Obesity

MKSAP: 49-year-old woman with obesity, hypertension, and type 2 diabetes mellitus

Conditions
September 1, 2018

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 49-year-old woman is evaluated during a follow-up visit. She is overweight and has hypertension and type 2 diabetes mellitus, both of which are well controlled. For several years, she has attempted to lose weight through various commercial diets; dietician-monitored, calorie-restricted diets; and physical activity. She has worked with a behavioral therapist, and …

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A physician’s warning on the keto diet

Conditions
July 11, 2018

The keto diet has recently garnered much fame for its apparent ability to improve diabetes and obesity – results so impressive the Journal of the American Medical Association recently highlighted the diet and thereby christened it as something more than a low-carb craze. However, not all the evidence supports such a positive outlook, leading the diet to straddle the increasingly blurred lines between faddist snake …

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Why are there vending machines in hospitals?

Policy
February 16, 2018

Why are there vending machines in hospitals? This seems like an odd question to ponder, and it certainly would seem to have nothing to do with the current state of medicine and health care in our country. But it is a question that I am having a hard time wrapping my brain around. Certainly, most hospitals do have vending machines that sell snacks and soda, and they are by no …

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Doctors: You’re just as unhealthy as your patients. Here’s why.

Conditions
August 8, 2017

Most people reading this would love to lose weight, feel better and live longer. Doctors are a smart and motivated group of people. Unfortunately, that intellect and drive has not prevented us from avoiding an increasing incidence of obesity, diabetes, and hypertension identical to the general population.

While this article may have started out sounding like an infomercial, I promise it will not end like one. …

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Overweight patients are not necessarily lazy

Conditions
June 4, 2017

My nurse practitioner was pleased to see me at my annual physical this year. “So how does it feel to be 20 pounds lighter?”

“It feels terrible,” I replied.

Allow me to explain.

Weight has been an issue my entire life. Raised on a standard Midwest diet of complex carbohydrates and the best processed delicacies that government assistance could buy, I spent most of my childhood socially segregated by my peer group due …

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Obesity and empathy: A physician’s New Year’s resolution

Physician
January 16, 2017

Empathy is the cornerstone of quality patient care. It is no surprise that the fundamental moral code that has facilitated human kindness for thousands of years is what drives physicians to commit to their oath today: Treat others as you would have yourself treated.

When it comes to the disease that is obesity, I can empathize. I’ve struggled with obesity for as long a time as I can remember. There are …

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This doctor stopped telling patients to lose weight. Here’s why.

Conditions
October 21, 2016

Several years ago, I was meeting a young woman in my clinic for the first time. She was healthy but had been obese most of her adult life, even though she had tried many methods of losing weight. We spoke for a few minutes about diet and exercise, and she agreed to see the nutritionist.

A few months later, she came back to check her progress. She had lost weight, about …

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Obesity changes the way our endocrine system functions

Conditions
July 8, 2016

A patient of mine brought donuts in yesterday for the staff, and I confess! I had the one with sprinkles.

But with the study published in JAMA reporting that 35 percent of U.S. men and 40 percent of U.S. women are obese, I felt the need to talk a little about obesity and reproduction.

The endocrine system is tightly regulated by hormones which provide feedback to the brain to control their …

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How to talk with your kids about exercise

Physician
March 18, 2016

No matter how early I rise with the intention of getting my workout done before my children wake up, I’m rarely able to do it alone. Most days my 3-year-old daughter climbs out of bed and comes straight down to our home gym and watches me do my workout.

Often times she’ll sit quietly in the corner, but sometimes she’ll join in and follow the trainer on my workout DVD and …

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Should junk foods carry warning labels?

Physician
June 3, 2014

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There is, of course, stuff we can chew and swallow that isn’t food. Play-Doh comes to mind. As does Silly Putty.

My thoughts turned to those substances, among others, when my friends at Time magazine asked me recently to opine on the suggestion that junk foods should carry warning labels. My first inclination was: No, that’s too much. But then it dawned on me: Is anything that …

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Should BMI be used to measure obesity in children?

Conditions
April 25, 2014

Stephanie wrote in about a very common problem:

My daughter is 4 years old. She isn’t the tallest cat in town (she is about the 15th-25th percentile for height), and her BMI always ends up being in the high range (like over 85%). I worry about it. I am very health conscious for myself and my family. We live by all of the “rules.” And yet.

The family doctor doesn’t worry — …

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The deadly consequences of media distortion in health and medicine

Physician
April 24, 2014

The recent concentration of misleading media hooey about health has been excruciating, but the problem is perennial. I trust I needn’t make the case that you are under constant assault by distorted, contorted, titillating, and insipid headlines. This is certainly true in my domain of health and medicine; it may well be true more generally, but I tend to limit my commentary to the realm of my actual expertise. But to …

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Weight loss resistance is real

Conditions
March 31, 2014

Weight is not a behavior, and weight is not a choice. Nobody wakes up and decides what to weigh today. In an age when healthy and unhealthy behaviors are increasingly subject to incentives and disincentives, respectively, this is all too easily forgotten.

Of course, weight is largely the byproduct of behaviors and choices, namely what and how much we eat, and what and how much we do: calories in and calories …

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Lebron James: The king of junk food

Conditions
January 13, 2014

lebronfood

Lebron James makes over $19 million per year playing basketball for the Miami Heat. Not surprisingly, this salary is peanuts compared his endorsement earnings, which in 2012 topped $42 million. Although perhaps peanuts is the wrong word to use when discussing James outside earnings, which to my knowledge have not involved foods anywhere near as healthy as peanuts. Instead, according to …

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Food deserts are incredibly complex problems

Policy
October 27, 2013

food-desert-1

Recently, food has become the center of a revival of interest in cultures that make up Chicago.

The smells, tastes, sounds, and even atmospheres created by cuisine allow both tourists and native Chicagoans to sample our city’s diverse cultural heritage. As such, food has become an increasingly popular and a relatively inexpensive way to enjoy what Chicago has to offer. In fact, one …

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When should insurance cover body contouring?

Conditions
September 7, 2013

Today in clinic, I interviewed a formerly morbidly obese woman. She has lost almost 300 pounds since undergoing gastric bypass surgery a few years ago, a presentation that has become increasingly common. She was here to see the plastic surgeon for her four week follow up appointment, status post abdominal skin flap removal.

See, after losing a ton of weight, loose skin remains, especially in places like the arms and abdomen.  …

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Don’t waste your time finding the perfect diet

Conditions
September 7, 2013

Nathan Pritikin: 69.  Robert Atkins: 72.  Roy Walford: 79. Adelle Davis: 70.  Aveline Kushi: 78.  Marjorie Shostak: 51. Jack LaLanne: 96.  Ancel Keys:100.

David Murdock is a billionaire who believes that he knows the formula for the perfect diet.  Not only has he built his own research institute to refine his theories, but he is confident that his food choices will keep him alive to the age of 125. This would …

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Did Mike Huckabee foreshadow his journey back to obesity?

Conditions
May 15, 2013

Ah, the addictive power of modern food.  Never underestimate it.

On a recent trip to New York I happened to be flipping through the channels on my in-flight TV when I ran across Mike Huckabee doing an interview on Fox News.  I was surprised to see that he had gained his weight back.  The former governor of Arkansas and presidential candidate had staked quite a bit on the success of his …

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