Tag Archives: obesity

Innovative Ideas For A Weight Loss Company

As I’m enjoying my time thinking about what’s next, one of the things that I’ve thought a lot about key problem areas in our healthcare system.  Obviously obesity is one of them.  And, you have lots of companies trying to figure out what to do here.  

So, I was thinking about what I would do if I were at a Weight Watchers or Jenny Craig or Vree Health

  1. Build an assessment tool (like Milliman or InterQual) which could be used for assessing patients and creating an evidence-based care plan.
  2. Work with KitchenAid or others to create a branded line of smart devices which used the Internet of Things to do things like re-order healthy foods and suggest menus.
  3. Work with Jiff’s assessment tool or with Newtopia to study the ability to take data and create personalized diet plans.
  4. Work with FitBit or other device company and a gamification company to create a kid’s device linked to a game where the key player got fat tied to their activity level and where they opened up new levels tied to their behavior (e.g., eating healthy).
  5. Create online communities for people to share stories and experiences (like PatientsLikeMe but moderated).
  6. Move from physical locations to a virtual site using American Well technology blended with Withings scales.
  7. Incorporate stress management and sleep management into the overall program.
  8. Work with Healthways and the Blue Zones effort to create a family centric option tied into the schools and focused on getting everyone healthy across generations.
  9. Create a mobile coach using embodied conversational agents (similar to avatars) to drive behavior change and create a location-based prompts (i.e., as I pull into McDonalds).
  10. Work with manufacturers to create a “beyond the pill” approach to obesity drugs that incorporates coaching and behavior change with the pill being the final mile which should drive greater formulary coverage.
  11. Create a detailed patient journey map based on ethnographic research for weight loss with different triggers and create a “Coach certification” that can be used with coaches to certify that they are following best practices.
  12. Work with biometrics companies (e.g., LabCorp, Quest) or clinics (e.g., MinuteClinic) to create an early identification process for obesity and/or metabolic syndrome with a process for them to “prescribe” a specific program.
  13. Research and design ethnic specific obesity related programs for sub-populations within the US.  For example, partner with the large Hispanic groups to create a Spanish (language, experience, culturally relevant) programs.
  14. Partner with the ADA and NKF to jointly address metabolic syndrome together.
  15. Work with the AMA and medical schools to teach MDs how to treat and talk with obese patients (something they don’t do well today).
  16. Work with a grocery store or food company to create an augmented reality process for smart phones or Google Glass that would highlight healthy foods on the shelf and help people shop better.
  17. Work with Medicaid to create a process by which people earned cell phone minutes or lower copays based on activity and participation.  

Just some ideas that I thought I’d share.  

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Aetna’s Metabolic Syndrome Innovation Program

I’ve been closely following Aetna’s innovation for the past few years (see post on CarePass and Healthagen).  I had the chance last week to speak with Adam Scott who is the Managing Director of the Aetna Innovation Labs.

Here’s Adam’s bio:

Adam Scott is a Managing Director within Aetna’s Innovation Labs, a group developing novel clinical, platform, and engagement solutions for the next generation of healthcare.  Mr. Scott specializes in clinical innovation, with a focus on oncology, genetics, and metabolic syndrome, as well as “big data” analysis.  His work is aimed at conceptualizing and developing products and services that better predict illness, enable evidence-based care and lengthen healthy lives.  Prior to joining Aetna, Mr. Scott’s 15-year healthcare career has included management roles in consulting, hospital administration, and most recently health information technology.  Mr. Scott holds a bachelor’s degree from Washington University in St. Louis and a Masters in Business Administration from Northwestern University’s Kellogg School of Management.  Mr. Scott resides with his family in Needham, MA, where he actively serves as a director on community boards.

This is one of my favorite topics – Metabolic Syndrome (although yes…I still hate the term).

Definition of Metabolic Syndrome from the NIH:

Metabolic (met-ah-BOL-ik) syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetesand stroke.

The term “metabolic” refers to the biochemical processes involved in the body’s normal functioning. Risk factors are traits, conditions, or habits that increase your chance of developing a disease.

The Aetna Innovation Labs are focused on bringing concepts to scale and staying 2-3 years ahead of the market.  They are looking to rapidly pilot ideas with a focus on collecting evidence.  In general, Adam described their work as focused on clinical, platform, and engagement ideas.  They are trying to collaborate with cutting edge companies that they think they can help to scale quickly.  It’s pretty exciting!

