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sicians break down the bias. The Yale Rudd Center for Food Policy & Obesity works to end weight bias through re- search, education, and advocacy and of- fers continuing medical education credit for physicians who complete Weight Bias in Clinical Settings: Improving Health Care Delivery for Obese Patients, a free web-based course available on- line, http://bit.ly/1ePX6V2. The course helps physicians implement strategies to reduce bias and provide better care for overweight and obese patients. Dr. Pont says effective strategies may include purchasing chairs that accom- modate larger patients in the medical office waiting room, providing larger gowns, and making other modifications for obese and overweight patients. The Yale Rudd Center’s policy brief


“Weight Bias: A Social Justice Issue” out- lines the following health consequences of weight bias:


• Binge eating, • Unhealthy weight-control practices, • Refusing to diet, • Avoiding physical activity, • High blood pressure, • Increased stress, and • Overall poor quality of life.


Self-report studies indicate physicians


frequently regard obese patients as “lazy, lacking in self-control, non-compliant, unintelligent, weak-willed, sloppy, and dishonest,” according to the policy brief. Access the full brief online at http://bit .ly/n3HYh.


Changing behaviors


Declaring obesity a disease will likely benefit those who suffer from it, Dr. Lef- fert says. “Anytime we increase the light we shine on a disease, it benefits those with the disease. Complications associated with obesity cost the state billions of dollars. Elevating obesity to the level of a disease allows us to move forward in researching and treating it,” he said. State officials estimate obesity costs


Texas businesses $9.5 billion annually. If the obesity rate and the cost of health care continue to increase as projected, the cost to businesses could reach $32.5


48 TEXAS MEDICINE January 2014


billion per year by 2030, according to a 2011 report released by Comptroller Su- san Combs.


The price tag for obesity is nearly


three times the estimate Ms. Combs re- leased in 2007. In February 2011, the comptroller


released a report, Gaining Costs, Losing Time: The Obesity Crisis in Texas (http:// bit.ly/17j457h), which calculates the cost of obesity-related health care, ab- senteeism, decreased productivity, and disability to Texas employers. In addition to saving the state money,


approaching obesity as a disease adds a level of urgency to the need for preven- tion and treatment, Dr. Avila Edwards says.


“I think obese people will see their dis- ease as something they can control and as something that doesn’t have to beat them. I believe this classification will actually stimulate behavioral change in obese patients,” she said. While Dr. Leffert acknowledges pre- vention is important in fighting the obe- sity epidemic, he says he doesn’t think classifying obesity as a disease absolves obese people from responsibility for their disease. “Some fear obese people will think they don’t have to work to lose weight because they have a disease. That’s far from what I see in my endocrinol- ogy practice. My patients are concerned about obesity and its association with heart disease, high cholesterol, and dia- betes,” he said. Dr. Leffert says his patients are will- ing to make lifestyle modifications and to take effective medications, opting for surgery as a last resort.


CDC report details drug-resistant health threats


Every year, more than 2 million people in the United States get infections that are resistant to antibiotics, and at least 23,000 people die as a result, accord-


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