The Doctors - Alex Cosio-Santillan, Mikey Carnevale, Johann Valder, Tommy Bouquin, Gabriel Navarro

Preliminary Questions

1. Should obesity be treated as an epidemic?
2. What other health issues can obesity lead to?
3. What are the costs of health care and procedures related to obesity?
4. How involved are health care professionals in informing parents and children of proper diet and exercise?
5. Are selective procedures performed by plastic surgeons on overweight people irresponsible in the lack of mental change towards the danger of being obese? In other words changing the looks doesn't change the mind, should health coaches be part of the process in the overweight person's recovery?
6. What are doctors doing to change people's perception of obesity and being overweight?
7. How prepared are doctors to deal with obesity?
8. Regionally, the average weight differs in the US, does this have to do with the inefficiency of health care in those areas?
9. To which point should insurance cover obesity?
10. Even though the ratio of obese to healthy people is nearing even, should society be accommodating a lean towards the needs of unhealthy people?

Summaries:

Obesity leads to rise in cosmetic surgery to reduce flabby skin


In an article in The Telegraph, Alastair Jamieson writes about the rise in plastic surgery for those people who have lost weight but retained the excess skin. These procedures are elective and end up costing incredible sums of money. As for the surgeries, they include “tummy tucks,” “breast reductions,” “breast uplifts,” and for the most part these are geared towards women. However, in the past few years, men have near overtaken women, statistically more likely after a nose alteration. Some 60 percent increase in elective surgeries has been accounted for by men. The surgeons who perform these operations pose their practice as a necessity for patients who are crushed to find all their hard work of losing the weight is in vain.

Elective Surgery Determined by Regional Doctors in U.S.


An article on ThirdAge.com, by Eric Lander, states that when deciding if a patient wants to elect to have cosmetic surgery the patient relies heavily on the opinions of the doctors they see. In a study focused on 65 year-olds covered by Medi-care drastic differences in choice presented themselves by geographic region. For the most part it is because health care is so "Doctor-centric." For example a man who live in Southern California is 12 times as likely to elect for surgery as a man in Georgia. Accompanied with these regional differences is the revenue received by the cosmetic surgeons. It would seem that the culture and beliefs of doctors by region determine their plan to help their patients.This is shocking to patients who believe that all doctors will have the same plan and the patients well-being in mind.

Liposuction on the rise as many women shun exercise and dieting


An article on NaturalNews.com, by staff writer David Gutierrez, addresses the growing rate of acceptance of cosmetic surgeries. Women who are tired of trying to work off the fat find the alternative easier. A Cosmetic Surgeon states "It is not desperately difficult, I could teach a four-year-old to do it. The skill comes in resculpting the body." However this new found public acceptance doesn't cover the fact that accidents, some major, do occur in surgery. A study shows that 7 out of 1000 surgeries end with an end result that wasn't desired. But there is hope. Some surgeons choose to refuse people who are 50 lbs or under overweight. But with the revenue at 15 billion a year for the practice one would not see a reason for the surgeons to protest.

by. Alex Cosio-Santillan



Recognizing the IssueGoodDoctor.jpg
Mikey Carnevale
Of all the topics doctors go through on a daily basis, telling patients about their weight issue remains the most difficult. Both the patient and the doctor know about the issue, yet they are both too scared and embarrassed to bring it up. It has to come down to the fact that it is the doctor’s responsibility to let their patients know. Otherwise, the issue could lead to other problems such as heart attacks or strokes. One doctor from Tennessee is working on programs that doctors can use to help and guide patients through their weight problems. One patient- after relieving some of her weight through the doctor’s program- even thanked her doctor for letting her know about her issue and is very grateful he caught it so early. One thing the doctor did was control the patient’s diet. He told her by the next time she sees him he wanted her to stop drinking soda and cut out fast food. He saw the patient once a month for a year and over time she dropped 149 pounds and also dropped her diet pill intake from12 to 6. Thanks to her doctor letting her know of her weight problem, she is now able to walk 2 miles a day and feels wonderful.

