This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (131)  • Contact me when this article is cited  Related Content  • Related letters  • Similar articles in this journal  Topic Collections  • Exercise  • Obesity  • Alert me on articles by topic  Social Bookmarking   What's this?

A Call to Action for Clinicians

JoAnn E. Manson, MD, DrPH; Patrick J. Skerrett, MS; Philip Greenland, MD; Theodore B. VanItallie, MD

Arch Intern Med. 2004;164:249-258.

Obesity and sedentary lifestyle are escalating national and global epidemics that warrant increased attention by physicians and other health care professionals. These intricately linked conditions are responsible for an enormous burden of chronic disease, impaired physical function and quality of life, at least 300 000 premature deaths, and at least $90 billion in direct health care costs annually in the United States alone. Clinicians are on the front line of combat, yet these conditions receive minimal attention during a typical office visit. Clinicians often feel overwhelmed by these challenges and point to an absence of clear guidelines and practice tools, minimal training in behavior modification strategies, and lack of time as reasons for failing to confront them. This report provides a "call to action" with step-by-step guidelines specifically directed at the pivotal role of physicians and other health care professionals in curbing these dangerous epidemics. This blueprint for action, which requires only a few minutes of a clinician's time to implement, will facilitate more effective intervention related to obesity and inactivity and should favorably impact public health.

From the Division of Preventive Medicine and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, and Department of Epidemiology, Harvard School of Public Health, Boston, Mass (Dr Manson); Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Health Publications, Harvard Medical School, Boston (Mr Skerrett); Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago Ill (Dr Greenland); and Obesity Research Center, St Luke's-Roosevelt Hospital Center, and Department of Medicine, Columbia University College of Physicians & Surgeons, New York, NY (Dr VanItallie). The authors have no relevant financial interest in this article.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTERS

Don't Forget to Prescribe Exercise for Your Older Patients
Richard J. Hodes, Chhanda Dutta, and Karen M. Pocinki
Arch Intern Med. 2004;164(18):2065-2066.
EXTRACT | FULL TEXT  

Key to Weight Loss—More Than Exercise?
John M. Galla and Michael S. Cuffe
Arch Intern Med. 2004;164(18):2066.
EXTRACT | FULL TEXT  

The Obesity Epidemic
Jonas Brachfeld
Arch Intern Med. 2004;164(18):2066.
EXTRACT | FULL TEXT  

Prescribing Exercise: Is Your Physician's Head in the Game?
Thomas J. Beckman
Arch Intern Med. 2004;164(18):2066-2067.
EXTRACT | FULL TEXT  

Putting an Obesity "Call to Action" Into Action
Robert F. Kushner
Arch Intern Med. 2004;164(18):2067.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Exercise Training for Type 2 Diabetes Mellitus: Impact on Cardiovascular Risk: A Scientific Statement From the American Heart Association
Marwick et al.
Circulation 2009;119:3244-3262.
FULL TEXT  

Internal Hernia Following Roux-en-Y Gastric Bypass Surgery for Morbid Obesity: Evaluation of Radiographic Findings at Small-Bowel Examination
Carucci et al.
Radiology 2009;251:762-770.
ABSTRACT | FULL TEXT  

Weight Loss Through Living Well: Translating an Effective Lifestyle Intervention Into Clinical Practice
McTigue et al.
The Diabetes Educator 2009;35:199-208.
ABSTRACT | FULL TEXT  

Small-Area Estimation and Prioritizing Communities for Obesity Control in Massachusetts
Li et al.
AJPH 2009;99:511-519.
ABSTRACT | FULL TEXT  

An Epistatic Genetic Basis for Physical Activity Traits in Mice
Leamy et al.
J Hered 2008;99:639-646.
ABSTRACT | FULL TEXT  

Weight Change in Diabetes and Glycemic and Blood Pressure Control
Feldstein et al.
Diabetes Care 2008;31:1960-1965.
ABSTRACT | FULL TEXT  

Cardiorespiratory Fitness and Obstructive Sleep Apnea Syndrome in Morbidly Obese Patients
Vanhecke et al.
Chest 2008;134:539-545.
ABSTRACT | FULL TEXT  

