Chicago — Don't be surprised at your next checkup if the doctor measures your waist and writes a prescription for exercise: They are among the recommendations in a new "call to action" for primary-care physicians.
By now it's a familiar refrain: Americans need to lose weight and get fit. But the necessity couldn't be more dire, the report says, citing data showing that about two-thirds of U.S. adults -- 131 million people -- are overweight.
Despite the enormous public health impact of excess weight and a sedentary lifestyle -- at least 300,000 premature deaths and more than $90 billion in health care costs each year -- many doctors are failing to capitalize on their unique ability to help change patients' ways, the report says.
Primary-care doctors "clearly have the access, as the average American makes three office visits per year," according to the report in Monday's Archives of Internal Medicine.
Many doctors might think they do not have time during already-rushed office visits, but the new recommendations could take only three extra minutes, the authors said.
That is less time than doctors spend treating high blood pressure, high cholesterol, diabetes and heart disease -- some of the major complications of being overweight, said Dr. JoAnn Manson, the report's lead author and chief of preventive medicine at Harvard's Brigham and Women's Hospital.
The message is directed at the journal's more than 105,000 subscribers, most of whom are internal medicine doctors who serve as primary-care physicians. The recommendations include:
- Assessing body mass index and waist measurements, and discussing patients' activity levels at every visit. Patients who are not overweight should be congratulated. Overweight patients should be told about the dangers, which include a doubling of the risk of heart disease and a tripling of the risk of diabetes for people with a body-mass index of 30 or higher, which is obese.
- Counseling overweight patients to reduce their daily food intake by 500 to 1,000 calories and get more exercise, with a goal of losing up to 2 pounds a week.
- Writing a prescription for exercise, such as walking a mile briskly at least five days a week.
- Using a pedometer, which can help motivate some patients to walk more. A good long-term goal is to take 10,000 steps daily; many people average about half that, Manson said.
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