Obesity Epidemic Threatens Our Society

There is an obesity epidemic in America and, not surprisingly, an epidemic of obesity related illnesses.  Here is an alarming graphic which demonstrates this growing problem.

http://www.policymic.com/articles/70457/watch-america-grow-fatter-in-one-scary-gif

While we worry about the unhealthy messages our thin-obsessed media is sending, unfortunately we are heading in the opposite direction.  What to do?  That is a difficult question about a multifaceted problem, but the solution it is likely to require a gigantic cultural shift.  We have become more sedentary.  More and more, jobs continue to require less physical effort.  We exercise less and spend inordinate amounts of time in front of TV and computer screens.   We eat bigger portions of more processed and less healthy foods.  We are under more stress.  We sleep less.  The changes in the way we conduct our lives over the past 60 years have lead this epidemic.  And, there is no end in sight.

Sure, it’s easy to say eat less and exercise more, but when the lifestyles our culture often requires create, or at least significantly contribute to the problem, that can be easier said than done.  While public awareness might be a helpful starting point, I am not confident that we have the ability, or even the desire, to make the necessary changes on a marco level.

We need to encourage individuals to take charge of their health and their weight, but we also need to give them the necessary tools to do so.  Banning large soft-drink cups or certain foods in vending machines is not going to cut it.  Individuals must have the will and the ability to have a lifestyle that promotes good health, including a healthy weight. Unfortunately, our cultural norms and expectations can make it difficult to find the time and opportunity to make that happen even under the best circumstances.

There is no clear path to recovery, but the current trend is not sustainable.  The costs of an obese population are staggering. From lost productivity to the inordinate consumption of health care, the synergy of the combined effects of this epidemic will eventually spiral out of control.  While it is not yet clear where this will take us, it is not someplace good.

It reminds me of what is going on with entitlement programs such as Medicare or Social Security.  We know something needs to be done to make those programs sustainable , but as a society we don’t have the will to do anything because the wall at the end of the tunnel is so far down the tracks.  I don’t know how to cure the obesity epidemic, but I do know that by that time we get to the wall, perhaps sometime in the next 100 years, it may be too late.

 

 

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Selfless Compassion often the Key to Successful Medical Research

In death, there are still many ways for us to make meaningful contributions to society.  For instance, a single person can forever change the lives of several through organ donation. Donating a body to a medical school can ensure that the next generation of physicians are well-trained.  And, donating all or part of a body to a research facility can advance the quest for better medical treatment, improving health care for all.  While these types of donations are not for everyone, this kind of generosity is often motivated by a desire to give back, and give back it does.

We all have the ability to make these choices for ourselves, but what about when a parent is called upon to make that decision for a child?  Few things in life can be more gut-wrenching than the loss of a child.  Yet, in the midst of that despair, parents can be asked to made hard decisions, but ones that can have life-saving consequences for others.

Case in Point  - A recent discovery was made involving diffuse intrinsic pontine glioma, a rare, inoperable cancer which invades a child’s brainstem causing death, leaving no real treatment options. Here is a link to some treatment study abstracts.

http://neuro-oncology.oxfordjournals.org/content/14/suppl_1/i26.abstract

Because the tumors are inoperable, doctors have not been regularly able to obtain samples of the cancer to study.  Recognizing the problem, they decided to ask parents if they could autopsy affected children and sample their tumors.  A surprising number of parents agreed.  Using that tissue, scientists then made a  remarkable genetic finding that is likely to be the basis for the development of future treatment.  That simply would not have been possible but for those selfless, compassionate parents who wanted to bring meaning to their children’s short lives and, hopefully, save the lives of children in the future

The Moral – So, the next time you have a medical procedure or are in need of medication that likely will prolong you life or make it more comfortable, remember to thank those that have gone before you whose contributions helped make those medical advances possible.  Better yet, do something for future generations yourself – become a donor.  Here’s how.

http://www.organdonor.gov/faqs.html

 

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Good Medical Care – It Depends on a Lot

I read this brief on-line article today.

http://healthyliving.msn.com/health-wellness/many-hospitals-ineffectively-treat-bloodstream-infections-study-suggests

The title suggested it would be about the ineffective treatment of bloodstream born infections by hospitals.  Bloodstream born infections can cause serious medical complications and death.  They require early recognition and treatment.

In its short space, however, for me it raised the subtle, but more important point that good medical care often depends on an awful lot of moving parts working efficiently and effectively.  In medicine there is so much more to a good outcome than simply making a timely diagnosis or performing a successful surgery.

