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Obesity, smoking and inactivity top health concerns

January 14, 2003 By Lisa Brunette

Who hasn’t made a New Year’s resolution involving one or more of the “big three” — losing weight (or simply eating a healthier diet), quitting smoking and exercising more often?

If those goals show up on your New Year’s list, consider this: You’re choosing the right priorities for your health.

In a recent informal poll of UW Health primary care experts, obesity, smoking and inactivity were ranked the health problems most patients need to take seriously. Depression, diabetes and hypertension were not far behind. The good news: tackling even one of these problems will likely improve your health in several areas.

Primary care is “first-contact” care most often provided by physicians, nurse practitioners and physicians’ assistants in internal medicine, family medicine and pediatrics. Prevention of health problems is a major part of their care, and they have a clear idea of the most important choices patients could make.

First on the list is that old standby, obesity and overweight. Of 41 primary care providers responding, 63 percent said patients don’t take being overweight as seriously as they should. With national rates of obesity increasing to nearly one in three of American adults — and rates among children not far behind — the problem is getting worse.

“On a professional level, I cannot count the number of patients I see with diabetes and heart problems who could exist on fewer medications (or none) if they could manage their weight,” says nurse practitioner JoAnn Wagner Novak of the UW Health Northeast Family Medical Center in Madison. “There is documented proof over and over again that exercise and ideal weight decrease risk of diabetes and hypertension, and that ideal weight plus exercise promotes longer life, healthier backs, less depression and influences a multitude of other medical conditions.”

Smoking was identified by 44 percent of the doctors and nurses as a major concern. “The single greatest impact we can have on a patient’s long-term health is if we can get them to quit,” says Eric Miller, a family medicine physician at UW Health-Beaver Dam’s Warren Clinic. While about 23 percent of Wisconsin residents smoke, most want to quit — and treatments now exist to help them do so.

Rounding out the top three is inactivity, which contributes mightily to many common, significant health problems.

Christie Seibert, an internist with UW Health-East Clinic, notes, “Physical activity has impact on weight control, anxiety and depression, and osteoporosis prevention. But, according to Healthy People 2010, only 15 percent of adults engage in moderate physical activity five times per week.”

Many of those surveyed also identified depression, diabetes and hypertension as issues patients tend to disregard. Those disorders — which are either preventable or treatable — are also closely tied to the big three. Untreated depression, for example, may lead to overeating and tobacco use. Diabetes, particularly the adult-onset variety, is powerfully affected by all three risk factors, as is hypertension.

Facing the results of these health choices every day, the UW professionals are realistic about changing behavior. Fast food seems to be available everywhere and time pressures make it attractive to us. Smoking is a habit most often acquired by those under 18. And it’s all too easy to find an excuse not to exercise.

But consider words of advice from Doug Smith, a family practitioner at UW Health-Verona, who offers hope for those making major lifestyle changes: “Small steps work! Start small. Every little bit counts. Look for options — options exist. If you can’t see them, talk to others who might help you see them. And take time to exercise! You get benefit from whatever amount you are able to do. Pick something you like.”