Conquering Obesity—Dilemma or Opportunity?

IMI US hosted a one-day symposium, “Conquering Obesity—Dilemma or Opportunity?” on October 26, 2013, to address the growing epidemic of obesity within the US. The event included a range of participants from diverse background and was preceded by a healthy breakfast. Dr. Nusrat Naqvi, Program Chair and Coordinator of the Women’s Wing of IMI opened the session with welcome notes on behalf of IMI and introduced the Master of Ceremonies for the morning session, Mr. Mustafa Jafri. The program involved presentations, panel discussions, an active speaker-audience interaction, and testimonies from patients who had lost weight and cured or managed their obesity.

The event presentations began by Ms. Nessrein Abu Shahaba discussing Religious Views Regarding Food Intake & Lack of Activity. In this session, Ms. Abu Shahaba emphasized the unifying theme of moderation present in most major religions, as well as the importance given to physical activity in these faiths. Following this, Dr. Zainab Syed spoke about the Role of Physical Activity for Normal Body Function and Dr. Shariq Ali explored ways in which one can overcome psychological barriers and different motivations. Advice on overcoming psychological barriers included the idea to make a small change: small changes such as beginning to exercise for even just 5 minutes twice a week, can lead to bigger changes later on. As a way to start this small change, and promote physical activity during normal routines (especially for those with office jobs), the event included periodic physical activity breaks—encouraging participants to get up and move every hour.

Dr. Shehla Naqvi spoke on Obesity in Children & Adolescents, for minorities and immigrants in the US. She discussed how cultural notions also lead to poorer health choices or justifications such as “he’s big because everyone in my family is big”. She emphasized that studies have shown that the family environment is one of the critical elements leading to childhood obesity and there needs to be family agreement on the healthy lifestyle. Similarly if parents are physical activity, children will too—“obesity runs in the family, because nobody runs in the family”. Dr. Naqvi also offered practical advice in closing: diets don’t work, lifestyle changes do. Change TV/computer time to outdoor fun and exploration for children, decrease junk food consumption and be mindful of your eating: eat slower and consciously.

Maura Bruno followed Dr. Naqvi and presented Perspectives of a Dietician about Diabetes as Impacted by Obesity. Ms Bruno discussed ways in which to read a nutrition label and the need for individuals to be careful about products that are advertised as “sugar-free”. The product may be low in sugar but it may have other sources of carbohydrates which is what should be limited. Individuals should chose fiber over other “bad carbs” as fiber produces a slower increase in blood sugar level. She also gave practical advice for eating out including limiting the amount of bread you eat, asking for substitutions (broccoli instead of potatoes) and asking for a take-out container at the beginning of your meal to pre-pack half of your entrée and help moderate your portions. Her key message was balance is best. Avoid extremes with nutritional choices and making changes—tackle on thing at a time and make it stick.

During Cardiovascular Issue of Obesity, Dr. Ali Raza Moosvi spoke about obesity as an epidemic with 1/3 of Americans now classified as obese and how obesity had led to 300,000 deaths annually, costing $190 billion. He emphasized that obesity is one of the modifiable risk factors for heart disease and recommended lifestyle changes to include diet modifications as well as physical activity. Addressing obesity and modifying behavior early limits challenges posed by investigation like nuclear stress tests and catherizations or risks associated with therapeutic (and later necessary) measures like stents and bypass surgeries. He also discussed some problems associated with anti-obesity drugs, noting that many have been withdrawn by FDA in the past, and that instead of reliance on these drugs, the best course of action is early prevention through lifestyle changes with healthy diet, regular exercise and proper behavior. As other presenters, Dr Moosvi again highlighted the importance of exercise noting that even the small change of adding 3 hours a week of brisk walking into one’s routine reduces the risk of cardiovascular disease by 35%.

Dr. Farheen Fahim then presented Psychiatric perspectives of Obesity and discussed ways in which managing our approaches to healthy eating are critical for mental health. She discussed neurological chemicals (leptin, insulin an glucose) associated with appetite control and the impact of food addiction on these—with individuals with obesity becoming increasingly resistant to leptin and insulin. She also touched on the impact of eating disorders (such as bulimia nervosa, binge-eating and anorexia) and the importance of managing these illnesses as well.

Moderated by Dr. Asghar Naqvi, the youth panel brainstormed Causes of the Increase in Obesity Over the Past Decade including economic hardship, food marketing, technology boom, depression, medication, increased lifestyle conveniences (less physical activity), recreational drugs, increased alcohol intake, bullying, processed foods (with steroids), artificial sweeteners and parenting.

Dr. Asghar Naqvi then provided an Overview on Obesity and Nutrition. He identified obesity as one of the risk factors for non-communicable disease including many addressed earlier juxtaposing the main cause of death in 1990, underweight childhood, with that in 2010: high body-mass index. Similar to other presenters, he provided tips on healthy eating including choosing fish over red meat, cooking with vegetable oil instead of ghee, limiting butter, fried foods and backed goods. He also highlighted a balanced approach—noting not all fats are bad and healthy sources of carbohydrates (such as whole grains, vegetables, fruits and beans) are important for balanced diets. He emphasized that a common misconception individuals have is equating fruits with fruit juice—however, the better option is to replace fruit juice consumption with eating fruits instead: an orange has twice the fiber and half the sugar found in a 12oz glass of orange juice.

Following a healthy lunch of turkey wraps, Dr. Wajih Rizvi continued the afternoon session echoing earlier sentiments that diets don’t work—but lifestyle changes last the rest of one’s life. Four of his patients also shared their inspiring success stories of weight loss—some as high as 136 pounds.

At the end of the individual presentations, panelists also provided closing statements about how to reach people who need help before it is too late. They noted that prevention must be emphasized at all levels and parents must take charge to ensure early integration of healthy lifestyles. In addition, structural changes need to be promoted in schools for increased activities and within our cultural attitudes and vehicles of expression: literature and entertainment must include new norms of health for this adjustment.

The symposium concluded with the launch of IMI’s new Cookbook: Healthy Eating (available upon request) and Dr. Nusrat Naqvi, the chair of the program, expressing her thanks towards all presenters and volunteers. Presenters and volunteers both received small tokens of IMI’s appreciation.