The article reports on a study which suggests that bloodstream born infections are more commonly mistreated in community care hospitals than in large multifaceted care facilities. It may seem intuitive that better medical care is generally provided in a setting with more resources and more physicians in more diverse practice areas, but there’s more to the study and the story.

One, bigger may be better, but it ain’t perfect.  Size matters, but you can receive poor care virtually anywhere.  Additionally, some medical conditions, like bloodstream infections, can be challenging to treat even in best of circumstances with the best of care.  Inappropriate treatment and ineffective treatment are two different things

Two, there has been an alarming increase in antibiotic resistant bacteria in recent years. This makes it difficult to treat infections even when properly diagnosed.  Often, it is not a matter of prescribing appropriate antibiotic therapy, but instead a matter of there being an effective treatment at all.  This problem will only get worse and continue to complicate timely and effective diagnosis and treatment for more an more infections as the become antibiotic resistant.

Three, there are a variety of risk factors associated with bloodstream infections.  These are often included in prior medical records.  The study suggests that medical records systems which identify such risk factors could assist health care providers when making decisions about appropriate antibiotic therapy.  Unfortunately, despite the tremendous advantages such systems would provide in virtually all areas of patient care, the medical records systems in the United States are not well integrated and are not likely to be anytime soon.

So, ineffective treatment of bloodstream born infections – there’s more to it (and the treatment of all medical conditions) than meets the eye.

 

 

 

 

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How to Value a Medical Malpractice Case

The ultimate question in any medical negligence case is “What’s it worth?”  So how do you value a medical malpractice case?  The answer is “It’s complicated.”  I am hired to obtain a sum of money which fairly compensates those who have been harmed by a medical error. What is fair, however, can only be determined in view of the host of facts and circumstances in any situation and is different in every case, even when similar harms are involved.   My clients rely on me to accurately assess the value of their medical negligence claims so they can make informed choices about the relative risks and benefits of settling a case where possible and going to trial, if necessary.  Unfortunately, there is no magic formula, but I believe the following considerations should play a significant role in any assessment of value.

Medical malpractice cases are more difficult than most other types of personal injury cases for many reasons that we have discussed in more depth on this blog previously.  For example, physicians and other health care providers hold an exalted place in our society and juries tend to set the bar for recovery against them higher than those involved in ordinary negligence cases.  In Arizona, juries side with defendants in medical malpractice cases about 90% of the time.  Physicians also can refuse to allow their insurance companies to settle a case, forcing them to trial, even if a plaintiff is willing to accept significantly less than what the case is worth.  Medical negligence cases are complicated and expensive to litigate, often involving multiple experts.  And, a plaintiff can be exposed to significant personal liability for the costs a defendant incurs in a lawsuit if the defendant prevails. This backdrop should be the jumping off point and touchstone for the valuation assessment in every medical negligence case.

It has been said that a case is worth what a jury says its worth.  However, this overlooks the reality that most cases are settled.  The settlement value of a case is different from a verdict.  It is what a jury likely would find the value of the damages to be, minus the value of the risk that the jury will award nothing at all in view of the relative strength of the liability claims and other value driving issues.  When all parties accurately solve this equation, a case should settle.  If one or more parties get it wrong, the case goes to trial.

In assessing what a jury is likely to do, one of the first and most important questions that must be asked is “Will they like my client?”  Jurors are ordinary people.  Like ordinary people, they are not going to want to help someone they don’t like.  Jurors might not like someone for any one of a variety of reasons from personality issues to specific instances of conduct.  This is not lost on defense lawyers who will know everything about a party and have a pretty good idea how that person will present to a jury after deposing them.  While an unlikable client may not be fatal to a case, unless the case is otherwise exceedingly strong, a case brought by someone who will turn off a jury is lost before a lawsuit is ever filed.

A corollary to this inquiry is “Will a jury want to help my client?”  Not if they dislike him or her, but there is more to it than that.  The harm suffered needs to be something the jury can help fix.  A jury only has the power to award money damages.  Jurors will ask whether money will help fix the harm that has been done – will it make a difference – and how much will it take?  For example, in a wrongful death case, some jurors will want to award nothing, regardless of fault, because they deeply believe that no amount of money will make a difference because it won’t bring a loved one back to life.  Jurors will also react differently to an injury that can’t be seen than they will to one that can.  Some jurors will not compensate the victims of emotional or cognitive harm as readily as other injuries, like paraplegia, because the harm is not readily apparent.  The better a jury is able to identify a harm they can fix, the more value they will assign to the claim.

