The Poor Dietary Habits Epidemic: Obesity as a Sign, Not a Disease

By Tera Naset, MS, RD

Poor Dietary Habits Epidemic

As a dietitian in the corporate wellness setting I spend the majority of my time counseling people on weight loss.  Because weight is so easily measured, tracked and assessed, it has become a focal point for wellness programs around the world.  And there is no doubt that weight is a problem – according to the Centers for Disease Control more than 1/3 of U.S. adults are now obese, a condition that leads to approximately $1,429 in additional medical spending per person, per year, compared to someone of normal weight.  This eye-opening data led to a landmark decision by the American Medical Association (AMA) in 2013: obesity is now classified as a disease.

At first glance, this is great news for registered dietitians.  As a profession, we struggle to convince insurers to cover our services, so calling obesity a disease is likely to positively impact our bottom line.  But what will it do for our patients’ health?  As the focus shifts towards excess weight as the disease, are we failing to see the forest for the trees?

I have the unique opportunity to work with my patients every single week as part of a weigh-in-based weight loss program.  The constant weighing leads to a much anticipated moment when people are either thrilled or devastated by weight changes that, in all honesty, are probably more representative of fluid shifts than actual body mass changes.  These patients live and die by food logs, calorie counting and pedometers in hopes of seeing that scale budge every week.  And when it doesn’t, more often than not they drop out of the program.  For the lucky few who see results, an inevitable weight plateau will eventually sway their commitment to getting healthier.  Because in this world, health has only one definition: weight.

Seeing the constant frustration among my patients, I have started encouraging them to look at things in a whole different light.  Contrary to the AMA’s proclamation and its implications for medical billing, the fact is that obesity is NOT a disease; it is a sign of poor dietary habits.  It has become increasingly clear to me that America doesn’t have an obesity epidemic, it has a poor dietary habits epidemic.  It’s not as catchy, but it’s the truth.  Poor dietary habits are at the root of so many signs and symptoms, from inappropriate weight and gastrointestinal distress to infertility and fatigue.  Like any disease, different people will present with a different set of signs and symptoms, but the root cause is the same.  When we begin to shift this paradigm, the focus of treatment shifts as well.  First, we need to be treating thin people just as aggressively as overweight people.  Excess weight gain is only one of many possible signs and symptoms of poor dietary habits.  Second, we need to rethink our outcome measures.  While it’s true that weight will likely improve with a healthful, whole foods-based diet, it should not be the primary focus.  And finally, our message to the public needs to change.  A 1,200 calorie diet packed with frozen dinners and 100-calorie packs may put a band-aid on one sign of poor dietary habits, but how many other signs and symptoms will flare as a result?  As dietitians we owe it to our patients to attack the root cause, not one arbitrary consequence of it.

 

Meet the Author

Tera Naset

Tera

Tera Naset is a Registered Dietitian with Rush University Medical Center where she provides corporate wellness programming to Rush employees. Her work focuses on weight loss, prenatal nutrition and chronic disease prevention and management. Tera received her Master’s in nutrition from the University of Illinois at Chicago in 2012. She is passionate about a “real food” approach to nutrition and spends much of her free time cooking and gardening with her husband and two dogs.
Bringing you the best nutrition information...

Our Academy Bloggers

CAND has several professional and student bloggers.  They write about a range of topics for the public.

Comment on this post

1 Comment

  1. Cassie Kerr on August 28, 2014 at 12:52 pm

    Great article, Tera! It’s the quality of the foods you eat that matters the most, not the calorie quantity.