21 Oct How to successfully combat overweight and obesity as an organization in COVID-19 times
Due to the COVID-19 pandemic shifting our lifestyle in such a fast and unexpected way our eating habits have changed. Work from home becoming the new normal has put many individuals under stress on how to lead a healthy lifestyle. Especially when it comes to nutrition and maintaining a healthy weight. Because a big issue for leading a healthy lifestyle is obesity and for the first time ever the U.S. adult obesity rate passed the 40 percent mark with 42.4 percent according to the State of Obesity: Better Policies for a Healthier America report. Obesity presents an increased risk of a bad outcome in case of infection. To learn more about obesity and its effects on our health, healthy nutrition, and steps individuals and organizations should take to combat it, we talked with dr. Donald Hensrud, one of America’s most respected doctors and leading author of the bestselling book The Mayo Clinic Diet. Donald Hensrud is a doctor and has a Master of Public Health in Epidemiology degree. He is the head of General Internal Medicine at Mayo Clinic and Preventive, Occupational and Aerospace Medicine departments. He is also a consultant at the Endocrinology, Metabolism, and Nutrition Department at Mayo Clinic. As a nutrition and weight management expert, he advises individuals, how to attain and maintain healthy body weight. He also conducts research in the field of obesity and body weight, gives lectures on the subject of nutrition, and is also the author of a world bestseller book titled Mayo Clinic Diet. Together we discussed the global problem of obesity and how to take appropriate measures to combat it at an organizational and individual level.
Now we have the current COVID-19 pandemic, but in the last few years, the world has been facing a global crisis on obesity. With the numbers being high and still raising do you agree that obesity is not a disease but a symptom?
Obesity is both a symptom and the fact that something is increasing around the world in such a large number of people shows how challenging it is to deal with that. Everybody didn’t just decide to gain weight, there are powerful forces in the environment affecting what we eat, affecting our physical activity, affecting our stress, and how we look at life. And all of these hundred factors are coming together to increase weight across most of the entire population. This will require substantial efforts and many different things to help to deal with this crisis. It is a symptom and has been defined as a disease by different organizations, but the point is it is pervasive and challenging to deal with. But it is not impossible if people go at it with the right tools.
In general, we are all aware that being overweight or obese is not very healthy and that a lot of diseases are related to an unhealthy diet. What are the true risks of being obese?
Obesity is related to many different conditions. It increases the risk for high blood pressure, for type-2 diabetes, for abnormal blood lipids, heart disease, certain cancers, obstructive sleep apnea, degenerative joint disease. The list goes on and on. Obesity is not just a cosmetic factor, it is a risk for many different conditions and a root cause for many of the things that are killing people in the United States and around the world.
In the recent New York hospital report, they reported that the majority of people who had some complications due to COVID-19 had obesity.
That’s exactly right. Obesity can affect our immune function and of course, that’s related to COVID-19. People who are obese, the elderly, all are at risk of increased complications due to COVID-19. So this has relevance even today and at what is going on around the world.
The reports are saying that four out of ten Americans are obese and even one out of ten suffers from severe obesity. And the global numbers are showing similar trends. The problem is not just obesity but also the percentage of body fat in our bodies. Are the high levels of body fat also a challenge?
Yes, obesity is an excess of body fat and not necessarily related to weight. In general the greater the weight the more body fat we have. But there are exceptions. For example, a bodyweighter focused on exercising, may increase their lean body mass but have a low body fat percentage. In this case, his health risk has not increased very much. On the other hand at Mayo Clinic there are some publications that came out where people have a relatively normal body mass index yet have a high percentage of body fat. Even though not weighing so much they are still at risk for the above health conditions. We need to focus not only on weight but on managing our weight through a proper diet and exercise regime.
Is sugar the only problem? Today some call it that sugar is the new smoking.
Sugar is a big one. There are many different factors related to this. But sugar is a big one. I like to refer to sugar as a quadruple whammy and what I mean by that is that there are four main effects of sugar that give it negative effects in total. Sugar provides empty calories that contribute to weight gain. Second sugar has no nutrients, but we need vitamins and nutrients to metabolize sugar so we have to rob other sources to get them. Number three sugar is a direct toxin, dental cavities being one example and the other is coronal diseases. And number four, sugar displaces other foods. In summary extra calories, no nutrients, toxic effects, and displacement of other healthy foods. This really makes sugar one of the top negative things in our diet, that we can do something about.