Another important question is how apparent is the fault of the healthcare provider?  In medical negligence cases, a plaintiff must prove that a healthcare provider’s treatment fell below the standard of care.   That means the health care provider had to act unreasonably. This can be difficult because a bad outcome does not always mean someone did something wrong.  Of course, operating on the wrong leg does not leave much room for debate but rarely is a deviation from the standard of care so cut and dried.

Once a plaintiff demonstrates a breach of the standard of care, he or she must prove that breached caused harm.  Even when a healthcare provider makes a mistake, something bad may have happened anyway.  Unless a jury concludes that a medical error, and not something else, caused a poor outcome, the defendant wins.

Expert testimony is required to establish both a deviation from the standard of care and causation, adding yet another element of uncertainty to these issues.  Experts are sized-up by the jury just like claimants.  A poor expert, or one the jury does not like, can ruin an otherwise strong case.  Even where a plaintiff has reputable, likable experts, the defense experts may be equally impressive. When this happens, juries tend to view it as a toss-up and ties go to the defendant.

While these considerations provide a broad basic framework for the overall assessment of value, each case is unique and its value is affected by its own unique set of circumstances. So what tools does a lawyer have to assess value?  The first three are experience, experience, and experience.  Until a lawyer has tried many cases, and litigated many more, he or she will not be in a position to appreciate how all of the pieces of a medical negligence case fit together and the many complex nuances that must be considered to arrive at an appropriate valuation.  Another tool is case reports.  All civil cases tried in Arizona are digested and reported. These reports give lawyers a birds-eye view of what juries are doing and can be used to get an general sense of value, but not to pinpoint a value based on a particular verdict or set of circumstances.  This reminds me of a mock trial I observed which was held before two juries simultaneously.  At the conclusion of the trial, the juries deliberated separately.  One came back with a defense verdict.  The other found for the plaintiff and awarded punitive damages.  While the results were extreme, it is a lesson that trial are always uncertain.  Focus groups are another way lawyers can gauge the strengths and weaknesses of the themes and facts of a case which affect value.

Case value is a moving target.  One of my former partners used to say cases get better and they get worse, but never stay the same.  It’s important to assess the risks and value of a case appropriately so clients can make reasonably informed decisions about whether to settle, if the opportunity is presented, or go to trial.  In the end it’s a judgment call, but if the case has been properly evaluated, the judgment of value should reasonably approximate what a jury would award minus the value of the risk that it awards nothing at all.

Posted in Medical Malpractice, Medical Malpractice Case Value, Valuing Damages in Medical Malpractice Cases | Tagged , , , | Leave a comment

A Doctor’s Suggestions For Keeping The Medical Profession From Killing You

I reported on this essay when it appeared in 2102 but it is so important and has been so ignored by the medical profession that it bears repeated discussion.  http://online.wsj.com/news/articles/SB10000872396390444620104578008263334441352  The author, Dr. Marty Makory, is a well-trained, highly respected surgeon, who practices at an eminent medical institution, Johns Hopkins Hospital.  He freely admits the number of medical mistakes made by doctors and other health care providers and the toll they take on families and on the medical bills we have to pay.  He correctly points out that if the number of people killed by medical errors died instead in plane crashes, we would be outraged and insist something be done.  He offers suggestions for making things better.  Since his essay was published, some of his ideas have been adopted by some doctors and hospitals but most doctors and hospitals have ignored them.  Do yourself a favor and read his essay.

Rankings for hospitals are now available to inform you about their complication and infection rates, which was one of his suggestions. Find them, read them and make decisions based upon what you read.  Hospitals are profit oriented.  If the public insists on good treatment as a condition of being admitted as a patient, hospitals will find a way to provide improved treatment.  Similarly, ask your doctors, especially surgeons, about their results.  Stay away from those who have higher complication rates.  If a doctor is offended by your inquiry, you are better off not letting that doctor lay hands on you.

As always, if you are an informed consumer, you are less likely to be injured by a medical mistake and less likely to be calling me on the phone.

