Philadelphia Medicine Fall 2021 - 19

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FEATURE
Obesity, diabetes take
toll on community
What are the causes?
The treatment?
By Klaus Krøyer Madsen, MPH with Cities Changing Diabetes - Philadelphia
S
ince 2019, Philadelphia County Medical Society has been an
active member of Cities Changing Diabetes - Philadelphia, a
global program sponsored by Novo Nordisk that creates local
private/public partnerships with communities to understand their
unique obesity and diabetes challenges, identify areas and populations
at greatest risk and design and implement targeted solutions.
The program brings together medical and public health institutions,
communities of faith, employers, insurers and nonprofit organizations.
Philadelphia Medicine asked two of our members
involved in Cities Changing Diabetes to share
their perspectives about the challenges of obesity
prevention:
Ajay D. Rao, MD, MMSc, associate professor of
medicine, Lewis Katz School of Medicine at Temple
University Center for Metabolic Disease Research.
Annette Gadegbeku, MD, associate professor,
Department of Family, Community & Preventative
Medicine, assistant dean of community health,
Drexel University College of Medicine; associate
program director, DUCOM/Tower Health Family
Medicine Residency Program chief, division of
community health.
Why is addressing obesity important?
Dr. Rao: Obesity continues to be a very significant health concern
for our communities. From the Community Health Data Base with
the Public Health Management Corp., we know that more than onethird
of Philadelphia adults (34%) are obese, and an additional 33%
are overweight. In addition, close to a quarter (22%) of children are
obese, according to the School District of Philadelphia.
Obesity is connected to a lot of downstream health concerns,
and maintaining a healthy weight appears to be very helpful for
reducing cardiovascular disease, diabetes and other comorbidities.
We talk a lot about the COVID-19 epidemic, and we should,
but the obesity epidemic is one that we have been fighting for many
years now.
Data from COVID-19 should force us to take a new look at
obesity prevention. We know that overweight people are at a much
higher risk for severe illness from COVID-19. Obesity is known to
triple the risk of hospitalization when you get infected by the virus.
The CDC estimates that a third of hospitalizations with COVID-19
can be attributed to obesity.
Dr. Gadegbeku: In addition to what Dr. Rao mentioned, I
would like to draw attention to the significant mental health aspect
related to obesity. As we have seen recently, mental health disorders
and mental health distress are very interconnected to COVID-19,
increased violence in our cities and various stressors from financial
distress and physical harm. These are all things that cause people to
have habits that also increase their risk for obesity.
We know about the significant mental health impact for adults
who are overweight and have diagnoses of obesity, where they report
lower self-satisfaction and self-esteem, and they have experienced high
rates of trauma and stigma, as well as discrimination. These factors
just touch and affect so many people in so many ways in so many
aspects of their life, including their physical health.
Dr. Rao, how can weight reduction reduce the diabetes
risk for people diagnosed with prediabetes?
Dr. Rao: Prediabetes definitely puts people at risk for developing
diabetes. Also, one important point is that these people also have
high risk for heart disease. This is probably because they don't know
it and aren't following healthy behaviors, or perhaps providers are not
so concerned with it as they don't have diabetes.
It is very important to identify these patients and for patients to
advocate for themselves. Many health systems and organizations
continued on next page
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