“We aren’t winning the obesity battle yet, but there are lots of promising activities underway,” Thompson said. “For the healthcare community, I want to emphasize every clinician at every interface needs to get patients to recognize the obesity problem.”

In addition to talking to their patients, Thompson would like to see healthcare professionals take action in their communities advocating solutions to the obesity problem. An example would be attending a school board meeting to request more physical activity at schools.

“Healthcare professionals get a lot of respect,” Thompson said. “We need them out in the community being vocal advocates for change. We need our healthcare professionals to reinforce the message of how important it is to find a balance and maintain a healthy weight. Obesity is the biggest threat to the health and productivity of our nation.”

Currently 15 percent of adults in Arkansas have type 2 diabetes, and nearly all of that is related to too many calories consumed for the amount of physical activity. There are some estimates that, unchecked, the diabetes rate could soar to 30 percent of the population in the future.

Turning that around means changing from a society whose activities promote obesity, to one that facilitates healthy choices. The changes have to start with children, setting them on a path to prevent obesity.

“We need a paradigm shift so we are investing in our future health and won’t need as much healthcare,” Thompson said. “It is going to take action by those who control the space where kids go to school, play and go to church. This state is leading the nation with some of the programs to address this such as the Child Wellness Intervention Project to get physical education back in schools, and the Mayors’ Growing Healthy Communities Initiative. We are currently the only state funding community organizations to use the school facilities after hours to promote physical activity and give kids a safe place to play.”

Karen Young, MD, UAMS College of Medicine associate professor of pediatrics, said the Arkansas Children’s Hospital Pediatric Fitness Clinic has been overwhelmed with patients from all over the state since it began ten years ago.

“The children we are seeing are more and more severely overweight,” Young said. “We’re also seeing children at younger ages with signs of insulin resistance and acanthosis nigricans – a dark ring around the neck that most parents think is dirt, but is a sign of high insulin levels. We are sometimes even seeing acanthosis with toddlers.”

The Pediatric Fitness Clinic has helped a lot of children reverse their insulin resistance syndrome by changing their diet, exercising more and slimming down.

“We have a window of opportunity to stop or delay the onset of diabetes by recognizing the signs and symptoms,” Young said. “Doctors all over the state have become aware of this and are intervening early. We see them recommending changes, and sometimes by the time a patient gets into our Pediatric Fitness Clinic, they have made healthy changes as recommended by primary care physicians. They have lost ten pounds and the dark ring is starting to lighten up.

I think a big message is that doctors can intervene and interventions do work.”

While a history of diabetes in the family can increase the risk of getting the disease, Young thinks it is important to tell patients that no one is immune from it. Drinking high sugar drinks and eating a lot of carbohydrates can stress the pancreas and release a lot of insulin. That can start a cascade of changes in the body that can lead to diabetes.

“And it can start early in childhood,” she said. “Now doctors are counseling even normal weight children to drink healthy drinks, and eat fruits, vegetables, and protein. Watch portion sizes from food that is starchy. Prevention is the key. You don’t want to wait until someone is 10 or 11 years old and gets diagnosed with diabetes. You want to catch them earlier before they get it and prevent it if possible.

“It is very sad when a child gets diabetes. It is very rewarding to make interventions and make the child slim down even a little, change their lifestyle, and they feel better and they are happier. It can be done, and regular primary care doctors can do it.”

Namvar Zohoori, MD, PhD, chronic disease director, Arkansas Department of Health, said recent studies have shown that the prevalence of obesity is even higher than previous studies where people self-reported their weight. The self reported-rate of adult obesity in Arkansas is 33 percent. But a study that actually went into homes to measure people’s weight found that obesity is 50 percent higher than what is self-reported. That study found 45 percent of adults in the state are obese.

“That is really high,” Zohoori said. “We see a similar thing when people self-report diabetes. Nine to 10 percent report having diabetes, when the actual rate is 15 percent.”

About 48 percent of adults in Arkansas have high blood pressure. As with diabetes, a lot of hypertension has not been diagnosed because people aren’t getting regular screening. Zohoori recommends healthcare providers do screening for diabetes and hypertension, even when patients are coming to see them about another condition.

Diabetes is a complex disease, and Zohoori said treating it effectively requires a team of healthcare professionals working continuously with patients. Too often, that doesn’t happen. Even after people are diagnosed, it is estimated that only 38 percent of people with diabetes do what is necessary to properly control the illness.

“It is important the healthcare community really impress on patients the importance of bringing diabetes under control in order to prevent organ damage,” Zohoori said. “The control of diabetes can be much improved by increasing physical activity, and improving nutrition. It takes a whole family, and a team of healthcare providers. These must be ongoing efforts. That can’t happen in a short period of time.”

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