Tackling Obesity Is A Long-Term Challenge - The King's Fund, UK
Main Category: Obesity / Weight Loss / FitnessArticle Date: 29 Jan 2009 - 3:00 PDT
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Commenting on today's publication of the Health Profile of England 2008 by the Department of Health, The King's Fund's Research Fellow in public health Dr Tammy Boyce said:
'Tackling obesity is a long-term challenge and even effective local programmes will not deliver big improvements in national figures right away. The government and the NHS must continue to focus their efforts on supporting people to change their engrained bad behaviours and maintain healthier lifestyles. Increases in exercise rates and consumption of fruit and vegetables are encouraging but lack of progress in reducing childhood obesity is a concern as unhealthy habits are learnt at a young age.
'It is crucial not to view problems like teenage pregnancy and rates of sexually transmitted disease in isolation from other policy. Improvements in both these areas are fundamental in reducing health inequalities and it's important to be aware of how different government health strategies can, and should, support each other.'
The King's Fund completed a 12 month investigation into how the NHS can help people live healthier lifestyles in December 2008. The Kicking Bad Habits programme final report 'Commissioning and Behviour Change' can be downloaded here: http://www.kingsfund.org.uk/kbh
The NHS Information Centre released figures showing 1 in 4 children aged 4-5 years old is obese in December 2008 - click here to read about it.
The King's Fund is a charity that seeks to understand how the health system in England can be improved. Using that insight, we help to shape policy, transform services and bring about behaviour change. Our work includes research, analysis, leadership development and service improvement. We also offer a wide range of resources to help everyone working in health to share knowledge, learning and ideas.
The King's Fund
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Obesity
posted by Dan on 29 Jan 2009 at 1:38 pmThoughts about Obesity
Obesity is when excess body fat accumulates in one to where this overgrowth makes the person unhealthy to varying degrees. Obesity is different than being overweight, as it is of a more serious concern. As measured by one’s body mass index (BMI), one’s BMI of 25 to 30 kg/m is considered overweight. If their BMI is 30 to 35 kg/m, they are class I obese, 35 to 40 BMI would be class II obese, and any BMI above 40 is class III obesity. Presently, with obesity affecting children progressively more, the issue of obesity has become a serious public health concern.
Approximately half of all children under the age of 12 are either obese are overweight. About twenty percent of children ages 2 to 5 years old are either obese are overweight. Worldwide, nearly one and a half billion people are either obese or overweight. In the United States, about one third of adults are either obese or overweight. It is now predicted that, for the first time in about 150 years, our life expectancy is suppose to decline.
Morbid obesity is defined as one who has a body mass index of 30 kg/m or greater, and this surgery, along with the three other types of surgery for morbid obesity, should be considered a last resort after all other methods to reduce the patient’s weight have chronically failed. Morbid obesity greatly affects the health of the patient in a very negative way. It has about 10 co-morbidities that can develop if the situation is not corrected. Some if not most of these co-morbidities are life-threatening.
One solution beneficial in many cases of morbid obesity if one’s obesity is not eventually controlled or corrected is what is known as gastric bypass surgery. This is a type of bariatric surgery that essentially reduces the volume of the human stomach in order to correct and treat morbid obesity by surgical re-construction of the stomach and small intestine. Patients for such surgeries are those with a BMI of greater than 40, or a BMI greater than 35 if the patient has comorbidities aside from obesity. This surgery should be considered for the severely obese when other treatment options have failed.
There are three surgical variations of gastric bypass surgery, and one is chosen by the surgeon based on their experience and success from the variation they will utilize. Generally, these surgeries are either gastric restrictive operations or malabsorptive operations. Over 200,000 gastric bypass surgeries are performed each year, and this surgery being performed continues to progress as a suitable option for the morbidly obese. There is evidence that this surgery is particularly beneficial for those obese patients that have non-insulin dependent Diabetes Mellitus as well.
So the surgery to correct morbid obesity greatly limits or prevents such co-morbidities associated with those who are obese. Two percent of those who undergo this surgery die as a result from about a half a dozen complications that could occur. However, the surgery reduces the overall mortality of the patient by 40 percent or so, yet this percentage is debatable due to conflicting clinical studies.
Age of the patient should be taken into consideration, as to whether or not the risks of this surgery outweigh any potential benefits for the patient who may have existing co-morbidities that have already caused physiological damage to the patient. Also what should be determined by the surgeon is the amount of safety, effectiveness, and rationale for a particular patient regarding those patients who are elderly, for example.
Many feel bariatric surgery such as this should be considered as a last resort when exercise and diet have failed for a great length of time.
If a person or a doctor is considering this type of surgery, there is a website dedicated to bariatric surgery, which is: http://www.asmbs.org,
Dan Abshear
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