Obesity and cultural authority.

[Guest guest]

To the topic of “cultural authority” consider the medical

management of obesity. I started thinking about this yesterday because on my way to work are

2 billboards within ¼ mile which are advertising Bariatric Surgery for weight

loss. Then I received the ACA news today (April 2012 issue) which has an excellent article on "The Obesity Epidemic".

In 2009-2010 the obesity rate was approx 35% for both men and women and 17% in children and adolescents. These individuals when seeing their PCP are advised to “eat healthy and exercise”, and perhaps given information which tells them to eat according to USDA guidelines. When they don’t lose

weight the morbidly obese may be encouraged to consider gastric bypass surgery. The argument is “you

will have multiple health problems and die prematurely if you don’t lose the

weight”. Statistics (from observational

studies) will support this. However, the surgical solution skips over the issue

of causation. The experts will tell us that

gastric bypass is a safe and cost-effective solution because it will reduce the

health risks associated with obesity.

Really? What about

the risks of the surgery and the aftermath? What if the risks associated with obesity are a result of

the cause

of the obesity and not primarily from the obesity itself. That cause—the

Standard American Diet—is not typically addressed. So, after being told by the experts to eat right

and exercise—but not how to eat right or exercise right—and then failing to lose weight, a person is encouraged to surgically change their GI system forever! And this is considered rationale, cost-effective ($25,000) and safe! (Read the gastric bypass article enclosed for how safe is defined!)

Now consider what could happen if insurers would pay

“experts” such as interested, educated and motivated Chiropractors to

appropriately counsel, coach and support the morbidly obese through weight

loss. Such change takes time, money and would not be 100% successful. However, wouldn't it be safer and more “cost-effective” than bariatric surgery?

Obviously, not all Chiropractors want to manage the

morbidly obese. But for those that are truly interested shouldn't we have the opportunity to help and get paid appropriately? Yes, we can currently treat and counsel such patients, but it is typically a cash proposition which depends entirely on individual reputation and marketing

rather than any “Cultural Authority”. If you haven't read the ACAnews article I would highly recommend it! The attached "Why we get fat" is the introductory chapter of a book of the same name by Taubes. Seitz, DC Tuality Physicians 730-D SE Oak St Hillsboro, OR 97123 (503)640-3724

3 of 3 File(s)

Why we get fat - Intro - Taubes 2010.PDF

gastric bypass cost-effectiveness 2008.pdf

ACA news cover 4-12 obesity epidemic.PDF