Behavioral Health

The Latest on Obesity, Diet & Exercise

November 23, 2016

Hand weight, green apple, orange and soft measuring tape  on a weight loss scale.

The United States has long heard it has an obesity epidemic. According to the U.S. Centers for Disease Control and Prevention, 36.5 percent of U.S. adults are obese, which leads to health problems like heart disease, type 2 diabetes, certain cancers and premature death. But being overweight is not just a problem for people in their later years. The U.S. is also experiencing a rise in childhood and adolescent obesity. Approximately 17 percent of individuals between the ages of 2 and 19 are overweight. Childhood obesity increases the risk of type 2 diabetes, heart disease, depression, anxiety and more. For adults, bariatric surgery is one treatment option for obesity.  However, preventive measures such as a healthful diet and exercise lead to more satisfying long-term results. As obesity and its related risks become more common, it is important to take a look at what we know about diet and exercise, and how utilization management (UM) can help patients pinpoint the right treatment at the right time.

Sugar is One of Many Culprits

Obesity has many causes, with many (often conflicting) theories proposed and much debate as to the validity of each.  Despite this, there is general agreement that it results from a combination of genetic risk factors, diet, and inactivity.  Food energy (measured in calories) comes from fat, carbohydrates, and protein. Historically, we were taught that a diet high in fat was the culprit. Recent research points to simple carbohydrates as another cause. Our body breaks down foods through complex pathways. In the end, our body stores unused calories as fat. Cutting back on simple carbohydrates (e.g., sugary snacks and beverages) can promote optimal health and weight.

Building a Safe and Healthful Diet

If you are confused about what to eat and drink, you are not alone.  Should you drink coffee or not? Are dark chocolate and red wine good for you? Different studies can support each of those trends, but there is research that has stayed consistent over time in regard to a diet you can trust. A healthful diet includes:

  • Lean meats
  • Beans
  • Unsaturated fats:
    • Monounsaturated and polyunsaturated fats are liquid at room temperature (e.g., olive oil, safflower oil, peanut oil and corn oil).
    • Omega-3 fatty acids are found in certain fish (e.g., salmon, tuna, trout, mackerel, sardines and herring) and plants (e.g., flaxseed (ground), oils (canola, flaxseed, soybean), and nuts and other seeds (walnuts, butternuts and sunflower).
  • Low-fat and skim milk products or dairy alternatives (e.g., almond milk, soy milk)
  • Whole grain breads and cereals
  • Fresh fruits and vegetables

Avoid processed and convenience foods that often have hidden trans fats and sugars. Enjoy alcohol and high-sugar foods such as dessert in moderation. Always consult your physician before significantly altering your diet or lifestyle.

Any Activity Is Better Than None

We all agree that exercise is important, but people are often confused about how much exercise they need and what kind. The current recommendation for adults is either 150 minutes every week of moderate aerobic activity, 75 minutes each week of vigorous aerobic activity or an equivalent combination of moderate-to-intense aerobic activity. Each aerobic activity, whether it is brisk walking, jogging, swimming or tennis should last for at least 10 minutes.

As to whether this is really enough, researchers assessed the benefits of exercising less than, at and more than the recommended amounts, The New York Times reported. Multiple studies found that little to no exercise for adults increased the risk of early death. However, exercising a little, but not meeting the recommendations, reduced the risk of premature death by 20 percent. Meeting the recommendations was better, reducing risk by 31 percent compared to individuals who never exercised. The optimal amount of exercise was just over 1 hour per day of moderate activity, which brought on a 39 percent reduction in risk of early death.

Reconsider Your Fitness Tracker

Wearable fitness trackers have been all the rage for a while now. People wear these devices to determine how much exercise they are getting, calories they have burned, and whether they are on track to lose weight. But are they helpful?

A two-year study evaluating the use of fitness trackers to lose weight found that they may not be helpful. In a University of Pittsburgh study, a group of participants was asked to take part in a low-calorie diet and increase their level of activity. Six months later, half of the students were given a wearable fitness tracker. At the end of two years, those with trackers actually lost less weight than the students without the devices. The researchers believe the devices may alter the wearer’s behavior and enable them to reward themselves more than they should after exercising, leading to less weight loss.

Most experts agree that a combination of a healthful diet and moderate exercise is the best first line of defense against obesity. In fact, most surgical treatments for weight loss first require a thorough demonstration that the patient is committed to keeping a healthy lifestyle. Failing to do so runs the risk of complicating obesity with additional health problems.

At Advanced Medical Reviews (AMR), an independent review organization, UM is a critical tool for helping patients achieve the best outcomes from their weight loss treatment, as it guides them through the available options and helps them understand when each type of treatment is appropriate. Dr. James A. “Jaime” Phalen, a Medical Director at AMR, explains, “When it comes to weight loss, there are both low-risk and high-risk options for treatment. For example, bariatric surgery carries more risk than diet and exercise. Our physician reviewers examine a patient’s history and day-to-day regimen for dealing with weight loss so we can ensure appropriate and safe treatment is approved.”

While new research and trends can skew our habits in different directions, one thing is clear: maintaining healthy dietary and exercise habits is critical in order to avoid the complications of obesity.



The Latest on Obesity, Diet & Exercise