Although the sale of fitness equipment jumped 170 percent during the coronavirus lockdown, history suggests that it will more likely be used to hold laundry rather than for burning calories. Fewer than one in four Americans get enough exercise, according to the Centers for Disease Control and, when combined with poor eating choices, it’s no wonder that obesity continues to rise. Where there is obesity, there also is high likelihood of cardiovascular disease, diabetes, hypertension, dyslipidemia and a host of other serious medical conditions.
Genetic links to obesity and cardiovascular disease contribute to the behavioral and environmental causes associated with obesity, as does the increased likelihood of obesity as adults age. Patients know it’s a problem, physicians know it’s a problem and the greater health care system knows it’s a problem. But still, despite a wealth of knowledge and wide range of weight management and lifestyle change options, the level of obesity in the country continues its upward trajectory. It seems somehow impervious to the extensive research, experience and technology that is available and at our disposal to treat it.
To make a real, effective difference requires that large scale changes be made not only by medical practitioners, but by other individuals and groups who have an impact on wider societal issues such as access to healthy food choices, transportation and nutrition education. This can seem staggering, but small steps in the right direction can have a tremendous domino effect on individuals, families, communities and society. Primary care physicians are the first step.
Because of these and other challenges, weight loss recommendations should be clearly discussed and customized to each patient’s individual circumstances. Meal replacements are among the safe and effective options for patients with cardiovascular risks. The use of Very Low Calorie Diets (VLCD), such as Robard’s New Direction Advanced program, is supported for these patients, including higher risk groups such as older adults and those with osteoarthritis. Weight loss induced by VLCD results in greater improvements in mean weight change, total cholesterol, triglycerides, systolic blood pressure and reduced waist circumference. Additional research studying the effects of VLCD on diabetes found further support of benefits to cardiovascular risk profiles.
A paradigm shift that recognizes obesity as a serious disease that necessitates prompt diagnosis and immediate treatment is an immediate and critical need. As an ancient proverb says, “A journey of a thousand miles begins with a single step.” That step must be taken now.