Federal guidelines for treating obesity updated by American Heart Association, College of Cardiology

Thanksgiving jumpstarts the holiday eating season, a time when most people gain five to 10 pounds.

This year, your doctor may step in with a warning about your waistline.

For the first time in 15 years, the American Heart Association ( http://bit.ly/1jRwIuy ) and American College of Cardiology ( http://bit.ly/IqUotQ ) updated the federal guidelines for treating obesity. The new guidelines target your risk of illness and encourage doctors to intervene long before patients move from the overweight category to obese.

In the past, intervention often didn't begin until the patient's body mass index, or BMI , ( http://1.usa.gov/1exvIuD) reached 30. Now, doctors may begin treating patients with a BMI of only 25 if they have added heart and health risk factors. So, the next time you go to the doctor, don't be surprised if he or she pulls out a tape measure.

"Stacey was not a big fat baby," Susie Sward said as she waited with her son, Stacey, to see the doctor at the Oklahoma University School of Community Medicine clinic in Tulsa. "He just has gradually put the weight on but now he's trying to take it off because he's tired of it," Sward stated. 

They have good news for the doctor on this visit. Stacey lost weight during the past three months.  

"20 pounds," said Erik Wallace, MD. "That's fantastic!" 

Under the National Institutes of Health 1998 guidelines, physicians focused on obese patients. Now, they will begin to target patients who are only slightly overweight.

"They are encouraging physicians to measure people's waists," according to Dr. Martina Jelley, OU School of Community Medicine physician and interim dean. "So, for a woman - your waist measurement should not be over 35 inches. And if you're a man - your waist measurement should not be over 40-inches."

"It's a balance of calories in, calories out. If you burn more than you take in you are going to lose weight."

Under the new guidelines, physicians should encourage patients to make changes to lower their risk of heart disease, diabetes and other health problems which are linked to obesity. The goal is for patients to start with diet, add exercise, and when needed, see a cognitive behavioral therapist to help make long-term changes.

"That intensive behavioral therapy is what has been shown to help people lose weight and keep it off for the longest," Dr. Jelley added. 

Physicians at the OU Community School of Medicine in Tulsa plan to hammer home the message: lose weight for good health.

"Over and over again. Absolutely. Just saying it one time is never enough," Dr. Wallace said. "You have to keep reminding them of the importance of doing so."     

As for Stacey Swart, he plans to keep losing. He feels better 20 pounds lighter.

"A little bit better," he said. "I have some nieces and nephews I have to keep up with!"

The physicians encourage patients to think about what is truly important in their lives. Whether it's being around to see a daughter get married, or a college graduation, they say making small changes on a daily basis can make a big difference to their patients' waistlines.

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