Creating a Culture of Wellness

1. Creating a Culture of Wellness Wayne Altman, MD, FAAFP Associate Professor, Department of Public Health and Family Medicine Family Medicine Pre-Doctoral Director Tufts University School of Medicine

2. Denial? • The Cupcake Scandal • Nachos running out • Friday pizza

3. Obesity Trends Among U.S. Adults Between 1990 and 2004 • During the past 20 years there has been a dramatic increase in obesity in the United States. • In 1991, only 4 states had obesity prevalence rates of 15-19%. No states had rates >20%. • In 2004, 33 states had rates of 20–24 percent; and 9 states had rates more than 25 percent.

4. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1991 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

5. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1992 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

6. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1993 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

7. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1994 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

8. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1995 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

9. No Data <10% 10%–14% 15%–19% Obesity Trends* Among U.S. AdultsBRFSS, 1996 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

10. No Data <10% 10%–14% 15%–19% ≥20 Obesity Trends* Among U.S. AdultsBRFSS, 1997 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

11. No Data <10% 10%–14% 15%–19% ≥20 Obesity Trends* Among U.S. AdultsBRFSS, 1998 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

12. No Data <10% 10%–14% 15%–19% ≥20 Obesity Trends* Among U.S. AdultsBRFSS, 1999 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

13. No Data <10% 10%–14% 15%–19% ≥20 Obesity Trends* Among U.S. AdultsBRFSS, 2000 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person)

14. Obesity Trends* Among U.S. AdultsBRFSS, 2001 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

15. Obesity Trends* Among U.S. AdultsBRFSS, 2002 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) (*BMI 30, or ~ 30 lbs overweight for 5’4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

16. Obesity Trends* Among U.S. AdultsBRFSS, 2003 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

17. Obesity Trends* Among U.S. AdultsBRFSS, 2004 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” person) No Data <10% 10%–14% 15%–19% 20%–24% ≥25%

18. 2005?2010?2020?

19. Overweight adolescents have a 70% chance of becoming overweight or obese adults. This increases to 80% if one or more parent is overweight or obese.

20. Overweight or obese adults are at risk for a number of health problems including heart disease, type 2 diabetes, high blood pressure, high cholesterol, and some cancers.

21. Type 2 diabetes, previously considered an adult disease, has increased dramatically in children and adolescents. • Overweight and obesity are closely linked to type 2 diabetes.

22. The most immediate consequence of overweight as perceived by the children themselves is social discrimination. This is associated with poor self-esteem and depression.

23. According to new report by the CDC, one in three American children born in 2000 will develop diabetes in his or her lifetime.

24. What can be done to reverse the childhood obesity trend? • Metanoia • Changing the mind • Changing the culture