As stated in their press release about this new effort:

“During the course of the last year, Aetna Innovation Labs has successfully piloted an analysis of Metabolic Syndrome and the creation of predictive models for Metabolic Syndrome. This prior work showed significantly increased risk of both diabetes and heart disease for those living with Metabolic Syndrome,” said Michael Palmer, vice president of Innovation at Aetna. “With this new pilot program with Newtopia, we are aiming to help members address Metabolic Syndrome through specific actions, before more serious chronic conditions arise, like diabetes and heart disease.”

Aetna selected Newtopia for this effort for their unique approach toward achieving a healthy weight with an integrative and personalized focus on nutrition, exercise, and behavioral well-being. Newtopia’s program begins with a “genetic reveal,” leveraging a saliva-based genetic test to stratify participants with respect to three genes associated with obesity, appetite, and behavior. Based on the results of this test and an online assessment, Newtopia matches each participant to a plan and coach trained to focus on the member’s specific genetic, personality and motivation profile. Through online coaching sessions, Newtopia will help members achieve results related to maintaining a healthy weight and Metabolic Syndrome risk-reduction, which will be measured by changes from a pre- and post-program biometric screening.

“Newtopia’s mission is to inspire individuals to make the lifestyle choices that can help them build healthy lives,” said Jeffrey Ruby, Founder and CEO of Newtopia.

If you’ve been following the story, this builds upon their project with GNS to develop a predictive algorithm to identify people at risk for Metabolic Syndrome.  As you may or may not know, there are 5 first factors for Metabolic Syndrome (text from NIH):

The five conditions described below are metabolic risk factors. You can have any one of these risk factors by itself, but they tend to occur together. You must have at least three metabolic risk factors to be diagnosed with metabolic syndrome.

  • A large waistline. This also is called abdominal obesity or “having an apple shape.” Excess fat in the stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips.

  • A high triglyceride level (or you’re on medicine to treat high triglycerides). Triglycerides are a type of fat found in the blood.

  • A low HDL cholesterol level (or you’re on medicine to treat low HDL cholesterol). HDL sometimes is called “good” cholesterol. This is because it helps remove cholesterol from your arteries. A low HDL cholesterol level raises your risk for heart disease.

  • High blood pressure (or you’re on medicine to treat high blood pressure). Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and lead to plaque buildup.

  • High fasting blood sugar (or you’re on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes.

So, what exactly are they doing now.  That was the focus of my discussion with Adam.

  1. They are running data through the GNS predictive model.
  2. They are inviting people to participate in the program.  (initially focusing on 500 Aetna employees for the pilot)
  3. The employees that choose to participate then get a 3 SNP (snip) test done focused on the genes that are associated with body fat, appetite, and eating behavior.  (Maybe they should get a few of us bloggers into the pilot – hint.)  This is done through Newtopia, and the program is GINA compliant since the genetic data is never received by Aetna or the employer.
  4. The genetic analysis puts the consumer into one of eight categories.
  5. Based on the category, the consumer is matched with a personal coach who is going to help them with a care plan, an exercise plan, and a nutrition plan.  The coaching also includes a lifestyle assessment to identify the best ways to engage them and is supported by mobile and web technology.
    newtopia
  6. The Newtopia coaches are then using the Pebble technology to track activity and upload that into a portal and into their system.

We then talked about several of the other activities that are important for this to be successful:

  • Use of Motivational Interviewing or other evidence-based approaches for engagement.  In this case, Newtopia is providing the coaching using a proprietary approach based on the genetic data.
  • Providing offline support.  In this case, Aetna has partnered with Duke to provide the Metabolic Health in Small Bytes program which he described as a virtual coaching program.

Metabolic Health in Small Bytes uses a virtual classroom technology, where participants can interact with each other and the instructor. All of the program instructors have completed a program outlined by lead program developer Ruth Wolever, PhD from Duke Diet and Fitness Center and Duke Integrative Medicine. Using mindfulness techniques from the program, participants learn practices they can use to combat the root causes of obesity. The program’s goal is to help participants better understand their emotional state, enhance their knowledge of how to improve exercise and nutrition, and access internal motivation to do so. (source)

We also talked about employer feedback and willingness to adopt solutions like this.  From my conversations, I think employers are hesitant to go down this path.  Metabolic Syndrome affects about 23.7% of the population.  That is a large group of consumers to engage, and pending final ROI analysis will likely scare some employers off.

