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Hi
Background
Last month the American Medical Association sparked headlines when it voted to officially classifyobesity as a disease.
The question of whether obesity is a disease or not to me is pointless, there is no universally agreed definition of what constitutes a disease and solutions are way more positive. However, it importantly turns up the public discourse around the subject, especially as obesity recently overtook smoking as the leading cause of preventable death in the world. Obesity is a growing problem (excuse the pun), with an estimated 10,000 deaths per annum in Australia attributed to excess weight.
“Obesity and overweight are widely prevalent in the Australian population, and this prevalence is quickly increasing.1 In 2004-05, more than half of Australian adults were overweight or obese (35% were overweight, and 18% obese).2 The proportion of obese adults doubled over fifteen years between 1989-90 and 2004-05.3 There is a similar, particularly alarming, trend among children and adolescents. Almost a quarter of Australian children and adolescents are overweight, with approximately one in four of these being obese.4 Obesity may run in families, with research showing children of obese parents are more than twice as likely to be obese themselves.5
References:
- The WHO defines 'overweight' as a BMI (weight in kilos divided by the square of the height in metres) equal to or more than 25, and "obesity" as a BMI equal to or more than 30. There is no standard definition of childhood obesity.
- ABS 2007, Australian Society Trends 2007, Overweight and Obesity, ABS Cat. No. 4101.0)
- ABS 2008, Overweight and Obesity in Adults, Australia, 2004-05, (ABS Cat No. 4719.0)
- Australian Institute of Health and Welfare (AIHW), 2004, Risk Factor Monitoring: a rising epidemic - Obesity in Australian children and adolescents. Risk Factors Data Briefing No. 2, October. Booth M, Okely AD, Denney-Wilson E, Yang B, Hardy L, Dobbins T (2006) NSW schools physical activity and nutrition survey (SPANS) 2004, NSW Department of Health, Sydney; and Hands, B., Parker, H., Glasson, C., Brinkman, S. & Read, H. (2004). Physical Activity and Nutrition Levels in Western Australian Children and Adolescents: Report. University of Notre Dame Australia
- Whittaker, R.C., Wright, J.A., Pepe, M.S., et. al., 1997,"Predicting obesity in young adulthood from childhood and parental obesity", New England Journal of Medicine, 337, pp. 869-873.”
https://ama.com.au/position-statement/obesity-2009
Obesity is a major risk factor for a range of chronic conditions;
- Type 2 diabetes
- Heart disease
- Hypertension
- Stroke
- Musculoskeletal disorders
- Impaired psychosocial functioning
Okay, so obviously there is a big picture problem, but all big pictures are made up of little pixels. One of our roles as primary contact practitioners, is to make it easier for people to make healthier choices. We can do this by up skilling our own knowledge base, providing a lead in our local communities and encourage healthy behaviors, being a role model and having positive, helpful information available for those clients of ours, wanting to take the next positive step.
Here are some resources that I have found to be useful, and are freely available.
Nutrition and Healthy Eating
Physical Activity
Smoking
The most recent national figures on tobacco prevalence from the Australian Institute of Health and Welfare show that Australia has one of the lowest smoking rates in the world, with the daily smoking rate among Australians aged 14 years and over at 15.1 per cent in 2010. This rate has been steadily falling from 19.5% in 2001. This reduced rate has contributed to Australia achieving one of the highest average life expectancies of any country.
Alcohol
Due to the different ways that alcohol can affect people, there is no amount of alcohol that can be said to be safe for everyone. People choosing to drink must realise that there will always be some risk to their health and social well-being. However, there are ways to minimise the risks. These sites are designed to give Australians a basic knowledge and understanding about alcohol and its consequences in order to make informed decisions so they might minimise the risk of alcohol-related harms.
The ‘Lifescripts’ initiative provides practitioners with evidence-based tools and skills to help patients address the main lifestyle risk factors for chronic disease: smoking; poor nutrition; alcohol misuse; physical inactivity; and unhealthy weight. The initiative assists with the provision of tailored advice to patients on modifying their lifestyle. Resources are divided into Consumer (for the waiting room) and Practitioner.
Consumer Resources
Include posters for practice waiting rooms, brochures and checklists to inform patients about the initiative and provide them with an opportunity to indicate to their GP if they wish to discuss lifestyle issues.
- Patient brochure
- Waiting room poster>/a>
- Waiting room checklist
Practitioner Resources
The practitioner resources are available in the four key chronic health areas of;
- Physical activity
- Nutrition & Weight Management
- Alcohol
- Smoking
Each resource contains a self assessment section in which the client completes information about the topic and how it relates to them, and another section that looks at goals, motivations, tips that can guide a positive discussion about the topic. Lifestyle advice can be tailored to each patient's needs or patients can be referred to other services, where available, to further support healthy lifestyle choices.
Resources are available as;
Being primary contact practitioners that treat a wide range of movement disorders, places us in a unique position to influence the many aspects associated with a healthy lifestyle, that will directly impact on the outcomes of our ‘standard’ treatments.
An important part of this influence is our long appointment time. It takes time to find out how a person is managing their ongoing back injury; changing relationship with spouse and colleagues, reducing their normal eating habits to match the lower energy demands, avoiding the trap of alcohol and smoking due to boredom or frustration and determining a level of physical activity to match their current ability.
Spending time listening and guiding our clients develops a trusting relationship, often occurring over many years. We may see them personally following an ankle injury at netball and again with a knee problem after a skiing holiday. Later with their child, who has Osgood Schlatters or with a parent, returning from a THR for rehabilitation. In a rural and remote community, the links can be especially frequent.
At all these separate stages, we have the opportunity to listen, guide, advise and educate them about how different healthy, lifestyle choices will have a positive impact both on their presenting symptoms and their quality of life in a much broader sense - the pixels make the bigger picture.
Recent Blogs of Interest
What do you see are the biggest 2 hurdles for people to control their weight?
What strategies have you found most helpful with children and adults in maintaining a healthy weight?
All the best,
Doug Cary FACP APAM
Specialist Musculoskeletal Physiotherapist
email doug@aapeducation.com.au
ph/fx 08 90715055
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