American patients are suffering from an obesity crisis, where it is estimated that 300,000 deaths per year are due to obesity.1 The obesity trend is predicted to worsen, where it is projected that 85% of U.S. adults will be overweight or obese by 2030.2 Consequently, obesity-related illnesses are on the rise, most notably cancer. More than 630,000 people in the United States were diagnosed with a cancer linked with being overweight or with obesity in 2014, and the rates of 12 of 13 obesity-related cancers have risen 7% from 2005 to 2014.3 The death toll, associated morbidities, and costs associated with obesity seem to be spiraling out of control, without any clear leadership in sight to defend our population from this malignant epidemic.
“We physicians need to learn from the success of tobacco control and start to lose weight ourselves and lead patients by example.”— Damien Hansra, MD
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Who can patients turn to for help? Doctors, viewed by most as the leaders in medicine, are not immune to the obesity crisis. According to the 2007 Physicians Health Study of 19,000 doctors, 40% were overweight and 23% were obese.4 Overweight and obese doctors may be significantly less likely to counsel their patients about weight loss.5 Also, overweight and obese doctors may feel less confident in counseling patients on weight loss compared with doctors who have a more healthy weight.5
Of concern, one study found 41% of patients with cancer preferred to listen to an oncologist who has a more healthy weight than an oncologist who is overweight or obese regarding weight-loss counseling.6 Essentially, doctors who are overweight or obese may tend to feel less confident about counseling their overweight or obese patients about weight management. To make things worse, a significant percentage of patients prefer to listen to doctors who have a more healthy weight.
Lessons to Be Learned From Tobacco Control
Does it seem right for doctors who smoke to tell their patients to stop smoking? Historically, smoking cessation rates, in part, increased after doctors themselves stopped smoking and increasingly engaged in smoking cessation programs for patients. We physicians need to learn from the success of tobacco control and start to lose weight ourselves and lead patients by example.
As doctors rise to the challenge and increasingly engage in healthy lifestyle habits to induce weight loss, they would be best suited to lead the charge into battle against our insidious opponent: obesity. Once doctors champion the fight against obesity, it is foreseeable that patients, and other parties such as medical societies, industry leaders, and policymakers, would be galvanized and align to engage in the formulation of treatment and prevention strategies to combat this deadly public health crisis.
—Damien Hansra, MD
1. U.S. Department of Health and Human Services: Overweight and obesity: A major public health issue. Prevention Report 16, 2001.
2. Hruby A, Hu FB: The epidemiology of obesity: A big picture. Pharmacoeconomics 33:673-689, 2015.
3. Steenhuysen J: Obesity-related cancers rising, threatening gains in U.S cancer rates. Available at www.reuters.com/article/us-usa-cancer-obesity/obesity-related-cancers-rising-threatening-gains-in-u-s-cancer-rates-idUSKCN1C826R. Accessed November 4, 2019.
4. Beck M: Checking up on the doctor: What patients can learn from the ways physicians take care of themselves. The Wall Street Journal. May 25, 2010. Available at http://online.wsj.com/articles/SB10001424052748704113504575264364125574500. Accessed November 4, 2019.
5. Bleich SN, Bennett WL, Gudzune KA, et al: Impact of physician BMI on obesity care and beliefs. Obesity (Silver Spring) 20:999-1005, 2012.
6. Hansra DM, Daniels C, Alvarez RH: Evaluation of cancer patients’ perspectives on weight management counseling at a comprehensive cancer center. J Clin Oncol 37(15 suppl):e18041, 2019. Abstract.