Adam told me that they’ve talked with 30 of their large clients, consultants, and mid-market clients.  While we didn’t get into specifics, we talked about all the reasons they should do this:

  • People with Metabolic Syndrome are 1.6x more expensive
  • People with Metabolic Syndrome are 5x more likely to get diabetes
  • Absenteeism
  • Presenteeism

This ties well with my argument that wellness programs aren’t just about ROI.

Obviously, one of the next steps will be figuring out how this integrates into their other existing programs to address the overall consumer experience so that it’s not just another cool (but disconnected) program.  And, of course, to demonstrate the effectiveness of the program to get clients and consumers to participate.

Two quotes I’ll leave you with on why this is difficult (but yet exciting to try to solve):

“The harsh reality is that scientists know as much about curing obesity as they do about curing the common cold: not much. But at least they admit their limitations in treating the cold. Many doctors seem to think the cure for obesity exists, but obese patients just don’t comply. Doctors often have less respect for obese patients, believing if they would just diet and exercise they’d be slim and healthy.” (source)

Thirty percent of those in the “overweight” class believed they were actually normal size, while 70% of those classified as obese felt they were simply overweight. Among the heaviest group, the morbidly obese, almost 60% pegged themselves as obese, while another 39% considered themselves merely overweight. (source)

The New Grade – A, B, C, D, Fat

We all know childhood obesity is a big issue and many parents don’t realize it.  But, I didn’t realize that for a few years now some schools have been changing the traditional report card to include new letters – BMI.

This is hot topic that I’ve highlighted in a few posts about boy scouts and obesity and in the new categorization of obesity as a disease.  We’ve also seen a huge rise in companies focused on biometrics like BMI.

So, is this movement at schools good or bad?

Here’s a few points to consider:

  • We learn early in life so helping kids to understand the importance of health early is important.
  • Most parents don’t know their kids are overweight and are often overweight themselves.
  • PCPs are encouraged to track BMI on an annual basis and report on it (but most don’t).

On the flipside:

  • Some people would argue that BMI’s not a good measure of health.
  • It doesn’t do much good to just tell people they’re overweight if you’re not going to provide a solution to help them manage their weight.
  • Schools already offer less physical activity and often may not have great food choices.

One other thing I think people overlook is that they assume just because their kids are active or play sports that they can eat whatever they want or that they’re actually getting enough exercise.

Obese Scouts (And Leaders) Told To Stay Away

Did you catch the story the other day that kids and adults that had a BMI of over 40 were told they couldn’t come to the annual Boy Scout Jamboree? And those that had a BMI of between 32 and 39.9 had to submit documentation that they could attend.

What do you think about that?

If you look at the adult US statistics, this would represent about 30%+ of the population. (United HealthGroup report: “United States of Diabetes“)

This is one story where I’m sure there’s a lot that we’d want to know. In Time, they talk about the fact that they published the restrictions two years ago. This would have allowed people time to improve their BMI. But, jumping from 40 to 31 might be too big of a jump in two years for some people to do in a healthy way.

If I were developing this type of program for a company, I’d expect to answer these questions:

  • What did you do to support the scouts and leaders in losing weight? Did you give them a coach? A registered dietician?
  • Did you create a culture of health? What types of foods are at boy scout meetings?
  • Is there a reasonable alternative for the obese scouts to get a similar experience if clinically appropriate?

Obviously, this isn’t a work environment so the rules are different. On the one hand, congrats to them for being brave enough to take this topic on and try to encourage scouts and leaders to have a healthy weight. On the other hand, they need to make sure they do this in a way that doesn’t shame these people and need to make sure they support their weight loss.

But, don’t be fooled. The world is going to continue to move this way. Obesity is too big of a driver of healthcare costs and other presenteeism and absenteeism impacts.

Just look at Japan…(source)

Under a national law that came into effect two months ago, companies and local governments must now measure the waistlines of Japanese people between the ages of 40 and 74 as part of their annual checkups. That represents more than 56 million waistlines, or about 44 percent of the entire population.

Those exceeding government limits — 33.5 inches for men and 35.4 inches for women, which are identical to thresholds established in 2005 for Japan by the International Diabetes Federation as an easy guideline for identifying health risks — and having a weight-related ailment will be given dieting guidance if after three months they do not lose weight. If necessary, those people will be steered toward further re-education after six more months.

