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Treating Obesity Vital for Public Health, Physicians Say

Physicians who once treated mainly elderly patients for health problems such as diabetes, heart disease and stroke are seeing increasingly// younger patients who have the same ailments.

A review in the December issue of Mayo Clinic Proceedings focuses on the increasing prevalence of metabolic syndrome, a state characterized by cardiovascular risk factors such as obesity, high blood pressure and abnormal levels of glucose (sugar) and fats in the blood. Authors Lewis Johnson, M.D., and Ruth Weinstock, M.D., Ph.D., of SUNY Upstate Medical University in Syracuse, N.Y., say physicians and public institutions must work in tandem to curb the obesity epidemic.

“Unfortunately, as the population becomes less active and more obese, we’re seeing a rise in this constellation of risk factors for cardiovascular disease,” says Dr. Weinstock, chief of Endocrinology, Diabetes and Metabolism at the university. “That’s of great concern because of the increased risk for heart attack, stroke and diabetes, and we’re seeing this occur in younger and younger individuals.”

Cardiovascular disease is the leading cause of death and disability among adults in the United States. The number of U.S. adults who are overweight or obese increased from 47 percent of the adult population in 1976–1980 to 65 percent in 1999–2002.

An estimated 1 million U.S. adolescents meet the criteria for metabolic syndrome. Based on these and other numbers, Drs. Weinstock and Johnson say a major increase in cardiovascular disease could occur in the next two decades.

“Increase of heart disease and stroke is of particular concern,” says Dr. Weinstock. “If that tide can be reversed, then hopefully we can make an impact in terms of improving public health in the future.”

The obesity epidemic has been making headlines for years, authors note, and strides have been made to address the problem. Schools are serving healthier meals, health insurers are offe ring price reductions to members who exercise, and cities are being designed so that residents can leave their cars at home and safely traverse trails and paths.

But more needs to be done, physicians say, including further research on how to prevent metabolic syndrome. Dr. Weinstock says physicians agree that treatment should be aggressive and urge patients to modify their lifestyles to include weight loss, physical activity and a healthy diet. Medications are important in treating risk factors such as diabetes and high blood pressure.

Another important component is informing the public that becoming obese can bring serious health problems, Dr. Weinstock says. Ultimately, helping prevent people from becoming obese is the top goal for physicians and other health officials, she says, especially because maintaining weight loss is the toughest challenge for people who are obese.

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