and diabetes. Researchers believe the camaraderie of the work environment contributed to the positive outcomes. It became a part of the culture, sort of a ripple effect.  

While in-person behavioral counseling, like the one conducted in the study above and counseling provided by physicians at The Center for Medical Weight Loss, has proven to be the most effective weight loss strategy, telephone and email counseling have also proven popular in our fast-paced world. 

If companies cannot afford to bring in a physician to the office to provide behavioral counseling, a program set up over the telephone or through email comes in a close second, considering we have email at our fingertips. In a six-month study that included counseling over the phone and email, dieters lost, on average, 8 percent of their body weight. Those who received in-person counseling lost 9 percent, on average.

When technology is used correctly, it can combine convenience with results, and the best results include behavioral counseling. Ninety-five percent of self-help diet attempts usually fail, and unfortunately, 83 percent of diet attempts are self-help.

But we are in a situation where now, more than ever with the development of technology, the workplace can make a difference and focus on providing effective wellness programs that include behavioral counseling in some way, shape, or form. 

We spend the majority of our time at the office, and it is where we likely adopt healthy or unhealthy behaviors. The statistics speak for themselves, and these easy-to-implement wellness strategies can make a big difference in the overall health of America. 

A recent study researching employee healthcare spending found 10 health risk factors, which could be altered by making lifestyle changes, contribute to more than one-fifth of employer and employee spending.

The study, which was published in Health Affairs, found that 22.4 percent of $366 million spent annually by seven companies was attributed to the following risk factors:

• High blood pressure
• High cholesterol
• High blood glucose
• Depression
• Obesity
• Stress
• Tobacco use
• Poor diet
• Physical inactivity
• Excessive alcohol use

Obesity, no surprise to me, clocked in as the highest cost per capita per year, followed by physical inactivity. Obesity costs alone clocked in at $347 per capita per year.

Yes, it’s jaw dropping. But here’s what gets me: The majority of these risk factors are largely prevented by controlling your weight. If this isn’t a strong enough case for the importance of employee wellness programs, then I’m not sure what is.

Upcoming changes to the Affordable Care Act encourage employers to invest in wellness programs, myself included.

Currently, employers can charge higher insurance premiums without discussing steps with their employees to better their health. Beginning in January 2014, employers will have to refer employees to various wellness programs in order to charge higher insurance premiums for not meeting a specific goal. If an employee refuses to participate, an employer will legally be allowed to increase premiums up to 30 percent higher than the standard premium, as long as employees are given ample time to change their habits through a wellness program.

Essentially, this change, which seems slight, can significantly alter the way we look at changing our lifestyles. This requires employees and employers to have the obesity conversation, regardless of whether they want to. It brings the issue to the forefront of employers’ and employees’ minds. It forces everyone to acknowledge it.

Hopefully, the focus on wellness programs will decrease the cost of these risk factors, leading to reduced overall healthcare costs. It’s a win-win situation.

As an employer, if I’m going be required to invest in and recommend wellness programs to my employees, I’m going to take the time to look at the facts and suggest a program with proven results.

A study published in the American Journal of Medicine found physician-directed medical weight loss produces significant, effective, and sustainable results. It makes sense. We trust our primary care physicians with the majority of our chronic health problems, so why would our weight be an exception?

I strongly believe the majority of these risk factors cited can be controlled with the guidance of trained physicians. Do you think these changes will lower long-term healthcare costs?

We spend the majority of our time at the workplace—at least eight hours a day. Most of us are glued to our chairs, have some sort of caffeine beverage within reach, and keep a secret stash of candy, chips, or pretzels to comfort us when we push our stress threshold. Case in point, we’re obese.

The cure to America’s obesity problem starts with building a healthy workplace. It’s where we develop most of our eating habits—healthy or unhealthy—and we take these habits home with us. As an executive of a company, you have the power to encourage healthier habits. Here’s how you can trade in a no. 2 cheeseburger with a side of fries combo for a healthy workplace combo with a side of extra productivity.

