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Message from the MGH

What a hospital can do in the face of America's growing obesity problem, by Peter L. Slavin and David F. Torchiana.

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Preventing obesity may seem straightforward: Eat less, exercise more. Yet the reality is much more complicated, and in any case, our society hasn’t followed that recipe. Too many people do just the opposite, consuming food laden with fat and sugar while working at sedentary jobs, with leisure activities that involve sitting at computers, watching TV and playing video games.

The most prevalent chronic disease of the twenty-first century, and potentially a fatal one, obesity continues to be poorly understood. The causes are complex and controversial, and treatment is usually unsuccessful. More than a third of American adults fit the criteria for obesity, and the number of children considered obese has skyrocketed. With obesity comes increased risk for heart disease and stroke, diabetes, arthritis and some cancers. It also carries an undeniable stigma, subjecting people to discrimination, low self-esteem and professional and personal rejection.

In this issue of Proto, we hear from experts who offer provocative ideas about how to tackle this public health challenge. Their prescriptions range from mounting an all-out attack akin to the 30-year campaign against smoking to doing nothing, letting those who have “chosen” obesity deal with the consequences.

A new initiative at Massachusetts General Hospital aligns us more closely with the attackers. Almost half of patients admitted to the MGH are obese, and our Weight Center has the capacity to treat just a fraction of them. So we’re helping caregivers throughout the hospital and in our community health centers learn how to counsel, care for and connect with obese patients. We’re also taking steps that could nudge all of us to curb our dangerous habits: Body mass index must be tracked for all patients; our cafeterias increasingly emphasize healthy options; our staff and patients are encouraged to take the stairs. Our goal is to find a balance between being nurturing, supportive and accommodating and being a health-conscious organization that promotes sound behavior and healthy lifestyles.

During the past 30 years, life expectancy has risen by nearly five years, and older Americans are increasingly healthy, active and productive, often into their eighties and nineties. But all this progress could be reversed if the rate of obesity continues to climb at its current pace. Preventing obesity throughout a person’s life is the only long-term solution, and it’s crucial that physicians, scientists and policymakers address the question of how to achieve that goal.

Peter L. Slavin, M.D.
Massachusetts General Hospital
David F. Torchiana, M.D.
CEO and Chairman
Massachusetts General Physicians
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