Heavy Michigan
Mikey Carnevalemichigan.jpg
A Michigan governor asked the doctors of his state to report the body fat level to a government registry in hopes to compete against the struggle of child obesity. The state doctors and hospitals welcomed it using it as a way to also test for HIV, cancer, and other possible diseases. The registry also wanted to make sure that the doctors gave them the body mass index of the child as well. They were taking all precautions necessary. Many do not know but BMI is basically a height to weight ratio that raises possibilities of diseases or heart attacks. The rise of child obesity is expected to add 7.8 million cases of diabetes, 6.8 million cases of heart problems, and 539,000 cases of cancer by 2030. It is said by the governor of Michigan that 67 percent of his states adults are obese. They are hoping that tests such as these can bring an end to the epidemic of obesity.



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Stopping Obesity Early

Mikey Carnevalefat_baby.png
Doctors who monitor infants and their weight, grant that child with the unlikelihood of becoming obese when they grow older. Doctors urge however, that obesity takes time to develop so it must be watched and should always be taken seriously rather than just tossed as a small problem. To catch obesity before it hits, the doctors take the child’s weight and height to get the average BMI and recommend keeping it there. Doctors are forced to tell the parents if they see that the child’s BMI is a little heavier than most. As of now, about 10 percent of our nation’s babies are too heavy for their size and age. Then 20 percent of toddlers and young children are too heavy as well.

What Doctors Don't Say About Obesity
Gabriel Navarro
An obese person has a higher risk of heart disease, diabetes, hospitalization, and even early death. According to a 2005 study in journal Pediatrics, doctors diagnosed obesity less than one percent on 2-18 years olds, below the one-third of Americans who are struggling with weight. BMI is an imperfect metric, because it does a poor job on taking body types and muscle mass, like a big person with low body fat can be labeled obese even though he isn’t. But BMI does help.

http://www.time.com/time/specials/2007/article/0,28804,1703763_1703764_1703938,00.html

Guide to Bariatric Surgery
Gabriel Navarro
People who have a BMI of 25 or above might be considered overweight and people who have a BMI of 30 or greater is considered obese. Individuals with a body mass index (BMI) of 35 or greater may initially perform an abdominoplasty, panniculectomy, or liposuction to reduce fat. Body lift may also be considered an option if the person’s BMI is under 35. People with over BMI of 35, body lifts are not appropriate. Many obese patients turn into a procedure called Gastric Bypass in order to achieve significant weight loss.

http://www.yourbariatricsurgeryguide.com/roundtable-obesity/

Gastric Bypass Surgery - criteria
Gabriel Navarro
Gastric bypass is a surgery to drastically change a person’s body and should only be done if all weight loss procedures or options have failed. The surgery is recommended fro people who are morbidly obese, at least 100 pounds overweight for a man and 80 pounds for a woman, and had been morbidly obese for the past 5 years or more and unable to loose a significant amount of weight through diet and exercise. Gastric bypass surgery is considered fro people who are morbidly obese, having a BMI of 40 or more.

http://www.aboutgastricbypasssurgery.com/gastric-bypass-surgery-criteria.html


Bias Affects Health Professionals and Ordinary Americans

In this article an investigator finds out that people are prejudice against obese people, even doctors and nurses. To find out who is prejudice against overweight people, the investigator gave them an interesting test. The test asks toput certain words in certain categories.The health professionals and doctors were faster at pairing "fat people" with "lazy," "stupid," and "worthless" than with "motivated," "smart," and "valuable." Judith Stern, a doctor, said she wasn’t surprised with the results,"health professionals just reflect the general population. I'm not surprised they reflect this pervasive bias," Stern says.

http://www.webmd.com/diet/news/20030926/even-doctors-have-obesity-prejudice


When Doctors Judge Their Obese Patients
In this article a doctor tells a story about an obese patient that tries to avoid doctors as much as possible. As the doctor found out, the patient’s previous doctors had treated her bad and judged her. She felt she wasn’t treated as a patient, but as a fat patient. This could be a reason why many obese people don’t get help because they are very self conscious about their bodies. This doctor that found out the truth about his patients last experiences with doctors but he still blamed her for her condition.

http://www.huffingtonpost.com/david-katz-md/obesity-of-blame-and-sham_b_834937.html


Blue Cross/Blue Shield Helping Doctors Treat Childhood Obesity


In this article the medical insurance provider Blue Cross Blue Shield developed a program to help doctors in their efforts to treat childhood obesity. The program was tested in North Carolina where a third of the children are obese. This program encourages kids to
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  • Eat 5 servings of fruits and vegetables every day
  • Limit screen time to 2 hours or less
  • Get at least 1 hour of physical activity
  • Limit sweetened drinks to 0
The U.S. department of health reports that children who are overweight have a 70% chance of being obese when they are adults.


