Stanley Feld M.D., FACP, MACE Menu


War on Obesity: Part 15

Stanley Feld M.D.,FACP,MACE

Cecelia and I went to flea market in North Central Texas on Memorial Day. There was a large crowd. I would estimate that more than 60% of the people were grossly obese and 30% were moderately obese.

There was a long line at the fast food restaurant.

Companies providing life and health insurance own nearly $2 billion worth of stock in the fast-food industry. The investments are in Jack in the Box, McDonald’s, Burger King, Wendy’s/Arby’s, and Yum! Brands, which includes KFC, Taco Bell, and Pizza Hut.

The life and healthcare insurance industries are not exhibiting the social responsibility they claim. They are in business to make a profit. The fast food industry is a profitable business. Why not invest in it?

President Obama ought to be investing taxpayers’ dollars for healthcare reform in convincing the public to not support the fast food industry.

The appeal of fast food is it is cheaper and more filing than fresh food such as fruits vegetables and chicken and requires no food preparation. The food also contains lots of salt and sugar which appeals to the tastes buds. Excess salt is a contributor to the onset of hypertension and sugar is empty calories.


Nearly half of all adults in the US have Type 2 diabetes, hypertension or hypercholesterolemia associated with an increased risk of cardiovascular disease, according to data from the National Health and Nutrition Examination Survey (NHANES).

Obesity is the underlying disorder precipitating these chronic diseases. If the U.S controls obesity it will decrease the incidence of these diseases and its complications. The cost of these diseases to the healthcare system is enormous.

Obesity and diet-related diseases are in fact far costlier than smoking, and they are just as preventable.

According to the latest statistics from the CDC, smokers incur health care costs of $96 billion a year in direct medical expenses.

Meanwhile, the annual health care cost of obesity in the US has reached $147 billion, and the medical bills for diabetes are at an estimated $217.5 billion a year!

Truly, the health care cost of smoking is dwarfed by the medical expenses caused by unhealthy food.

If you are obese, you will spend an average of 42 percent more on health care than someone of normal weight. This is just one of the reasons why I keep reiterating that someone needs to spend some time in the kitchen to prepare meals.

In response to my last post on consumer driven healthcare a fellow physician wrote;

Hi Stan,
You are assuming that patients, especially, will be willing to admit they might get sick and take steps to prevent it. I can’t even get overweight male diabetics to lose weight. All cigarette smokers know that smoking is bad for them.

I replied by asking “how much he was paying his overweight male diabetic patient to lose weight.”

When will President Obama listen? If he is listening he is not hearing. He is spending tons of money on bureaucratic infra structure that will not solve our healthcare problems or the costs incurred by those problems

The problem of obesity can be solved. It will take a societal change of cultural and attitude toward food and exercise. It will take innovative incentives. The ideal medical saving accounts provides that incentive.

The government has to develop incentives, and not penalties for the farm and food industry to reverse the production of obesity producing foodstuffs.

To some of us the incentive to stay healthy is enough. However, it is very difficult to eat healthy with all the advertising and food stimuli coming at us all the time.

My son Brad’s Foundry Group’s chief of technology officer, Ross Carlson, had an epiphany.

I saw Ross Carlson before he started his fitness program (see photo). He told me about his fitness program.

“ I’ve been hesitant to write this post for quite a while as it feels rather self-serving.  But as I’m ending phase two of my training program and now entering what I’m calling phase three I figured it was time for a little reflection.

Phase 1
If you’ve known me for more than 3 years you know I used to be fat.  Hey, let’s not dance around it, I was fat.

Fortunately for me I’d finally had enough and decided to finally get healthy.  This is what I call phase one of my fitness program or really fitness progression.

  I tend to be fairly obsessive with things I care about and fitness has been no difference.  My first goal was to lose weight – and a lot of weight.

I did two very simple things to accomplish this: I ate significantly less and exercised significantly more (that is to say I finally started exercising regularly).  I cut my daily caloric intake to around 1000 calories and added in cardio work, mostly cycling.  I continued on this program for roughly 10 months to reach my first goal. 

I guess it’s time for some numbers huh?  Wow, these are pretty scary: (I’m 5’11” by the way…)

Beginning: 235lbs | 40” Waist | 32% body fat | 32.8 BMI
Ending: 145lbs | 30” Waist | 8% body fat | 20.2 BMI

So in those first 10 months I lost roughly 90lbs total, 10” off my waist, 65lbs of fat (and 22lbs of muscle).  It was that last stat that made me begin phase 2 about 3 months ago.

Phase 2 and 3 are combinations of dynamic fitness training to increase muscle mass and cardiovascular fitness.

The key to exercise is to make fitness a way of life.

The key to decreasing caloric intake is to make eating less a way of life.

The key to weight loss is to exercise and burn more calories than you eat.

Nothing is new in the laws of thermodynamics. The patient must be responsible to and for themselves.

Final Thoughts
I plan on blogging more regularly about this subject now that I’ve finally published this post.  I hope to write about thoughts on eating, exercising, and my journey through all this.  If you’ve got questions or comments please let me know, they can be very motivating.  And if you’re considering doing something similar to this START NOW.  There is no better day than today to be healthy.

Oh, and now to leave you with a picture that I’m still scared by.  Left is old,
Fat Ross.  Middle is thin Ross from about 3 years ago.  Finally on the right is me a few days ago.  Just wait until you see me in 90 more days.


Hooray for Ross. Nice job. I am very proud of you.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

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