Crisis in Our Disease Management System, Part I.

By Radhia Gleis PhD, C.C.N.

Almost daily, we hear in the media about the crisis Americans face with our present “health care system”. Today’s health insurance and the medical paradigm have little or nothing to do with supporting or keeping us healthy, but rather, it is a system of disease management. Very few medical insurance plans allow for treatment beyond drugs, and surgery, let alone nutrition or preventative medicine. Even if your medical physician wanted to go further in investigating your health status their decisions seem to be dictated by your insurance adjuster. Yet, at the same time, as “health care” costs skyrocket, so is the prevalence of disease.

Obesity alone, in the United States represents a significant health threat to millions of Americans. 64% of Adult Americans are Overweight/Obese and 400,000 deaths per year are related to obesity! Health officials from the Centers for Disease Control and Prevention (CDC) say. "Obesity rose 6 percent nationally over the course of one year. The increase affected all regions of the country and all demographic groups. Diseases directly related to obesity are heart disease, cancer and diabetes. The total annual number of deaths associated with obesity and heart disease, cancer, and diabetes per year are:

• Heart Disease 720,000
• Cancer 520,000
• Diabetes 187,000

Since 1980, the number of Overweight Americans has doubled while “childhood obesity is becoming an epidemic”, says the U.S. Surgeon General. Dr. David Satcher. Dr. William Dietz, Director of Nutrition for the CDC estimated that “by 2020 the cost of the increase in obesity of the younger generation alone will exceed $100 Billion”!

Between 1990-1998 Diabetes increased 33%, 40% of that increase was between the ages of 40-49 while 70% of that increase was between the ages 30-39. Diabetes II is otherwise known as “adult onset diabetes”, however, soon this name will become obsolete, as we are seeing younger and younger people with diet related, diabetes II.

Obesity and Cancer Statistics in the U.S.

• 90,000 Cancer Deaths
• 14% of all Male Cancer
• 20% of Female Cancers
• American Cancer Society* *estimates excess weight contributes to 33-50% of breast cancer in older women

Obesity and Heart Disease in the U.S.

• Since 1984, statistics show more female deaths, than male.
• 512,000 female Deaths
• 447,000 male Deaths
• 10,000 women under 50

A study published in the January-February 2003 issue of the American Journal of Health Promotion found overweight employees have medical bills up to $1,500 greater a year than did their thinner counterparts. In a recent conversation with an endocrinologist I learned that the average cost of medication for today’s diabetic patient can be easily up to $1000.00 a month. Many companies are now looking for ways to inspire workers to change their lifestyles in order to curb rapidly escalating health insurance costs.

This study, conducted by researchers at the University of Michigan Health Management Research Center, looked at 178,000 adults enrolled in the General Motors' health care plan. Plan members include workers, retirees, and family members. Researchers compared medical costs with federal Body Mass Index (BMI) categories ranging from underweight to greatly obese. Medical costs rose as weight did. The average medical cost for those of average weight was $2,225. The lowest category of overweight was slightly more, at $2,388, but costs rose more sharply after that, reaching $3,753 for the most obese people.

Here are some startling facts.

• One in every 3 Americans has a substantial problem with their weight: that is, a body weight 20% or more above recommended.
• Morbid obesity (more than 100% above normal) involves 3% of the population.
• Obesity and its associated problems is estimated to cost $68 billion each year.
• 1 in 3 Americans are dieting at any one time -- only 1 in 20 will attain their desired weight.

It all seems so simple: eat less, exercise, lose weight. Yet approximately 44 million Americans are overweight, and dieters are spending an average of $30 billion a year on commercial weight loss programs to take it off. Yet no matter what approach most people use to diet, their weight loss is temporary. The weight they lose almost always returns in the long run.

Last Spring, studies from a panel of experts on obesity by the National Institutes of Health (NIH) concluded that as much as two thirds of the weight lost through dieting is regained within one year, and almost all the weight is regained within five years. Other weight loss techniques such as behavior modification, exercise and drugs--even in controlled settings--usually produce only short-term results.

Many health care practitioners and the public at large are looking at body weight and obesity as the primary issue. To me this is a serious oversight and for most weight loss methods, there are few scientific studies evaluating their effectiveness and safety. The available studies indicate that persons lose weight while participating in such programs but, after completing the program, tend to regain the weight over time. This is because the focus is on “weight” and not on metabolic imbalance. Excess weight is a by-product or symptom of metabolic imbalance. Metabolic imbalance can be caused by a number of things:

• Hormonal imbalances
• Neuro-chemical imbalances
• Food sensitivities
• Metabolic toxins
• Environmental toxins
• Improper or deficient nutrient intake
• Stress
• Genetics

If we do not address and overcome these imbalances we will never get a handle on the present health crisis.

The most important feature of a successful weight loss program in order to reduce weight or maintain stable weight is first target metabolic imbalances and correct them. Continued regular contact with a supervising professional may be necessary to maintain permanent weight loss and disease prevention.

Methods whose primary goal is short-term rapid or unsupervised weight loss, or that rely on diet aids such as drinks, prepackaged foods, or pharmacologic agents but do not include individual metabolic rebalancing or education in and eventual transition to a lasting pattern of healthful eating and activity, have never been shown to lead to long-term success. It has been fairly said that such programs fail people, not vice versa. Recognition of this by society and individuals and a focus on approaches that can produce health benefits independently of weight loss may be the best way to improve the physical and psychological health of Americans seeking to lose weight, prevent disease and stay healthy.

For more information on how to find out if you are metabolically imbalanced or how you can lose weight, reduce your risk of disease, and become and stay healthy, please contact our office.