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Stemming the obesity epidemic

April 26, 2012
By ZACH KUKKONEN - Features Editor/DMG writer ( , The Daily Mining Gazette

LAURIUM - In an effort to stem the rising obesity epidemic, the federal Medicare program is making it easier for those who are obese to get on a weight loss program that works.

With more than one out of every three Americans classified as obese - meaning their body mass index is greater than 30 - Aspirus Keweenaw Hospital in Laurium is joining with the Medicare system to begin a new Intensive Behavioral Therapy for Obesity program in order to help turn that trend around.

"Clearly obesity is a problem in this country and it is growing rapidly," said Aspirus Keweenaw Medical Director Dr. Jerry Luoma. "The incidence is continually increasing and it has huge impacts on the morbidity and mortality of our population. People are getting sick because of it, they're dying because of it and it's starting at a younger and younger age."

The program should be fully up and running by May 1, according to Luoma, and is an intensive, six-to-12-month program without a copay or deductible for Medicare beneficiaries and people with active Medicare. Luoma imagines most people will start the program with a primary care physician referral, but is not a requirement.

"I would envision that many of these are going to be referred by their primary care physician, because one of the criteria is going to be that they have to meet this BMI and most people don't know what their BMI is," Luoma said. "If they feel that they would qualify, they could talk to their primary care physician and ask for a referral and set up an appointment.

"On the other hand, I think if someone called and asked for an initial consult to be set up without a referral ... that would be accepted as well," he continued. "They just have to understand that they have to qualify for the Medicare with a BMI greater than 30."

The program begins with an initial consultation, and is not just an attempt to control obesity symptoms, according to Aspirus Family Nurse Practitioner Patricia Koskiniemi.

"It will be for intensive behavior therapy," Koskiniemi said. "The goal is preventative and interventional therapy versus just addressing ... problems after they've happened."

The initial consultation will help to identify the underlying factors for a person's obesity and help to set up a plan to change those factors.

"We're going to work on behavior modification," Koskiniemi said. "It will involve identifying stressors like emotional and lifestyle stressors, and other risk factors such as tobacco use, alcohol use, any family history of genetic obesity, any diseases contributing to the problems, issues with sleep and then working with the patients to develop a diet that's centered on their lifestyle that they can adjust."

In addition to setting up plans for diet and exercise, the program involves one face-to-face visit every week for the first month, one face-to-face visit every other week for months two through six and if the patient has met a 6.6-pound weight loss requirement after the first six months, the patient can get face-to-face visits once a month for months seven through 12.

"Most people fail on diets and exercise ... because they have too high of expectations or they don't have the proper tools to do this correctly," Koskiniemi said.

Although some people may think they are too old for a program like this or have other health issues, Koskiniemi said the program will work within everyone's individual needs.

"We'll also work within ... (the patient's) limitations if they have any other health problems," she said. "Our goal is to make this successful for people that really want to lose weight.

"It's a voluntary thing, and so even if they have mobility limitations or they're on certain special diets, with the help of a dietician we can come up with a diet plan that can definitely meet the requirements of their individual health needs."

Losing the weight and keeping it off will help a person's physical health immensely, according to Luoma.

"The life expectancy of those who are obese at age 40 is six to seven years less than those who are not," Luoma said. "Obesity alone in the U.S. accounts for 14 percent of all cancer deaths in men and 20 percent of cancer deaths in women."

Although the program will not likely be all the way complete until May 1, much of the program is already set up and those interested can get the process started right away. Those without Medicare can also go through the program, but will likely have to pay out of pocket for the visits. For more information, contact Aspirus Keweenaw at 337-6500.



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