Stanley Feld M.D., FACP, MACE Menu


War on Obesity: Part 18


Stanley Feld M.D.,FACP,MACE

 There are many perverse economic incentives causing obesity in our society. A cultural change toward food has to occur in America in order to decrease the ever-increasing obesity epidemic. Obesity leads to chronic disease. Chronic disease leads to increased healthcare costs. Eighty percent of the healthcare dollars are spent on the treatment of the complications of chronic disease. 

It is time for action to neutralize the barriers that exist for people to overcome obesity in America. 

I do not believe therapeutic tricks work. I know short-term diets do not work. We tried a very low calorie diet program at Endocrine Associate of Dallas P.A. in 1985. The program combined behavior modification along with a very low calorie diet for obese Type 2 Diabetics. It worked short term but failed long term.  We discontinued the program.

I do not believe medication to decrease appetite works. Many of the medications are harmful to one’s health.  A shift in society’s thinking about food is necessary.

Mrs. Obama has planted a garden in the White House’s back yard. She has started a public service program that focuses on obesity in children. Her program should focus on the entire population because adults’ behavior influences childrens’ behavior.


Mrs. Obama’s initiative falls short. There has been no visible continuous follow-up. The media is the message. As our TV addiction grows so does our exposure to junk food advertising. It can be overcome by continuous news about her initiative.  

Mrs. Obama’s message also has some scientific errors. Her message pushes fresh vegetables only. Fresh frozen vegetables are just as nutritious as fresh vegetables and cheaper. The diet should contain food from all food groups.

In order to lose weight you have to eat fewer calories than you burn or burn calories more than you eat.

The public has to be taught the caloric value of food. The public has to be taught to evaluate the number of calories they burn with exercise in terms of calories. The public must learn that in order to loss 2.2 lbs. one has to burn 9,000 calories more than one eats. In order to loss 22 lbs. one needs to burn 90,000 calories more than one eats.

The solution to obesity is to get all Americans to do more and eat less. They must understand the relationship of calories in to calories out.

My son, Daniel Feld, sent me this You Tube from a TED meeting in San Jose presented by Chris Wang of Ideo. His idea is innovative.   

It is actionable solution. It can be fun. It could start a national trend.  It has educational potential. It is an enjoyable video. 

Unfortunately, few know that a baked potato contains 100 calories. The same potato made into French fries has a caloric value of 450 calories. Water is boiled out of the potato and replaced by fat. Fat contains 9 calories per gram.  Water has zero calories per gram.   

My son, Brad Feld, and the Foundry Group invested in the Fit Bit Company.  I thought he was nuts. He sent me a Fit Bit to critique and I became a Fit Bit fan

My first impression was it was an overgrown pedometer. It turns out it is much more. It provides an education that puts individuals in control of their intake and output. It is easy to underestimate intake and overestimate output. 

 Fit Bit also has a chance of creating the educational trend necessary to help conquer obesity. 

 Technology is the future!

 Meal Snap is an IPHONE application that estimates how many calories are in a meal. All you do is snap a picture with your IPHONE of the meal and Meal Snap estimates the calories in the meal.   

So how do you get started going from overweight to healthy,

Leo Babauta in his blog Zen Habits covers it well.

Essentially it is the same way one would eat an elephant. “One bite at a time.”

You need to make slow changes silently with full awareness of intake as opposed to output. I have described some innovative tools that can be used. Decreasing obesity can lead to healthier living.

It is the individuals’ responsibility to  “just do it.”  Incentive must be provided by the cultural change in society to help individuals make their own good choices.

President Obama’s healthcare reform act does not accomplish that. 

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












  • Daniel

    For years, my physician said “eat less, exercise more.” She had the mantra right, but never asked how much I eat or how much I exercised. More importantly, she never took her message the next step to help “activate” this message. It would have been helpful to hear concrete examples of what eat less exercise more looks like for a person of my age, height, weight. After hearing her simple mantra I would start to visualize giving up all the foods I like and exercising every day to try to accomplish her mantra… This was never going to happen.
    Your suggestion to get started by making slow incremental changes is right on! I eventually activated my own message to myself and slowly started cutting out little things that didn’t really matter (I stopped eating bread before dinner, I take only 3 bites of dessert to get the taste instead of finishing dessert every time, I take the stairs instead of taking the elevator when I can), and over the course of 2 years, I’ve seen significant improvements in my overall health.
    If the changes in food choices and lifestyle are too dramatic too quickly, people will resist the change because it is too unpleasant to give up what we enjoy and have gotten used to. If we make smaller more tolerable changes that can then become integrated into our lifestyle, then it becomes easier to maintain AND incrementally add the next slight change that can make an even bigger difference.
    Just my 2 cents. Thx.

  • LDEakman

    Stan – I think you should also emphasize reading labels on everyting you decide to put in your mouth. Melissa has taught me that value as it not only forces you to consider what but how much you’re taking in calories. One more point of emphasis would be the sugar addiction in our society. I’m seeing it begin to happen in emerging markets and it makes me more cognizant of our own sugar overload here in the States. A large part of the challenge with youth obesity has to be linked to sugar intake. Keep up the good work on the blog, hope to see you in Austin soon. Lindel

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