http://www.myoverweightchild.com/blog/2011/01/blue-crossblue-shield-helping-doctors-treat-childhood-obesity.html


Written by: Johann Valder







Tommy Bouquin
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Why kids are becoming so obese





In a recent interview with Bob Rice, M.A., and Aki Morita, Ph.D., who are licensed therapists,
they discussed the factors that lead to childhood obesity. One factor that they say contributes to it is genetics.
People’s individual statistics and how their gene pool is constructed shapes who they are and what
type of person they will become, even eating habits. Another factor that contributes to obesity is
people’s lifestyles. Back then there wasn’t tv and video games to keep kids inside.
They had fun by going outside and playing with their friends. Another thing that is hurting kids is their
parents’ work schedule. Instead of coming home to a nice home cooked meal, parents turn to fast food
to get dinner into their kids so they don’t have to become distracted from their job. Boredom is also another
contributing factor. Kids eat because it is the easiest form of entertainment that they can find and that is
hurting them as well. Parents need to step in and take control of their child’s eating habits before it becomes
too late for them.




No fatties allowed!
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A recent study done in South Florida showed that out of 105 health practices, 15 said that they wouldn’t treat a patient if they were over a certain weight, some even at 200 pounds. The doctors that refuse service give excuses such that their equipment can’t handle the payload
that the extra-heavy patients have and some they that they don’t want to deal with the patients that are more susceptible to develop an illness that would be more difficult to treat. The doctors say they won’t deal with obese patients at all because there is more of a risk with overweight people and if something goes wrong they are more at risk of getting sued. Doctors who do treat obese people and found out about this said that it is unethical and border line discrimination for doctors who don’t treat somebody because they are obese.



Why kids are having trouble losing weight

Many doctors today use the same procedure for every obese kid that walks into their office. They tell them right up front that they are obese and that they need to change that, so they discuss the right eating habits and exercise until their next check up. But it never works. Year after year the kids just come in fatter and fatter and doctors don’t know what could be the problem. One problem that doctors say that kids may have trouble losing the weight is because of denial. Many people that are obese think that because they look like everyone else, who is also obese, that they are fine and just keeping getting more and more fat. Another reason why people have trouble is that they procrastinate to start their diet and make up excuses to not start it. Discouragement is also a contributing factor to it as well. People say to themselves “why am I torturing myself to eat healthy” and they don’t follow through with their diet. The final reason why it is hard is just because it is so difficult to overcome the fact that people have to say to themselves “ok, I’m fat, I have to lose weight or else I will die” and that is really hard for someone to do. There are a few reasons why people shouldn’t lose weight but the reasons that they should lose weight is a far greater list.


WORKS CITED
Helmic, Nanci. "Doctors Join Fight Against Obesity." USA Today 6 Oct. 2009: n. pag. USA TODAY. Web. 15 Sept. 2011. http://www.usatoday.com/news/health/ weightloss/2009-10-06-doctors-obesity_N.htm.

Kelleher, James B. "In Health Push, Michigan to Track Childhood Obesity." Reuters. N.p., n.d. Web. 15 Sept. 2011. http://www.reuters.com/ article/2011/09/14/us-obesity-michigan-idUSTRE78D63G20110914

Moyer, Christine S. "How Physicians Can Help Children Avoid Obesity." AMED. N.p., 11 July 2011. Web. 15 Sept. 2011. [[http://www.ama-assn.org/ amednews/2011/07/11/hlsa0711.htm]].

The Daily Beast. “Strong Medicine,Doctors must do more to help patients battle the bulge.” The Daily Beast. N.p., 13 Mar. 2010. Web. 16 Sept. 2011. [[http://www.thedailybeast.com/‌newsweek/‌2010/‌03/‌13/‌strong-medicine.html]].

Freeman, David W. “Fat-phobic doctors refuse to treat obese patients: Is that fair?” CBS News. N.p., 17 May 2011. Web. 15 Sept. 2011. [[http://www.cbsnews.com/‌8301-504763_162-20063541-10391704.html]].

Vivo, Meghan. “The Obesity Epidemic - To the Heart of the Matter: The Experts Weigh in on the Causes of Childhood Obesity.” My Overweight Child. N.p., n.d. Web. 22 Sept. 2011. [[http://www.myoverweightchild.com/‌obesity-epidemic.html]].