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Taking part in the discussion of obesity in Tennessee were, from left, Jamie Pope, R.D., Ronald Clements, M.D., Kevin Niswender, M.D., Ph.D., Gregory Plemmons, M.D., and Joan Randall, MPH. (photo by Susan Urmy)

Obesity epidemicís impact on workforce explored

BY: LESLIE HILL

10/21/2010 - In Tennessee, about 72 percent of the population is overweight or obese.
There are about 400,000 excess deaths per year in the United States directly related to obesity, costing the economy as much as $400 billion per year.

The impact of those numbers drew local employers to Vanderbilt University Medical Center last week for the Corporate Relations Forum, sponsored by Vanderbilt Corporate Relations Program. The program has established relationships with 62 key employers in Davidson County and surrounding areas.

Five experts from VUMC formed a panel to discuss “Obesity Epidemic: Cause, Effect, Solutions.” They addressed trends and challenges surrounding weight gain and provided corporate partners with ideas to take back to the workplace.

Jill Austin, MBA, assistant vice chancellor for Strategic Marketing and chief marketing officer for VUMC, served as moderator and opened the discussion by noting that $73 billion a year in productivity is lost from obese workers, and spending averages about $16,000 more a year for a morbidly obese person than those who maintain a normal weight.

“We got here because we engineered activity out of our lives and food is pervasive. We've made it too easy for ourselves to put on the pounds,” said Joan Randall, MPH, administrative director of the Vanderbilt Institute for Obesity & Metabolism.

Jamie Pope, R.D., instructor of Nutrition at Vanderbilt University School of Nursing, said that Americans consume the most calories per capita of anywhere in the world and are eating 200-500 more calories per day than 20 years ago.

“One reason for that is portion distortion,” she said. “Our concept of a normal portion has dramatically increased. We're also consuming foods with higher energy or caloric density, like fast food meals. Liquid calories are also an issue, particularly with children, because they don't often turn off your hunger and contain very little nutritional value.”

More than 600 children have been seen in the Pediatric Weight Management Clinic at the Monroe Carell Jr. Children's Hospital at Vanderbilt, directed by Gregory Plemmons, M.D. He said the younger a patient is treated for obesity, the better the results.

“We know that overweight toddlers have about a 20 percent chance of staying overweight. By the time they are in school, it's about 50-50. By the time they are in high school, they have an 80 percent chance of staying overweight,” Plemmons said.

“We think that the obesity levels [in children] may be plateauing, but we haven't even begun to see the tsunami of health care costs that will come from this generation when they reach their 20s and 30s. Conservative estimates show that of children born in 2000, approximately one out of three or four will have Type 2 diabetes by the time they're 30.”

Kevin Niswender, M.D., Ph.D., assistant professor of Diabetes, Endocrinology & Metabolism, discussed clinical options for treating overweight and obese adult patients. Although there are a few medications available, he said, “there is no magic bullet.”

Niswender said that research is indicating that obesity is a strongly genetically programmed disorder, but there is no one gene that dictates a person's weight.

“The way we think it works is that there are a lot of different genes that program how these metabolic circuits work that are very susceptible to our environment. It's the accumulated effects of somewhere between 15 and 30 genes,” he said.

For the morbidly obese (those with a body mass index over 40), the only treatment that has been proven effective at long-term weight loss is bariatric surgery, said Ronald Clements, M.D., professor of Surgery and director of the Vanderbilt Center for Surgical Weight Loss.

“A good candidate has to be physiologically fit and able to undergo an operation, be well-informed and understand the lifestyle changes we're asking them to make, and psychologically able to adapt to these changes,” he said.

Randall closed with advice for employers to promote a healthy work environment for employees.

“Look at the ages of your employees. Look at the choices they make. Could you have a walking meeting or give employees walking desks? Do you give employees time to be active on the job site? What is in the vending machines and cafeteria?” she said.

“There are many things you can do to create a culture of wellness in a workplace, and the more that employees see it is driven by the highest level, the stronger the culture.”

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