CEDAR FALLS — The obesity epidemic seems as intractable as the extra pounds 30 percent of Black Hawk County residents carry with them.
The latest figures from the County Health Ranking and Roadmaps show Black Hawk County had its highest rate of obesity yet, as 30 percent of residents have a body mass index of 30 or higher. The number is still below the state average, though both Iowa and Black Hawk County fare worse than the national average.
The reasons are the same everywhere: easy access to unhealthy food and less exercise.
“Obesity is deep-seated,” said Amy Metcalf, a nurse health coach at Covenant Clinic. “It’s part of their culture. It’s part of who they are. They didn’t get that way overnight, they got that way because of how they’ve lived their lives. So we’re asking somebody to completely change their lifestyle, and that’s a lot to consider.”
Nationwide, the average rate of adult obesity is 28 percent. It didn’t happen “overnight” and can’t be fixed quickly.
“It’s not something that you are encouraged by your success, because success takes a long time,” Metcalf added.
Takes a village
For some it is tempting to brush aside concerns about the obesity epidemic as “not my problem.” But experts say it affects everyone.
“Having nearly a third of all adults being diagnosed as obese is going to put a big pressure on your health care system. It’s going to reduce people’s lifespans and their ability to live a healthier life while they’re alive, so this is why we keep track of this, really, it’s a vitally important measure,” said Amanda Jovaag, rankings team director at County Health Rankings and Roadmaps.
Matthew Glascock, bariatric surgeon at the Midwest Institute of Advanced Laparoscopic Surgery, knows the impact obesity can have on the community.
He notes the morbidly obese — those with a BMI over 40 or over 35 with an obesity-related condition — strain the health care system in ways other patients don’t.
And that doesn’t include the costs associated with obesity-linked conditions like diabetes, high blood pressure, obstructive sleep apnea, progressive premature joint failure and other conditions.
Those ailments also reduce workplace attendance and productivity.
The worst-case scenario begins when the number of people who are obese is so great it impacts who can use recreation facilities and therefore limits what is offered.
“If these things aren’t pursued and utilized, then communities fail to see the massive investment of time, effort and money to provide these things, and they go away,” Glascock said. “There’s a lot of aspects where having a high population of people that are so severely overweight that it limits their ability to participate will always have a negative impact on what that community can offer.”
While Black Hawk County’s numbers saw a slight uptick, Jovaag says awareness of the epidemic has led to “ever so slight” improvements in tackling obesity nationwide.
And there’s no shortage of programs in the Cedar Valley working to fight obesity.
Both UnityPoint Health-Allen Hospital and Wheaton Franciscan Healthcare-Iowa clinics and hospitals offer weight management programs.
Specialists help establish achievable exercise routines and nutritious diet plans while overcoming roadblocks to weight loss goals.
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“Education is the biggest thing,” said Linsey High, a physician assistant at UnityPoint Clinic Diabetes and Endocrinology. “I think we need to start to look at food differently. And get more active, of course.”
High said people typically come to a weight management program after their own attempts at dieting fail.
“Some people have tried off and on for decades before they come to us and just kind of get to a point where they’re ready for help,” High said.
Glascock offers a surgical option, and speaks like a true convert about the benefits of bariatric surgery. That’s because he is.
Glascock thought little of bariatric surgery until, during his residency, he saw a patient who benefited. The woman not only looked more healthy, two years after her surgery she no longer had any obesity-related conditions.
“That was the one thing, is the efficacy of bariatric surgery successfully performed in properly selected patients who do a good job is that it can for all intents and purposes cure diabetes,” Glascock said. “As a surgery resident, you learn to absolutely despise the disease of diabetes because it causes such horrible damage throughout the body.”
But he and other health care professionals say there’s no panacea for obesity, and there’s no alternative to a nutritious diet and physical activity to maintain a healthy weight.
Glascock and Hanna Nuss, surgical services program coordinator for the weight management clinic at Sartori Memorial Hospital, are working to create a one-stop shop for addressing obesity — including nonsurgical interventions — at the Cedar Falls hospital. The center is set to be operational this summer.
That center not only will work to address obesity but prevent it.
That’s a big piece of what the Cedar Valley Blue Zones Project is engaged in. While it’s still working to nudge adults toward healthier options — particularly through its Facebook page — the Blue Zones Project recently received a grant with Wheaton Franciscan aimed at keeping youths healthy.
Sue Beach, spokesperson for the Cedar Valley Blue Zones Project, said her group is using the money to focus on getting a Blue Zones designation for all Waterloo schools and potentially others in the Cedar Valley. The designation means those schools offer healthier eating choices, talk more about nutrition and provide more physical activity.
“Our little people are our biggest treasure,” Beach said. “We really feel like that’s an impactful time to be able to start making (healthy choices). … If we can instill some of those things into those folks, then we’re hopefully making a difference for our future.”
Nuss’ portion of that grant funds a voucher program for families to purchase fruits and vegetables at farmers markets. They work with dieticians on using those fruits and vegetables as well.
“The biggest impact we saw was to target families as a whole unit versus just that one kid that is struggling with this, because it comes from a family,” Nuss said. “It takes a whole family change, and everybody has to be on board and ready to move forward.”
Health care professionals point to things that make a community healthier — cheaper indoor exercise options, walkable and bikeable cities, easier access to farmers markets, smaller portion sizes at restaurants.
But Glascock says it’s about more than new amenities.
“There is no lack of opportunities for maintaining a healthy lifestyle here. There is every manner of infrastructure built into this community,” Glascock said. “The problem is we need to change the culture, and that has to happen at an early age.”
He said the only way to foster a culture of health and wellness is “one person and one community at a time.”
“We are working against a decades long tide that created this problem,” Jovaag said, “and it will probably take that same kind of effort, concentrated effort, to bring these numbers down.”