Health Care Reform Healthy Living Nutrition

Obesity: Finding hope in a seemingly hopeless struggle

I like positive thinking. Optimism helps keep inflammation at bay. You can’t be a heart doctor and think problems are hopeless or that bad outcomes will occur.

But…I have to tell you, obesity and its flume of chronic diseases makes it tough to stay upbeat. As an office doctor, obesity frustrates; as an internationalist, working on obese patients beats you down. As a proud and hopeful American, obesity makes you frown.

It’s a real problem, with no clear end in sight.

One thing is for sure: to reverse the obesity epidemic, it will take the powers of many–not just doctors. Smart people like to say, “the solution will mandate a multidisciplinary approach.”

Along these lines, I would like to share a 19-minute TED talk with you. David Jones, Jr, is a venture capitalist from Louisville. His firm specializes in finding companies that offer innovative solutions for improving healthcare. As the chairman of the board of Humana Inc from 2005-2010, David has sat on the front row of the ongoing health crisis. It’s also important to add that David and I are friends. We ride together and have even been masters-swimmer lane mates–a strong bond indeed. (Lane 5).

I strongly suggest taking the 19 minutes to watch the presentation. I love David’s take. It’s controversial, and passionate and nuanced. Hearing this talk will make you smarter.

Some highlights…

Does the fact that one in three young people are too fat to serve in the military bother you?

Are the farmers, restaurateurs and grocers killing us?

Can we change our broken food culture?

What do you think of “lean technology?”

How about David’s policy suggestions?  You might consider strategies to “beat back agribusiness” or curb over-consumption of toxic high fructose corn syrup as anti-liberty. That’s reasonable; but David smartly counters with the anti-liberty effects of chronic disease—and how the treatment of such tethers people to healthcare.

Enjoy: (It’s not bad if it makes you squirm a little.)


9 replies on “Obesity: Finding hope in a seemingly hopeless struggle”

One of my particular grievances with the food industry is salt. Could someone please explain to me why a serving of frozen peas has 8% of the RDA of sodium? The lasagna that we used to buy (note the use of the past tense) has a “new recipe”; a serving went from 28% of the sodium RDA to 40%. It’s just revolting. Why is there so much salt in frozen food? Occasionally it would be nice to have a break from cooking every night, but it looks like those days are over. I have no issue with FDA guidelines requiring better food in our grocers’ freezers.

Allison, you got me curious, so I went freezer mining and checked all of our frozen veggies. Sodium – nada, zip, nothing, so it must be that particular brand.

I used to buy the prefrozen flattened chicken breasts, but they had a lot of injected sodium for flavor, so I stopped getting those. I now bake a few pounds of fresh, boneless, skinless chicken breasts when they are on sale, and freeze my own – ready to defrost and use. Extra work, but worth it.

I remember when we used to have that tasty canned corned beef hash and eggs for breakfast many, many years ago (ages in fact). I checked a can at the store recently, and the label said one serving had 55% of daily fat, and 66% of sat fat as well as 40
% of the sodium! There were 4 servings in this one can! It might as well have been labeled Clogged Artery Hash. Yummm . .. . . . .

Great video!

How is it possible to differentiate between a medical treatment for a condition primarliy caused by poor lifestyle versus conditions which are not?

After spending the day with 1/2 million drunk, obese, out of shape Kentuckians at Thunder yesterday, I realize how naive this guy is. People have to want to change and I just don’t see it happening. People in this country like their big gulps, Appleby’s and queso. I see an attitude similar to gun activists. “you can’t take my big gulp out of my cold dead fist”. In fairness, I am one of those docs that the speaker describes in the presentation. Real change is hard.

Here’ an obesity epidemic solution that will work quicker and more reliably than Mr. Jones’s.

Tie health insurance premiums to 1) performance on a maximal exercise treadmill test, and 2) body mass index.

The poorer your performance on those measures, the higher your insurance premiums. Even opt out of the testing if you wish (but pay a higher premium than average).

As Doc D says is necessary, folks must want to change. They need to see lifestyle effects on their pocketbooks NOW, rather than seeing adverse effects on their health 30 year from now.


OK- but how do you avoid discriminating against those who, through no fault of their own, might score low on these tests?

Finding middle ground here won’t be easy. Where does one draw the line–of health. How high a BSA will we tolerate; what’s long enough on a treadmill; what percentage of a disease is acquired and what percent is hereditary? These tough questions only scratch the surface of the complexity inherent in making sweeping ‘health’ definitions.

As David said in the presentation, not all incentives need be punitive. We can surely incent without overt discrimination. I would be against mean-spirited inflexible measurements of health. Not all are born to run on a treadmill efficiently.

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