To reach its goals of shrinking the overweight population by 10 percent over the next four years and 25 percent over the next seven years, the government will impose financial penalties on companies and local governments that fail to meet specific targets. The country’s Ministry of Health argues that the campaign will keep the spread of diseases like diabetes and strokes in check.

Should You Care That Obesity Is Now A Disease?

The AMA has opened an interesting discussion in the past few days with their decision to recognize obesity as a disease.  On the one hand, we all know obesity is a problem that’s impacting our overall health and productivity across the world.  On the flip side, will this actually change anything?

Key discussion points:

  • What is a disease?
  • Is BMI a good metric to use?  If not, what should be used to measure obesity – waist?
  • How do you treat it?

Here’s a few quotes from some articles:

“Right now, physicians will treat high blood pressure, diabetes, give patients medications and say, ‘Oh you also need to lose weight,’” Khaitan told FoxNews.com. “I think (this) gives the physicians a little more credibility in pushing patients to address obesity and become healthier. It’s recognized as a disease…not just something that (because) you have poor lifestyle habits, this is your problem.”  (Fox News)

Obesity is not just a health risk but a disease. Estimates of the genetic contribution to weight gain in susceptible families range from 25—40% with a greater heritability for abdominal fat distribution of 50%1>2.  Obviously there is a major environmental effect but this genetic susceptibility alone removes this condition from a social stigma to the disease category.  (British Medical Bulletin 1997)

“The American Medical Association’s recognition that obesity is a disease carries a lot of clout,” says Samuel Klein, director of the Center for Human Nutrition at Washington University School of Medicine in St. Louis. “The most important aspect of the AMA decision is that the AMA is a respected representative of American medicine. Their opinion can influence policy makers who are in a position to do more to support interventions and research to prevent and treat obesity.”  (USA Today)

Telling all obese people that they have a disease could end up reducing their sense of control over their ability to change their diet and exercise patterns. As experience with addictions has shown, giving people the sense that they suffer from a disease that is out of their control can become self-defeating. So the disease label should be used sparingly: just as not all drinking is alcoholism, not all overeating is pathological. (Time)

Here’s a few facts from the Obesity Action Coalition:

  • In the United States, it is estimated that 93 million Americans are affected by obesity.
  • Individuals affected by obesity are at a higher risk for impaired mobility and experience a negative social stigma commonly associated with obesity.
  • Socioeconomic status plays a significant role in obesity. Low-income minority populations tend to experience obesity at higher rate and are more likely to be overweight.
  • In 2001, the states with the top five percentages for obesity were Mississippi, West Virginia, Michigan, Kentucky and Indiana.
  • Almost 112,000 annual deaths are attributable to obesity.
  • In the United States, 40 percent of adults do not participate in any leisure-time physical activity.

Here’s also a few things you might not realize about obesity from Yale:

  • Finding 1: Obesity can raise some cancer risks
  • Finding 2: Obesity is tied to heart attacks in younger adults
  • Finding 3: Obesity can ruin your day
  • Finding 4: Obesity speeds up girls’ puberty
  • Finding 5: Obesity is a cause of diabetes in kids
  • Finding 6: Obesity in middle age increases risk for dementia

Let me give my hypotheses on why this might matter:

  1. In theory, this is supposed to increase the likelihood that physician’s talk about obesity with their patients.  This would be great, but I think most research shows physician’s aren’t prepared or comfortable with this discussion.  Will the fact that it’s a disease make this easier?  Maybe.
  2. This may be a boon for the obesity Rx market (assuming any of them work and have minimal side effects).  Physician’s may be much more likely to write an Rx for a disease than a lifestyle issue.
  3. This may help get obesity Rxs and bariatric surgery to be covered by health insurance.  The downside of this is that more people may not actually change behavior (diet, exercise, sleep) but instead look for a “quick” fix through drugs and surgery.

In my mind, there is a best case scenario here:

  • Calling it a disease drives awareness among the healthcare community.
  • This increases investment in resources to treat obesity.
  • Treatment is viewed more like mental health to include drugs and behavioral therapy.
  • Physician’s get trained on the disease.
  • Pharma details physicians on the disease and creates CME programs.
  • Patients start to take this more seriously.
  • Plans cover obesity – insurers, employers, CMS.
  • Obesity becomes a broad program including diet, exercise, coaching, Rx, and bariatric surgery following a progressive approach to treatment tied to your starting point.
  • Companies link incentives to managing weight.
  • New metrics are designed that are better than obesity.