If we take a look from an organizational perspective there comes a moment when we have to address the obesity cases. But companies have a feeling that this topic is not for them to address. Do you think companies could and should support their employees with some weight management measures?
I think companies have an obligation to do that. It makes good business sense. It has been shown that health employees contribute more to the bottom-line, they have fewer sick days and are more productive at work. So supporting well-being is not just the right thing to do for your employees but also for your business. We want to use the carrot and not the stick approach. If companies are invested in their employees they provide opportunities and programs for employees to take advantage of. Implementing healthy behaviors sends a positive message. So worksite wellness programs that offer increased physical activity, putting healthy foods in vending machines, having healthy foods available, having resources such as the program Mayo Clinic Diet or the 24alife app. These are all things that are positive messages that can help people to improve their health and are good for business as well. There is a stigma surrounding obesity and while we are aware of racial and gender discrimination we are not talking a lot about discrimination against obese people. And it has been shown that at the workplace there is certain discrimination about it. We need to get that out at the table and need to treat everyone with respect. Again when something happens that powerfully in a general population it is not that somebody decided to do it, so there should be no moral judgment against it. It is something that is very difficult to prevent and treat and we have to realize that to support people with programs that help them in a non-discriminatory fashion with a positive message. Just like there is no room for racial or sexual discrimination, there should be no room for discrimination against somebody’s weight.
What can companies do to offer really evidence-based knowledge and strategies to employees?
I think first they have to do their homework and have someone at the company who is an advocate for these practices. Oftentimes is human resource management, there may be some resident experts, people who are passionate about this at the company. Then they need to formulate the strategy, how can they help people to do this. People working remotely will need different strategies than those on site. Going about it with a positive message and encouraging instead of penalizing people. Here at Mayo Clinic, we did a worksite wellness program. Many people are intimidated to go to a wellness clinic to discuss their own weight. So we took wellness to the workplace and included local people at each worksite that have a passion for it and want to help their fellow employees. We gave them some resources and some information to help them design their own program that works the best. We made it into a competition, who can come up with the best program. That program has since increased and to my latest knowledge, there are 450 wellness champions around the various worksite places. It helped people to empower themselves to address the things that were important to them through organizational support. It is important to partner with the correct company that has the right resources. If the organization doesn’t have the correct expertise there are many others who do and can help.
In these COVID-19 times when organizations do not have so many opportunities to do wellness programs in person, a system like the Mayo Clinic Diet program through the 24alife app can provide them with motivation to follow through?
Whatever program people are on should be individualized. And the Mayo Clinic Diet provides a framework for people to do. But it should be individualized. The Mayo Clinic Diet has two phases, the Lose it! phase which is a two-week jumpstart phase where we ask people to implement and change 15 habits. The more habits they change the better the weight loss during that period of time. And these are simple things, like eat breakfast, eat more fruits and vegetables. The challenging ones are you can’t eat while watching tv and you can only watch as much tv as the amount of time you have spent exercising. Of course, people might be watching more tv due to COVID-19 so this one can really help. In the Live it! phase people take these habits and turn them into a lifestyle. During the COVID-19 pandemic of course there is less possibility for group sessions, but you can join virtual groups to get the support.
At the Mayo Clinic you also have a specific kitchen to teach people more about healthy nutrition. Do you think companies should also have such cooking classes?
People often look at diet as a four-letter word. And the way people approach this makes all the difference in the world. I see patients who come into my office, being almost depressed about the fact they have to go on a diet. Such feelings make it likely that they will be defeated even before they start. On the other hand, if people approach this with the right attitude, that makes all the difference in the world. We have a participation kitchen at Mayo Clinic where we give people food and teach them the basics of making healthy simple ways of eating. Our executive chef there helps people to make simple healthy meals.
Do you think that the current situation raised the awareness to live more healthily? Is this the right time to change our behavior?
When we talk about other people, they have to understand for themselves if this is the correct time for them. For some this time is represented by financial loss and other stress factors, for others its remote work. It all depends on individual experiences in the end. It isn’t one size fits all. People need to take the current situation, do what they can, be realistic about it, and make the most out of it.