Lifelong Health by Dr. David Lipschitz

Throughout history, certain medical conditions have been associated with major social stigmas — from leprosy and HIV to drug addictions. But as our medical knowledge grows, we redefine our views, eliminate many of the negative stereotypes, and cast a more compassionate light on these serious illnesses.

There is at least one condition that has yet to lose its negative connotations: morbid obesity. In America, being obese carries a major social stigma. It affects relationships with others, limits employability and seriously undermines self-esteem. Society views the obese as failures who lack discipline and have inner weakness. More than any other condition, obesity is seen to be a readily solvable problem simply with exercise, diet and willpower.

Unfortunately, it is not so simple. For the morbidly obese — those who are often 150 to 300 pounds overweight — "kicking the habit" without major medical oversight and intervention is very difficult.

Morbidly obese individuals almost always have large numbers of medical problems and utilize the health care system frequently. Not only is life expectancy substantially reduced but also there is a tenfold increased incidence of common diseases, such as diabetes, hypertension and heart disease. The morbidly obese have difficulty walking, find exercise virtually impossible and are in constant pain from osteoarthritis of the back, hips and knees.

Because of problems with blood drainage, many morbidly obese adults have massively swollen legs, which contributes to pain and limits movement. Because of the excess weight, sleep is difficult, and more than 50 percent of these individuals have severe sleep apnea. Severely fatigued and sedentary, most morbidly obese individuals find themselves in a vicious cycle that is not broken easily.

In addition to the physical limitations, it is not unusual for a morbidly obese patient to take 10 or more prescription medications daily, which often carries serious side effects. Considering that these patients have many medical problems and that they are shunned in society, it's not surprising that many of them have very low self-esteem and can be seriously depressed.

It's time to change our views on morbid obesity.

So what can we do to help reverse the trend of continued weight gain and worsening symptoms? One solution lies in intensive health boot camp models, such as the TV series "The Biggest Loser." In this arena, obese contestants can lose hundreds of pounds with counseling, exercise and medically monitored diets.

Unfortunately, for participants in these boot camps, the recidivism rate is high, and many return to their original weights within a year or less. A boot camp — not unlike an addiction rehabilitation center — must be accompanied by long-term follow-up, with continued supervision, counseling and support groups.

Beyond boot camps, there is bariatric surgery, which has seen a dramatic rise in incidence in the past several years. Studies show that these operations, accompanied by counseling and support prior to and after the procedures, have high rates of success. Unfortunately, they are not widely supported by the insurance industry (which likely reflects the social stigma associated with obesity).

While insurance companies — and taxpayers — pay millions of dollars for the unnecessary and inappropriate treatment of most medical conditions, morbid obesity is not deemed "acceptable," and this type of surgery is typically available only to those who can afford it. For the majority of morbidly obese patients, there are few easily accessible medical options and life is full of suffering, depression and serious medical illness.

As we as a society grow fatter and fatter, the adverse effects on our health are clear. But rather than shun the overweight among us and accuse adults of "losing control" or "lacking willpower," we must recognize their suffering and inability to reverse the problem without help. We must stop viewing them as losers or failures and provide the support needed to correct an overwhelmingly severe medical condition.

Dr. David Lipschitz is the author of the book "Breaking the Rules of Aging." To find out more about Dr. David Lipschitz and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate Web page at www.creators.com. More information is available at www.DrDavidHealth.com.

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