Of course, one of the more recent articles which was depressing on this topic was that exercising regularly may not overcome the impact of sitting the rest of the day.  That makes it very hard to increase caloric burn while having a job that requires lots of desk, computer, and meeting time.

Costs Of Obesity In America

Why CVS Caremark Asking For Your Weight Is Good For You

I continue to annoyed by all the fear-mongering in the industry around what CVS Caremark is “doing to their employees”.  What about focusing on how they are helping their employees to get better?  (If interested, you should read some of the information they have on their blog.)

Our “Plan for Health” combines an evolving, best-practice approach to health coverage with preventive care and wellness programs. Our colleagues will be more accountable for taking control of their health and associated costs. The first step is getting to know your numbers by getting a health screening and completing an online wellness review each year. If colleagues complete both by the May 1, 2013 deadline, they will avoid paying an additional $600 for the 2013-2014 plan year. (from the CVS Caremark blog)

I was hopeful to hear someone come out strongly and speak about it yesterday on CBS, but instead the CEO of Mercer just talked about “soft” programs that depend upon consumers being proactive around their health.  I would rather hear about the value of screenings and how it helps employees.  In talking with one friend of mine at a biometrics company, he told me that in one case almost 40% of the people that they identified with diabetes (or pre-diabetes) and hypertension (or pre-hypertension) didn’t know they had the disease (or were at high risk).  That to me is a valuable insight to the individual especially when coupled with a program to help them learn and manage their disease (or risk).

For example, companies for years have been using Health Risk Assessments (HRAs) to try to baseline employee health and use that to accomplish several things:

  1. Help the employee to understand their risks
  2. Identify people who should be in coaching programs to improve their health
  3. Learn about their population and how to improve their health benefits

Use of biometrics is the right evolution from the HRA.  People have tried HRAs for years with some success.  Companies pay as much as $600 for people to take this online survey that has no necessary link to reality.  Most HRAs aren’t linked to lab values.  Most HRAs aren’t linked to claims data.  Most HRAs don’t necessarily trigger enrollment in health programs.  They are supposed to activate the employee to be proactive which doesn’t work for many sick consumers especially those in the “pre-disease” phase.  (Here’s a good study that does show some increased activation.)

As I mentioned the other day, this use of biometrics and link between incentives and participation (and ultimately outcomes) is normal and will ultimately improve the link between the workplace and the employee around health.

Let’s take a broader look at insurance to help set some context:

  • For life insurance, you have to disclose certain data and depending on the policy level you have to do other things like get a physical and have blood work drawn.  That effects your costs and their underwriting.  
  • For car insurance, if you get in accidents, your costs go up.  In some case, you can have a monitoring device put on your car to lower your costs.  (like getting blood work done)
  • For home owners insurance, your costs go up if you live in a flood zone or a earthquake zone.  It also goes up if you have lots of claims.

Whether we want to admit it or not, we do determine a lot of our healthcare costs based on decisions we’ve made or had made for us since we were kids.  Some of these are conscious and some are subconscious.  And, obesity which is a large driver of many of these chronic conditions and has an impact on your likelihood of having cancer.  So, a company asking for your BMI and other data to help understand your risks for healthcare costs (of which they typically pick up 80%) doesn’t seem unusual.

Certainly, some are environmental such as those that live in “food deserts” like Detroit.  In other cases, workplace stress can affect our health.  We’re just starting to get smarter about “sitting disease” and it’s impact on our health.  Or, we may take medications that affect our blood pressure (for example).  It’s certainly important to understand these in context of your lab values and discuss a holistic strategy for improving your health with your physician and any care management resources which are provided to you (nurse, social worker, nutritionist, pharmacist).

This idea of learning more about employees in terms of biometrics, food, sleep, stress, social interaction, and many other data points is going to be more and more of a focus.  Companies want to learn how their employees do things.  They want to understand their health.  They want to improve their health.  They want to invest in their workforce to improve productivity, innovation, and ultimately job satisfaction.

While the glass half-empty people won’t see this and there are some companies that don’t always act this way, I generally believe that companies are trying to act in a way to increase their top line and most intelligent executives understand the correlation between health and wealth and the link between employee satisfaction and growth.

Ultimately, healthcare costs are estimated to put a $240,000 burden on us after we retire (even with Medicare) so if someone wants to help me become healthier and thereby save me money which improves my ability to retire and enjoy life I’m happy for them to do.

