The sour side of sugary drinks and what family physicians can do about obesity

Tags: obesity, sugar-sweetened beverages, family physician, weight of the nation, weight loss

Regularly drinking sugar-sweetened beverages like soda and sports drinks will make you fat.

By now this is an old message, but it gains more ground with each new article, study, or documentary released about the American obesity epidemic. The latest research comes from three studies published in the New England Journal of Medicine. Two of the studies found that drinking noncaloric drinks could lower children’s weight gain, and the third study found that people with a genetic predisposition for weight gain were twice as likely to gain weight if they drank sugary beverages compared to people who did not drink these beverages.

One of the studies’ authors, Dr. David Ludwig from Boston Children’s Hospital, told Reuters Health, “I know of no other category of food whose elimination can produce weight loss in such a short period of time. The most effective single target for an intervention aimed at reducing obesity is sugary beverages.”

Such strong statements grab the attention of policymakers, both the public-health minded and the economists.

Earlier this month, after the New York City Board of Health approved a ban on the sale of sugar-sweetened beverages larger than 16 ounces at restaurants, street carts, and movie theaters, Mayor Michael Bloomberg said in a New York Times article, “This is the single biggest step any city, I think, has ever taken to curb obesity. It’s certainly not the last step that lots of cities are going to take, and we believe that it will help save lives.” That’s, of course, the public health side.

In the four-part HBO documentary Weight of the Nation, free to watch online, Thomas Frieden, M.D., M.P.H., director of the Centers for Disease Control and Prevention, touches on the economic side. “Someone who is obese costs on average more than $1,400 more to care for per year than someone who is not obese. Someone with diabetes costs on average $6,600 more to care for per year than someone without diabetes. Collectively, obesity costs about $150 billion a year.”

Physicians have a history in addressing public health issues and influencing patients to change their behavior. TAFP President Troy Fiesinger, M.D., recently highlighted a post from Shots, NPR’s health blog, on his blog that points to two of the greatest public health triumphs of the 20th century: improvements in traffic safety through seat belt and car seat use, and the decline in smoking rates. Both also had economic consequences and were heavily influenced by physicians.

Family physicians are in a unique position to affect the obesity epidemic. Though your counseling time is stretched thin as it is, you benefit from a strong patient-physician relationship cultivated over years of care. And you see the bigger picture: how your patient’s health relates to family responsibilities and community culture.

A soda ban won’t be the single answer to the obesity epidemic just like counseling a patient to a healthy weight won’t happen in just one visit. But you can partner with your patients to make small but significant changes that will eventually result in shifts in their behavior. This will help them improve their health, achieve long-term weight loss, and turn an alarming trend.

– kalfano

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