Stock the break room with healthy snacks. A break room filled with cookies, doughnuts, and chips won’t do your employees’ health any good, and it affects more than their waistlines. Fattening and sugary foods often come with a crash, which could be why eyes start glazing over in those late afternoon meetings. It’s time companies trash the junk and offer healthier snacking alternatives like fruits, nuts, nutrition bars, and even baked chips. The couple extra bucks you spend on healthier snacks could save you thousands of dollars in medical costs.

Encourage movement. The most recent buzz in the news is that sitting is the new smoking. New research shows spending too much time in a chair can increase your risk of heart disease, obesity, and diabetes. Encourage your employees to really take a whole hour for lunch and to use a portion of that time to be on their feet. Even better, next time you have a meeting with just one or two people, take it outside and make it a walking meeting.

Be a role model. Setting a good example can make all the difference. Healthy living is a domino effect. If one person leads, others are likely to follow. Sometimes it’s just about taking that first step.

Offer wellness programs. Some employees may require professional help to achieve better health. An employee will be more inclined to participate in these programs if their company covers at least part of the cost. However, it’s important to invest in a program with proven results. The Center for Medical Weight Loss comes with a weight loss guarantee. Physicians are specifically trained to coach, mentor, and motivate patients struggling with weight. Providing employees with discounts to health clubs is an obvious and good incentive, but it’s not compelling enough for everyone. A program like CMWL keeps employees on top of their weight loss plan because the program requires meeting with a physician regularly.

Have fun. A fun workplace is a healthy workplace. Laughter and a positive attitude go a long way. When workers genuinely enjoy what they are doing, they are more productive, creative, and feel less stressed. You can have fun and get a lot of work done too!

Your primary care physician is the first person you turn to if you have a health-related concern. You put trust in your physician to guide you in the direction to better health and trust he or she has confidence to do so.

One chronic condition many primary care physicians are not confident in treating: obesity.

A recent survey, published in BMJ Open, found only 44 percent of primary care physicians reported success in helping obese patients lose weight. This low percentage may come as a shock to you, but it doesn’t surprise CMWL’s chief medical officer Dr. Michael Kaplan. He tells me it’s training you just don’t get in medical school, and you learn more about malaria than obesity. Ironically, he’s never had to treat malaria, but he has seen countless obesity cases.

Why is this a problem? Think of primary care physicians as defensive linemen—the first line of defense. They’re the first people to see the play unfold and determine the actions necessary to stop the offense from advancing and reduce the number of yards gained. Primary care physicians are usually the first people exposed to a patient at risk for obesity, and the sooner it is acknowledged, the sooner steps are taken to treat it, resulting in fewer long-term health issues.

When it comes to treating obesity, many doctors feel underequipped, unprepared, uncomfortable, or a combination of three. However, I was surprised to find, as the survey indicated, that the majority of physicians believe obesity screening should be a routine part of a visit, and BMI should be included as a fifth vital sign.

This attitude, which 93 percent of primary care physicians surveyed supported, is promising. Doctors are starting to hear the noise that says they should be on the forefront of treating obesity. It’s a chronic condition that needs to be treated over time, and physicians are most qualified to do so.

Physicians recognize obesity as a problem and support regular screenings, but how do we boost their confidence? They need a toolbox.

CMWL equips physicians to be on the front line of preventative obesity medicine. I wouldn’t be here if I didn’t believe it works. It’s not just my speculation, but science backs it up. A study published in the American Journal of Medicine found people enrolled in a 12-week, physician-led weight loss program lost an average of 28 pounds. It proves the positive effect physicians can have on a patient battling with weight issues.

Imagine how much smaller our healthcare costs would be if 100 percent of doctors felt confident in treating obesity; if 100 percent of doctors had the proper treatment platform and tools to help patients lose weight and manage weight loss over time. The dollars obesity is costing America warrants its own post. But what do you think? Should primary care physicians be more active in treating obesity?