How The CVS Program Will Change The Employer – Employee Contract

Have you heard that CVS Caremark is requiring employees to go get biometrics and going to take action on it? OMG!

I’m not sure I understand why people are all upset. Let’s look at the facts:

And, by the way, have we forgotten how much healthcare costs have gone up over time and who pays that bill. It’s either the employer or the government. Both of those things impact our pay as individuals either in terms of lower raises to cover healthcare costs, shifting healthcare costs to us, or taxes. It’s not sustainable so the person who pays the bill has to step in since we’re not. (Which is also why I support the NY ban on soda.)

Now, let’s look at our healthcare system where in the current fee-for-service model, there isn’t an incentive for physicians to address this.

For now, people should be happy. They’re only being required to do the biometrics. The penalty isn’t linked to whether they’re fat or have high blood pressure or smoke or have high cholesterol or have diabetes. A recent study by Towers Watson shows that while 16% of employers do this type of outcome based incentive program today (2013) that this is going to jump to 47% in 2014. So, this will be the norm.

And, guess what…sticks often work better than carrots in some cases.

And, healthcare costs are making us uncompetitive globally as a country.

  • The cost of healthcare is greater than the cost of steel in a car.
  • The cost of healthcare is greater than the cost of coffee in a Starbuck’s cup of coffee.

And, health reform is allowing (even enabling) this to happen. It says that you can treat people differently and create up to a 50% differential in costs associated with their health. (Not a legal definition so read the fine print.)

But, what I think all of us (consumers and employers) will need to realize is that moving to this (which I agree with) will change the employer and employee relationship in several ways.

  1. You can’t put these programs in place without something to help me manage my obesity, cholesterol, and/or other chronic condition. This will drive wellness and disease management programs to be more engaging and successful.
  2. This will put pressure on employers to create a culture of health since we spend so much time at work and work contributes to our health conditions.
    1. Need more time to be active. Less sitting. Treadmill desks. Standing meetings. Nap time. Walking breaks. Use of devices to track steps. Incentives. Gym discounts. Healthy food discounts.
    2. Need less stress.
    3. Need more sleep.
    4. Better food choices at work.
  3. This will drive a lot of the new tools and run counter to some trends about limiting dependent coverage since you can’t address obesity without engaging the entire family and the social network.
  4. This will also create a whole exception process by which people who gain weight due to certain drugs have to be excluded. People who can’t exercise may have to be excluded. People may have to see short-term goals (i.e., dropping BMI from 35 to 32). Physicians will have to be engaged.
  5. Coaching will have to expand to include dieticians, social workers, and others to help people beyond the historical nurse centric coaching model.

If none of this motivates you, then just think about the “gift” we’re giving our kids and maybe that will be a wake-up call why someone has to do something here. (As I shared the other day, I struggle with my weight so don’t think I’m some super skinny, high metabolism person who thinks this is easy.)

What’s Your #Moment4Change?

I’ve being doing a lot of work lately on how to tackle the obesity problem in the US. This has been great personally as it has forced me to look at lots of research to understand all the tools out there.

  • Diet
  • Exercise
  • Coaching programs
  • Devices
  • Social networks
  • Physicians
  • Centers of Excellence

It’s also made me look at different drivers of obesity including sleep and stress. The new report out showing that sitting is a huge problem (even if you exercise) is very eye-opening also.

For years, I’ve talked about my challenges is managing my weight which lead to some fluctuations, but at the end of the day, I think a lot of this boils down to a “Golden Moment” or a “Moment4Change”. Even people who do this every day (e.g., doctors or sports coaches) are often overweight. We have to have something which prompts us to change our life. We aren’t generally motivated by dropping our HDL. We’re motivated by being able to play with our kids or living long enough to see our kids get married.

In my life, there have been several Moment4Change points so I thought I would put this out there to hear what’s motivated others:

  • In 2002, I went to the doctor for the first time in a decade. He saw some health risks in my blood work and sent me to another physician. He told me I was obese. (Something less than 50% of physicians actually tell their overweight patients.) I was shocked. I was 215 pounds and 5′-10″. After 2 days of agony, I decided that I couldn’t accept that diagnosis and proceeded to lose 40 pounds in the next 60 days (all through exercise and social motivation through a running group).
  • Last fall after letting much of that weight creep back on over the decade, I decided to do a 5K with one of my kids. I’d run 3 marathons and was running several days a week (although at an average pace of 9 minute miles). I got killed as my kid ran at a 7:30 pace in their first race ever. Not only did I feel old, but I felt like I wasn’t being much of a role model. That motivated me to change. Now, after using the FitBit (see several comments), I’ve had good success losing 25 pounds in 3 months and seeing my cholesterol drop 120 points in that same time frame.