Posted in disclosure of medical mistakes, Doctors, Health Care Costs, Hospital Negligence, Hospitals, Malpractice costs, Medical Costs, medical errors, Medical Malpractice, medical mistakes, Secrecy, Surgical Errors | Leave a comment

It’s Not The Lawyers Who Are Greedy – Part III

The New York Times is running a series on health care costs and the incomes of high earning physicians. The most recent article was entitled, “Patients’ Costs Skyrocket; Specialists Incomes Soar”.  It appeared on line on January 18, 2014.  The article focused on a college professor who had a minor skin lesion and who, after being shuttled between three high income specialists, ended up incurring over $25,000 in medical bills in less than one day.  According to the Times, the bills were so high because the professor’s treatment involved three of the most highly compensated specialties in medicine (dermatology, anesthesiology, and ophthalmology) and her removal procedure was done on the grounds of a hospital.

As reported by the Times author, “Many specialists have become particularly adept at the business of medicine by becoming more entrepreneurial, protecting their turf through aggressive lobbying by their medical societies, and most of all, increasing revenues by offering new procedures – or doing more of lucrative ones.”  Minor procedures typically offer the best return on investment.  In addition to whatever they may receive for actually providing care, many physicians receive additional large sums from business activities such as labs to which they send their patients for tests or facility charges at ambulatory surgery centers.  In each case the facility is owned by the physician ordering the test or doing the surgery.

Health care costs are indeed skyrocketing.  There are some fascinating numbers in the Times story which help explain why and they don’t involve lawyers.  Fees paid to doctors are the second largest component of overall health spending in this country, after hospital costs.  Our physicians make far more than do physicians in other developed countries.  The incomes of dermatologists, gastroenterologists, and oncologists in the United States have gone up by 50% or more since 1995, even after adjusting for inflation.  On the other hand, the incomes of primary care physicians, who are in desperately short supply, have only risen 10% since 1995.  Is it any wonder that we don’t have enough primary care physicians?  Why would anyone take on a career in primary care when the big money beckons from other specialties?  The shortage of primary care physicians will only get worse as more people become insured and seek medical attention.

Meanwhile, the Justice Department has joined multiple whistleblower suits against Health Management Associates, a for-profit hospital chain based in Naples, Florida.  The suits allege that sophisticated software was used to monitor hospital admissions.  Physicians employed by the hospital chain were given admissions targets and their progress in meeting those targets was monitored on daily scorecards.  It is further alleged that physicians who did not meet their targets or who questioned why patients who did not need to be hospitalized were being admitted were fired.   Significantly, the Justice Department is involved in investigations into similar claims at other hospital chains.

The next time you are asked to blame the rising cost of health care on greedy lawyers, take the time to look into the actual facts and see where the money goes.

 

Posted in Doctors, Fee for Service, Health Care Costs, Hospitals, Medical Costs | Leave a comment

It’s Not The Lawyers Who Are Greedy – Part II

I received a recent comment from a reader who asked why, if the lawyers weren’t greedy, no one would take his six figure medical malpractice case.  The lawyers whom he consulted apparently told him that his case wasn’t big enough.  I wrote him back about the economics involved in these cases and it occurred to me that this might be a good time to write about these factors in our blog.

The deck has been stacked against patients who are injured by medical negligence.  The doctors, hospitals, and insurance companies have convinced the public that doctors are being driven out of business by frivolous malpractice suits and that medical bills are being pushed up by the cost of frivolous malpractice suits.  Neither of these things is true.  Every study ever done has consistently shown that the cost of malpractice suits is no more than 1/2 of 1% of the annual medical spending in this country.  Furthermore, for the reasons I will discuss below, no lawyer can afford to bring a suit which is frivolous without running the risk of unsustainable financial losses.  The suits that are brought are almost all meritorious.  Even the prestigious New England Journal of Medicine has done a study which reached that conclusion.  Despite the fact that these things are not true, the public, from which juries are drawn, believes them to be true and jurors are therefore very reluctant to find against health care providers at trial.

Not only has the jury pool been persuaded that medical malpractice cases are almost all frivolous, the Arizona Legislature has enacted many laws which it freely admits are intended to make it harder for injured patients to successfully recover against their health care providers.  Many special rules apply only to medical malpractice cases.  Of course, the legislators defend this on the grounds that these limitations are necessary to curb frivolous suits.  As a result, lawyers who know what they are doing in medical malpractice cases are taking and filing fewer cases.

So why do I say these suits are not frivolous?  Why won’t lawyers take smaller cases in which the patient was clearly injured by the negligence of a health care provider?  Here are the reasons:

1)     Because of current juror attitudes, it is very difficult to get a favorable verdict unless the injury is a bad one and the jury believes the patient will need their help going forward with his or her life.

