Obese Don't Lose Weight Even After Health Breakdowns

Smoking and obesity are two of the biggest risk factors for chronic and deadly diseases. So it would seem that if a smoker or an obese person suffered a heart attack or stroke, or was diagnosed with lung disease, cancer or diabetes, he would quit smoking or lose a lot of weight – fast.
   
It turns out, however, that, while smokers are three times more likely to quit after a serious health scare than before, obese and overweight people lose only two to three pounds under the same circumstances. The findings were published recently in the Archives of Internal Medicine.

The researchers speculate that the reason why health wake-up calls would cause people to quit smoking far more readily than to lose weight might be that weight-loss programs are often not covered by insurance, with the exception of bariatric surgery, while free or low-cost stop-smoking programs are widely available through businesses and local health departments.
   
“People really are open to changing their behaviors after a health event, and this could really be a window of opportunity,” said study author Patricia S. Keenan, assistant professor of health policy at Yale School of Medicine. “I’m not sure the health care system is capitalizing on it, in terms of giving people the support they need to make these changes as they go forward.”
   
The study entailed analyzing data from a large survey done every other year between 1992 and 2000 on middle-aged and older people under age 75. Among those in the survey were 20,221 overweight or obese people and 7,764 smokers.
   
Keenan’s study found that smokers, before they had a health breakdown, quit at a rate of about one in 10, but that after such an event the quitting rate was almost three in 10. The obese, on the other hand, lost only a trivial amount of weight after a heart attack or stroke, or after a diagnosis of lung disease or cancer. But they lost a little more – up to half a point from their body mass index – after learning they had diabetes.
   
“One of the reasons they may not have found a big weight loss is because physician counseling alone is not going to impact weight loss,” said Sherry Pagoto, an assistant professor at the University of Massachusetts Medical School who co-wrote an editorial accompanying the paper. “The evidence for behavioral weight loss treatment suggests an intensive program is necessary.” Indeed, she said, “if there is a window of opportunity for weight loss, we’re missing it.”

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