By Dr. Zack Steele
I love to tell the story about a diabetic retina specialist whom I worked under as an intern. After a long day of politely educating each patient in the Shreveport Louisiana eye clinic, he was just about to boil over.
When I followed him into a room to check on a patient who had come in for a follow up visit with bleeding retinas, he indeed boiled over. The patient was enjoying a box of doughnuts in the exam chair. He looked her square in the face and said “You are too fat. You will go blind soon if you don’t stop what you are doing to your body, and you will die soon after that.”
When we left the lady crying in the exam chair sobbing over her doughnuts, he told me that he was fed up, and every once in a while, he lets loose on a patient. His next words stuck with me- “I’m old, and I’m not about to kiss every diabetic patient’s rear end who comes in here. But you have to, at least until you get old and burned out like me.”
It’s been over 10 years since then, and with obesity and diabetes exploding in the U.S, I often wonder when I will reach my own boiling point.
Don’t worry. I am not there yet, but these stats straight from the CDC are pretty sobering:
More than one-third of U.S. adults (35.7%) are obese. No state has met the nation’s Healthy People 2010 goal to lower obesity prevalence to 15%. The number of states with an obesity prevalence of 30% or more has increased to 12 states in 2010. In 2009, nine states had obesity rates of 30% or more. In 2000, no state had an obesity prevalence of 30% or more.
Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer, are some of the leading causes of death. In 2008, medical costs associated with obesity were estimated at $147 billion; the medical costs paid by third-party payors for people who are obese were $1,429 higher than those of normal weight.
During the past 20 years, there has been a dramatic increase in obesity in the United States and rates remain high.
By state, obesity prevalence ranged from 21.0% in Colorado to 34.0% in Mississippi in 2010. No state had a prevalence of obesity less than 20%. Thirty-six states had a prevalence of 25% or more; 12 of these states (Alabama, Arkansas, Kentucky, Louisiana Michigan, Mississippi, Missouri, Oklahoma, South Carolina, Tennessee, Texas, and West Virginia) had a prevalence of 30% or more.
The South has the highest prevalence of obesity (29.4%) followed by the Midwest (28.7%), Northeast (24.9%) and the West (24.1%).
Among non-Hispanic black and Mexican-American men, those with higher incomes are more likely to be obese than those with low income. Higher income women are less likely to be obese than low-income women. There is no significant relationship between obesity and education among men. Among women, however, there is a trend—those with college degrees are less likely to be obese compared with less educated women. Between 1988–1994 and 2007–2008 the prevalence of obesity increased in adults at all income and education levels
Combining county-level estimates for obesity, diagnosed diabetes, and leisure time physical inactivity for 2008 show that counties with high levels of all three conditions are primarily concentrated in the South and Appalachia, while counties with low levels of all three conditions are primarily concentrated in the Northeast and West. In Alabama, over 10% of adults have type II diabetes. One in ten. That is amazing to me.
How did we get this way? We can point blame everywhere from McDonald’s to Direct TV. But there is no doubt in my mind we have to do everything in our power to fix it. We do that by educating our kids about the importance of exercise and eating the right things. I wouldn’t hurt for us adults to get off of the couch and walking to start with, and watching what we eat a little bit better. We have a long way to go, but I think we all have to make some changes to help with the health risks and skyrocketing costs of eating ourselves to death.
Dr. Zack Steele is a 2003 graduate of UAB School of Optometry. His practice, Trussville Vision Care, is located in downtown Trussville. You can follow his blog at http://cectvc.blogspot.com.