Lifestyle and Risk of Cardiovascular Disease and Type 2 Diabetes in Women: A Review of the Epidemiologic Evidence
Bassuk and Manson
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2008;2:191-213.
ABSTRACT  

Cardiovascular Disease in Diabetes
Bloomgarden
Diabetes Care 2008;31:1260-1266.
FULL TEXT  

State of the Art Reviews: Patient and Physician Communication About Weight Management: Can We Close the Gap?
Beran et al.
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2008;2:75-83.
ABSTRACT  

Patients' Commitment to Their Primary Physician and Why It Matters
Berry et al.
Ann Fam Med 2008;6:6-13.
ABSTRACT | FULL TEXT  

Modified MyPyramid for Older Adults
Lichtenstein et al.
J. Nutr. 2008;138:5-11.
ABSTRACT | FULL TEXT  

Benefits of lifestyle modification in NAFLD
Harrison and Day
Gut 2007;56:1760-1769.
FULL TEXT  

Physical Inactivity Rapidly Induces Insulin Resistance and Microvascular Dysfunction in Healthy Volunteers
Hamburg et al.
Arterioscler. Thromb. Vasc. Bio. 2007;27:2650-2656.
ABSTRACT | FULL TEXT  

Nonalcoholic Fatty Liver Disease Is a Risk Factor for Type 2 Diabetes in Middle-Aged Japanese Men
Shibata et al.
Diabetes Care 2007;30:2940-2944.
ABSTRACT | FULL TEXT  

Death Rates and Causes of Death After Bariatric Surgery for Pennsylvania Residents, 1995 to 2004
Omalu et al.
Arch Surg 2007;142:923-928.
ABSTRACT | FULL TEXT  

Exercise Capacity and Cardiovascular/Metabolic Characteristics of Overweight and Obese Individuals With Type 2 Diabetes: The Look AHEAD clinical trial
Ribisl et al.
Diabetes Care 2007;30:2679-2684.
ABSTRACT | FULL TEXT  

Weight Gain Prior to Diagnosis and Survival from Breast Cancer
Cleveland et al.
Cancer Epidemiol. Biomarkers Prev. 2007;16:1803-1811.
ABSTRACT | FULL TEXT  

Heterogeneity in the Prevalence of Risk Factors for Cardiovascular Disease and Type 2 Diabetes Mellitus in Obese Individuals: Effect of Differences in Insulin Sensitivity
McLaughlin et al.
Arch Intern Med 2007;167:642-648.
ABSTRACT | FULL TEXT  

Patterns in food intake correlate with body mass index
Periwal and Chow
Am. J. Physiol. Endocrinol. Metab. 2006;291:E929-E936.
ABSTRACT | FULL TEXT  

Effects of moderate variations in macronutrient composition on weight loss and reduction in cardiovascular disease risk in obese, insulin-resistant adults.
McLaughlin et al.
Am. J. Clin. Nutr. 2006;84:813-821.
ABSTRACT | FULL TEXT  

Assessment and Preparation of Patients for Bariatric Surgery
Collazo-Clavell et al.
Mayo Clin Proc. 2006;81:S11-S17.
ABSTRACT | FULL TEXT  

Overweight and Mortality among Baby Boomers -- Now We're Getting Personal
Byers
NEJM 2006;355:758-760.
FULL TEXT  

Frequent Outpatient Contact and Decreasing Medication Affordability in Patients With Diabetes From 1997 to 2004.
Grant et al.
Diabetes Care 2006;29:1386-1388.
FULL TEXT  

Sleep disruption is related to allelic variation in the ob gene
Lydic
Am. J. Physiol. Regul. Integr. Comp. Physiol. 2006;290:R892-R893.
FULL TEXT  

Association of Physical Activity and Body Mass Index With Novel and Traditional Cardiovascular Biomarkers in Women
Mora et al.
JAMA 2006;295:1412-1419.
ABSTRACT | FULL TEXT  

Midlife Body Mass Index and Hospitalization and Mortality in Older Age
Yan et al.
JAMA 2006;295:190-198.
ABSTRACT | FULL TEXT  

Body Mass Index and Risk for End-Stage Renal Disease
Hsu et al.
ANN INTERN MED 2006;144:21-28.
ABSTRACT | FULL TEXT  