2)     Health care providers and their insurers fight these cases tooth and nail.  This means many depositions will be taken.  There will be substantial travel expenses to go to the cities where the expert witnesses reside.

3)     The cases require numerous expert witnesses on both sides, who usually charge in excess of $500 per hour to consult with the attorneys and to testify at deposition and at trial.

4)     It is almost impossible to get an Arizona doctor to testify that another Arizona doctor committed medical malpractice.  Attorneys representing patients must therefore go out of state to find witnesses willing to testify.  This increases cost of consulting with an expert and also increases the cost of bringing the expert to court to testify in the event the case proceeds to trial.

5)     Almost all doctor insurance policies give the doctor the right to veto settlement of the case by the insurance company.  Because settlements result in reports to the Arizona Medical Board and to the National Practitioners’ Data Bank, and because juries treat doctors quite favorably at trial, doctors are very reluctant to approve an out-of-court settlement.  Without doctor consent to settlement, the case is forced to trial.

6)     Lawyers representing patients must pay experts to consult with them about whether there was negligence and, if negligence was found, they must usually consult with additional experts about whether the negligence caused the injury.  They often also need experts to testify about the cost of future care and experts to testify about the effect of the injury on the patient’s ability to earn income in the future.  Depending on the number of defendants in a case and whether the case goes to trial or not, these out-of-pocket payments by the lawyer may run from $50,000.00 to well over $100,000.00.  I know one lawyer who incurred over $1,000,000.00 in costs on a single case.  Most lawyers will not ask the client to repay them in the event the suit is not successful.  If the suit is successful, the client must repay the attorney for these costs.  The reimbursement for the costs the lawyer has paid is in addition to the attorney’s fee for the lawyer’s time spent on the case.

7)     Medical malpractice cases are time consuming.  Lawyers will usually spend a minimum of $100,000 in legal time to investigate, prosecute and try a medical malpractice case.  Sometimes it is many times that amount.  The lawyer is typically paid for his or her time out of any recovery made for the client.  The usual fee is 40% of any recovery made.

8)    In the event the case proceeds to trial and the patient loses, the court will enter a judgment against the patient for the “taxable costs” of the defendants.  These “cost judgments” will usually be around $15,000.00 to $20,000.00 for each defendant.  Clearly, there is a substantial financial risk to the client if a case goes to trial.

From all of the foregoing, I hope it is clear that these cases are complex, time-consuming, and hard to win.  Every time a lawyer takes a case, he or she is committing to invest many hundreds of thousands of dollars in actual money spent and time spent on the case.  It is important for both the lawyer and the client that the lawyer be able to evaluate the merits of a possible case and decide whether it makes economic sense to go forward.  The client will not be happy, and understandably so, if the lawyer takes a case which, even if successful, results in a recovery in which the lawyer gets paid but the client gets very little after the attorney’s fees and costs are deducted.  I am not doing my clients any service if I take a case which is not likely to be won at trial or one which, if successful, will pay me but not the client.

It is unfortunate that the deck is stacked against patients.  Patients who are injured by medical negligence should be fairly compensated for their injuries without having to jump through a hundred hoops and wait two or three years to make a recovery.  It is up to you whether you let this state of affairs continue or whether you do something about it.  If you wait until you or a family member are injured, it will be too late to change the system.  In any event, don’t blame the attorneys who are forced to work in the system for not being able to take cases which are not economically viable.

 

Posted in Doctors, Hospitals, Lawsuits, Malpractice costs, Medical Malpractice, medical malpractice lawyers, Medical Negligence, medical negligence lawyers, tort reform | 4 Comments

New Approaches to Heart Disease and Stroke May Be Near.

Although the past twenty years have seen great advances in the treatment of heart disease and stroke, progress has slowed, especially in comparison with the progress which has been made in the treatment of cancer.  Heart disease remains the greatest cause of death among Americans.  Stroke is the fourth leading cause of death.  There were approximately 800,000 deaths caused last year by heart disease.  Experts believe that about 200,000 of those could have been prevented with better assessment and treatment.  We need new tools to take the next step.  Researchers are looking for those new tools now and are taking a page from the successful strategies used with cancer treatment.

It was recognized in cancer treatment that some drugs worked for some patients but not for others.  Similar observations have been made about some treatments for heart disease.  In cancer treatment, researchers discovered that a patient’s genetic makeup determined which drugs would work.  This allowed drug therapies to be tailored to the individual patient.  Researchers in heart disease believe that the same factors are involved in the inconsistent response to some heart disease therapies and are planning to look for genetic connections there as well.  If discovered, treatment for heart disease could also be tailored to the individual patient, which would save money overall and improve patient outcomes.  Researchers also intend to study why African Americans are more susceptible to heart disease and stroke, even when their risk factors are no worse than those of Caucasians.