So, I’m interested. What has motivated you to changed? And, how do you measure success? I suggested that while women may use the “skinny jeans” test that men might be more likely to use the “belt buckle” test.

 

 

I think this image below from the AON Hewitt 2012 Health Care Survey is a good one about the fact that 80% of our costs are driven by 8 behaviors.

I also thought that this presentation at the FMI by The Well which was a GSW project was right in line with this.

Short Sighted View Of Freedom With NY Soda Ban

pouring-on-the-pounds

There are lots of fundamental issues here:

  • Was the law legal?
  • Does soda make you fat?
  • Should the government be able to steer you to positive choices?
  • Did this impact our freedom?

At the end of the day, I look at it very differently.  I think the proposed ban was great.  I was very annoyed last night to find out it was overturned.

Why?

  1. I don’t see this as any different than moving unhealthy foods to a less obvious place in the food line at school.  It simply was meant to help steer people to make healthier decisions.  We should all be thankful for someone helping us since we generally don’t seem to be able to help ourselves.
  2. Government has to be run like a business.  (It usually isn’t.)  Obesity is a big driver of costs.  It requires more power for public transportation.  It requires bigger chairs.  It requires bigger hospital beds.  It requires bigger ambulances.  And, all of us taxpayers pay for this.
  3. 80% of healthcare costs are driven by personal decisions that we make mostly around diet and exercise.  Since most people will end up on Medicare at some point, we need to change the cost curve in healthcare sooner rather than later.  Otherwise, we either bankrupt our country or we bankrupt Medicare.

So, enjoy your big 64 oz soda now, but when you’re 69 and Medicare has been rolled back to 70 due to funding challenges, you can smile and remember that you got to enjoy all that sugar for years without anyone trying to help you. (I can picture a great political cartoon here of the patient getting a healthcare bill looking over their shoulder from their wheelchair to see a big pile of soda cups!)  Never mind the fact that you’re bankrupt due to your healthcare bills and not able to walk around to keep up with your grandkids.

The Business of Obesity
Source: top-nursing-programs.com

Body Peace Treaty As Mentioned On Biggest Loser

I was finally catching up on my Biggest Loser shows yesterday.  They talked about the Body Peace Treaty from Seventeen magazine. Not something I read, but there are some good points in the treaty.  Here are a few for you.

  • Do the little things that will keep my body healthy, like walking instead of hanging on the couch, or drinking water rather than something sugary.
  • Appreciate what makes my body different from anyone else’s. I love that I’m unique on the inside, I will try to feel that way about the outside too!
  • Support my friends, who just like me, have their own body issues. Hey, we’re all in this together!
  • Remember that the sun will still rise tomorrow even if I had one too many slices of pizza or an extra scoop of ice cream tonight.
  • Quit judging a person solely by how his or her body looks — even if it seems harmless — because I’d never want anyone to do that to me.
  • Remind myself that what you see isn’t always what you get on TV and in ads — it takes a lot of airbrushing, dieting, money, and work to look like that.
  • Respect my body by feeding it well, working up a sweat when it needs it, and knowing when to give it a break.
  • Realize that the mirror can reflect only what’s on the surface of me, not who I am inside.
  • Not let my size define me. It’s far better to focus on how awesome I look in my jeans than the number on the tag.
  • Surround myself with positive people. True friends are there to lift me up when I’m feeling low and won’t bring me down with criticism, body bashing, or gossip.

So, while some of the things on the list may be more biased towards young women, the fundamentals are the same for all of us.

Childhood Obesity Quiz On The Biggest Loser

This season, on The Biggest Loser, they’ve invited 3 kids to be ambassadors for childhood obesity. They aren’t living on the ranch, but they are coming out for some of the challenges. In last night’s show, they quizzed the contestants on several facts about childhood obesity. They were pretty scary. I thought I’d share them here with the research to support them (or at least as close to the questions as I can remember).

There are lots of efforts in this area. Here’s a few links to resources:

Childhood Obesity Epidemic Infographic
Brought to you by MAT@USC Masters in Teaching


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