Body mass index and waist circumference both contribute to differences in insulin-mediated glucose disposal in nondiabetic adults
Farin et al.
Am. J. Clin. Nutr. 2006;83:47-51.
ABSTRACT | FULL TEXT  

Access to exercise referral schemes - a population based analysis
Harrison et al.
J Public Health (Oxf) 2005;27:326-330.
ABSTRACT | FULL TEXT  

All obese individuals are not created equal: insulin resistance is the major determinant of cardiovascular disease in overweight/obese individuals
Reaven
Diabetes and Vascular Disease Research 2005;2:105-112.
ABSTRACT  

Effect of bezafibrate on incidence of type 2 diabetes mellitus in obese patients
Tenenbaum et al.
Eur Heart J 2005;26:2032-2038.
ABSTRACT | FULL TEXT  

Analgesic Use and Risk of Subsequent Hypertension in Apparently Healthy Men
Kurth et al.
Arch Intern Med 2005;165:1903-1909.
ABSTRACT | FULL TEXT  

Trends in Obesity and Arthritis Among Baby Boomers and Their Predecessors, 1971-2002
Leveille et al.
AJPH 2005;95:1607-1613.
ABSTRACT | FULL TEXT  

Obesity in US Workers: The National Health Interview Survey, 1986 to 2002
Caban et al.
AJPH 2005;95:1614-1622.
ABSTRACT | FULL TEXT  

Hyperinsulinemic Hypoglycemia with Nesidioblastosis after Gastric-Bypass Surgery
Service et al.
NEJM 2005;353:249-254.
ABSTRACT | FULL TEXT  

Different Cycle Ergometer Outcomes in Severely Obese Men and Women Without Documented Cardiopulmonary Morbidities Before Bariatric Surgery
Dolfing et al.
Chest 2005;128:256-262.
ABSTRACT | FULL TEXT  

Getting There: Statin Plus Ezetimibe for Low-Density Lipoprotein Cholesterol Goals
Hurley and Isley
Mayo Clin Proc. 2005;80:585-586.
 

Prospective Study of Body Mass Index and Risk of Stroke in Apparently Healthy Women
Kurth et al.
Circulation 2005;111:1992-1998.
ABSTRACT | FULL TEXT  

The Obesity Epidemic as Harbinger of a Metabolic Disorder Epidemic: Trends in Overweight, Hypercholesterolemia, and Diabetes Treatment in Geneva, Switzerland, 1993-2003
Morabia and Costanza
AJPH 2005;95:632-635.
ABSTRACT | FULL TEXT  

Arkansas School Nurses' Role in Statewide Assessment of Body Mass Index to Screen for Overweight Children and Adolescents
Gance-Cleveland and Bushmiaer
The Journal of School Nursing 2005;21:64-69.
ABSTRACT | FULL TEXT  

The obesity epidemic
Ponz de Leon and Bosi
QJM 2005;98:234-234.
FULL TEXT  

Nutrient Oxidation during Moderately Intense Exercise in Obese Prepubertal Boys
Maffeis et al.
J. Clin. Endocrinol. Metab. 2005;90:231-236.
ABSTRACT | FULL TEXT  

Key to Weight Loss--More Than Exercise?
Galla and Cuffe
Arch Intern Med 2004;164:2066-2066.
FULL TEXT  

Putting an Obesity "Call to Action" Into Action
Kushner
Arch Intern Med 2004;164:2067-2067.
FULL TEXT  

Don't Forget to Prescribe Exercise for Your Older Patients
Hodes et al.
Arch Intern Med 2004;164:2065-2066.
FULL TEXT  

The Obesity Epidemic
Brachfeld
Arch Intern Med 2004;164:2066-2066.
FULL TEXT  

Prescribing Exercise: Is Your Physician's Head in the Game?
Beckman
Arch Intern Med 2004;164:2066-2067.
FULL TEXT  

Elevations in Markers of Liver Injury and Risk of Type 2 Diabetes: The Insulin Resistance Atherosclerosis Study
Hanley et al.
Diabetes 2004;53:2623-2632.
ABSTRACT | FULL TEXT  

Relationship of Physical Fitness vs Body Mass Index With Coronary Artery Disease and Cardiovascular Events in Women
Wessel et al.
JAMA 2004;292:1179-1187.
ABSTRACT | FULL TEXT