Over a third of all American adults are estimated to be obese. Obesity has been linked to longer hospital stays and an increase in physician and health care services use. Obesity has also been linked to numerous health conditions and some of the top preventable causes of death including type 2 diabetes, stroke, heart disease and particular kinds of cancer.
The estimated medical cost each year in the U.S. for obesity was $147 billion in 2008 with the individual medical costs for obese people $1,429 greater than those for people of healthy weight.
The U.S. Preventive Services Task Force (USPSTF) recommends all adults get screened for obesity. The USPSTF further recommends any patient with a body mass index (BMI) of at least 30 kilograms per square meter undergo intensive, multipronged weight control behavior interventions. Detailed below are the most popular and effective forms of obesity screening and weight management interventions with an in-depth focus on one such type of intervention, diet counseling.
There are many reputable and reliable obesity screening methods, most of which utilize the BMI as their basis indicator. Your BMI is a calculation based on your weight and height. The correlation between your BMI and your weight status are as follows:
- Underweight – less than 18.5
- Normal weight – between 18.5 and 24.9
- Overweight – between 25.0 and 29.9
- Obese – 30.0 and higher
A common alternative method of screening for obesity to BMI is measuring waist circumference. Having a higher-than-normal waist circumference can be linked with cardiovascular disease, hypertension, dyslipidemia and type 2 diabetes. Men with a waist circumference of over 40 inches and women with a waist circumference of over 35 inches fall into this category. Particularly at risk are those who also have a BMI of 25 to 34.9 kilograms per square meter.
Weight Management Interventions
There are many effective interventions to help overweight and obese people to get their weight under control. Weight management related behavioral interventions have been associated with an average weight loss of six percent. Further, the higher the intensity and greater the frequency of the interventions, the more effective they may be. The more types of behavioral interventions implemented at the same time can also increase their overall effectiveness. Among the most common and effective of weight management interventions are the following:
- Set weight loss goals
- Perform physical activity
- Address your barriers to change
- Actively self-monitor
- Strategize ways to maintain the lifestyle changes you have made
- Improve nutrition and diet
Under the Affordable Care Act (ACA), most health plans cover diet counseling for individuals at high risk of chronic illness and health conditions. Depending on the insurance you have, diet counseling may even be provided free of charge.
A reduced calorie diet has been associated with weight loss in obese and overweight people. Diet counseling is aimed at promoting and supporting that reduced calorie diet in people. The essence of a healthy diet in terms of achieving and maintaining a healthy weight is balancing the number of calories you consume through food and drink with the number of calories you burn. Numerous studies have validated the efficacy of diet counseling in serving an overall program and goal of weight loss. A healthy diet is important whether trying to lose weight or to implement a healthy lifestyle. Find more preventive care tips here.
Among the foods typically recommended by diet counselors are fruits and vegetables, whole grains, low-fat or fat-free dairy products. Also recommended is a variety of lean protein sources, both animal and vegetable, including poultry and lean meats, beans, eggs, seeds, nuts, peas, soy products and seafood. In addition to these recommended foods are certain food components diet counselors commonly recommend people avoid, including:
- Starches and refined grains such as are found in white bread, cookies and many snack foods.
- Saturated fats found in animal products such as fatty meats, poultry, butter, cheese, whole milk and many snack foods and sweets. Plant products like coconut and palm oils also contain saturated fats.
- Sugars added as opposed to natural sugars, such as are found in fruits. Added sugars include manufactured sweeteners and syrups put in cereals, yogurts, sodas and other products. Adding sugar to foods and beverages like oatmeal or coffee also qualifies.
- Sodium, also known as salt, including both table salt and sodium added to packaged and prepared foods.
Besides combating obesity, other benefits of diet counseling may include reductions in your risk of developing certain kinds of cancer as well as high blood pressure, type 2 diabetes and heart disease. There are many tips commonly recommended in diet counseling sessions. Diet counselors recommend you keep a food diary tracking what, when, where and how much you eat as well as how you feel afterward. They recommend shopping with a list, avoiding shopping when you are hungry and reading the nutrition facts label before purchasing any food item.
Obesity in Pregnancy
Preventive health care for women is especially important when pregnant. Obesity is particularly problematic in pregnant women. Over half of all pregnant women in the U.S. are either obese or overweight. Further, being overweight during pregnancy increases the risk of retaining an unhealthy amount of weight postpartum.
If a pregnant woman is diagnosed as obese, then there are several other screenings she may undergo the following:
- Sleep apnea – Associated with obesity, sleep apnea during pregnancy, in particular, can raise your risks of lung and heart disorders, eclampsia, preeclampsia and high blood pressure, as well as increased fatigue.
- Preeclampsia – A disorder related to high blood pressure that is common in pregnant and postpartum women. In addition to causing possible liver or kidney failure, seizures or stroke, it could lead to premature delivery.
- Gestational diabetes – Diabetes first diagnosed during pregnancy could lead to a cesarean delivery. Women with gestational diabetes during pregnancy are more likely to deliver a child who develops diabetes at some point in his or her future.