While we are all waiting for the next magic bullet from the medical profession which will extend our life expectancies and conquer heart disease and stroke, we need to do our part to increase the chances that we will live a long and healthy life.  This means watching what we eat, keeping our weight down, getting moderate exercise, and monitoring our blood pressure and cholesterol levels.  It is the beginning of a new year.  There is no better time to make positive changes in our health than now.  Good luck and Happy New Year.

 

Posted in General Health, healthy living, heart attack | Leave a comment

Hospitals – Ask Before You Go.

I have written often about the importance of being an informed consumer of medical treatment.  As we become more connected, more and more information becomes available to consumers to identify doctors with questionable histories and hospitals with less than stellar results.  Today I want to let you know about a tool that every person who is going to a hospital will want to look at.  I suggest you look at it now for your local hospitals since you won’t have time to consult it in the event of an emergency.

The tool is provided by Medicare.  Here is the link:  http://www.medicare.gov/hospitalcompare/search.html?AspxAutoDetectCookieSupport=1  The site allows consumers to find a hospital and then see how the hospital does in comparison with others in treating things such as heart attacks, strokes, medical emergencies, pneumonia, and pregnancy and delivery as well as some other areas.  The site also contains a summary of patient surveys about the care they received at the hospital.  Medicare is also reporting on those hospitals doing hip and knee replacements and which get the best and worst results.

This is an invaluable tool for identifying the good hospitals and the not-so-good hospitals in your area.  While going to a good hospital is no guarantee that you won’t be mistreated, going to a not-so-good hospital certainly increases the chances that you will be mistreated.  Good hospitals often insist that the doctors who practice there have good records and practice good medicine.  They also usually train their staff better and make sure the staff meets expectations.

As I have said over and over, be an informed consumer and there is less chance you will have to call me and tell me a horror story about what went wrong when you went to the hospital.

Posted in healthy living, heart attack, Heart Attacks, Hip Replacement, Hospital Negligence, Hospitals, joint replacement, medical errors, medical mistakes, Medical Negligence, Medicare, Nurses, Stroke | Leave a comment

Fit or Fat, but Not Both?

Let’s face it, Americans have a health problem.  We are not healthy and the problem is getting worse.  It’s not because we don’t have access to good medical care.  It’s not because we are forced to eat thousands of unnecessary calories.  It’s not because we exercise too much.  And, it’s not because we smoke too few cigarettes  No, its generally because we knowingly make bad choices.  Blame McDonald’s, sugary soda manufacturers and super-duper sized convenience store drinks all you want, but we do have free will and we are ultimately responsible for our lifestyle choices when it comes to diet and exercise, even during the holidays.

It’s no wonder then that recent medical literature suggesting there might be such a thing as “healthy obesity” had so much appeal.  No magic bullet necessary – no change in lifestyle needed.  Stay large and in charge and things will work out great.  Well, turns out that may not be entirely true.  The literature on the subject of healthy obesity generally refers to “metabolically healthy obesity,” where blood pressure, cholesterol, blood sugar and other measures of metabolic health are normal.  By examining metabolic health, researchers were really attempting to identify patient populations that were most at risk for obesity related illnesses or most in need of obesity related care.  Obese individuals who were metabolically healthy were thought to be just as “healthy” as those metabolically healthy individuals at a normal weight.  Therefore, the reasoning went, fewer resources needed to be devoted to such individuals.  The attempt to isolate at risk populations, however, was not meant to suggest that obesity is a healthy.  The snapshot of metabolic health in obese individuals, was just that, a snapshot.  It did not hold up over time.

How do we know?  A new meta-analysis of eight studies involving over 60,000 patients, some of whom were followed for over 10 years, concluded that obesity raised the risk of heart attack and stroke by nearly 25%, even in metabolically healthy individuals.  These results confirm what other studies have demonstrated for years - fat, in and of itself, is a risk factor for heart disease and a variety of other health conditions.

Unfortunately, and not surprisingly, there is still no such thing as a “calorie free” lunch and no magic bullet for good health.  Small lifestyle changes, however, can make a big difference.  A healthy diet and exercise are still two of the best friends your body has.  Keep those friendships in good shape and they’re likely to keep you alive and well for a good long time.

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