Dr. Scott Kahan was nominated for the 2012 Robert Wood Johnson Foundation Young Leader Award by one of his patients who wrote the following nomination letter.

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Dena Kahn, one of NCWW’s yoga and movement specialists, was featured in a WTOP feature: Overweight, Chronically Ill Find Yoga Without Judgment. Dena teaches Yoga…for Real People at NCWW and specializes in curvy yoga, which is a healthy and gentle form of movement that can be performed by anyone (yes, even if you can’t touch your toes, like me!). Come join Dena for one of her small-group sessions on Fridays at NCWW.

Dr. Tricia Psota was asked to provide tips for on nutrition and staying hydrated on the Dr. Steve Show on WPIX11 in New York.

PRESS RELEASE

Scott Kahan, M.D. to Assume Role of STOP Obesity Alliance Director

Founding Director Christine Ferguson, JD accepts position with State of Rhode Island to run the state’s health benefits exchange, maintains university post

WASHINGTON, DC – June 21, 2012 – Obesity expert and George Washington University (GW) faculty member Scott Kahan, MD, MPH has been named Director of the Strategies to Overcome and Prevent (STOP) Obesity Alliance, a national multi-stakeholder coalition based at the GW School of Public Health and Health Services, Department of Health Policy. Dr. Kahan previously served as the organization’s Clinical Advisor, providing counsel for the Alliance’s ongoing health research initiatives.

The leadership transition comes as founding Director Christine Ferguson was tapped by the Governor of Rhode Island to run the state’s health insurance exchange. Maintaining a part time faculty post at GW during her return to state service, Ferguson will continue to provide the Alliance with strategic leadership and support initiatives. She was closely involved in identifying Dr. Kahan for the director role.

“The STOP Obesity Alliance is lucky to have Dr. Scott Kahan take on this increased role. The coalition and the cause to overcome and prevent obesity will benefit from his deep knowledge of the issues – both from a clinical and public health perspective,” said Ferguson. “It has been an honor to work with Alliance members over the years and now to have the extraordinary opportunity to apply my experience on obesity issues and overall delivery system and insurance reform to a state at the forefront of healthcare transformation.”

Dr. Kahan, a physician trained in both clinical medicine and public health, is board-certified in Preventive Medicine and his clinical practice specializes in weight management and obesity medicine. He serves on the Faculty of the George Washington University School of Medicine and School of Public Health and Health Services and the Johns Hopkins Bloomberg School of Public Health. He received his undergraduate degree in bioengineering from Columbia University, his medical degree from the Medical College of Pennsylvania, and his Masters of Public Health degree from Johns Hopkins School of Public Health. Kahan has published 14 books in the fields of medicine, nutrition and public health and is the Editor-in-Chief of a series of medical texts that have been published internationally.

While director of the Alliance, he will remain in his post as Director of the National Center for Weight and Wellness where he specializes in preventive medicine and obesity prevention and treatment.

“I’m looking forward to the opportunity to help lead the Alliance,” Kahan said. “The coalition has made great strides over the past five years to change the conversation in America about overweight, obesity and weight-related health risks through its multi-pronged approach to address the issue,” Kahan said. “With our members and work in the area, I believe we will achieve a healthier future.”

The academic home for the Alliance will remain at the GW School of Public Health and Health Services, Department of Health Policy. The established GW obesity research team will continue to provide the substantive knowledge base for the Alliance’s initiatives and projects.

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“Doctors tend to shoo away people who have obesity,” says Dr. Scott Kahan, who was quoted in an Associated Press article published on The Huffington Post.

The article, Obesity Screening: Doctors Urged To Routinely Check Patients’ BMIs, describes the recent update by the United States Preventive Services Task Force that reiterates the importance of primary care screening for obesity.

Dr. Kahan argues that insurance companies often don’t cover services aimed to treat obesity and comprehensive weight management programs aren’t often available to patients who need them. He further points out the doctors tend to shoo away those who have obesity, often with attitudes such as “Don’t come back to me and tell me your back hurts or you have acid reflux or high cholesterol until you will do something about it.'”

The article points out that Dr. Kahan has created and teaches several courses to medical students and other young professionals intended to help train them to have a compassionate, scientific, and strategic perspective toward helping patients with obesity to build an empowered approach to managing their health.

Read the article here.

Dr. Scott Kahan has been invited to speak at a Congressional Briefing. The Briefing, sponsored by the nonprofit Partnership To Fight Chronic Disease and Wellpoint, one of the largest insurers in the U.S., focuses on collaborative efforts to address childhood obesity.

In addition to Dr. Kahan, expected speakers include:

• Representatives Marcia Fudge (D-OH), Patrick Tiberi (R-OH), Ron Kind (D-WI), and Dave Reichert (R-WA)
• Dr. Kenneth Thorpe, Professor and Chair of Health Policy at Emory University
• Dr. Harvinder Sareen, Clinical Programs Director at Wellpoint
• Katie Adamson, Director of Health Partnerships and Policy at YMCA of the USA

Dr. Kahan will discuss roles of the healthcare system in childhood obesity prevention and treatment. His presentation will be available online shortly.

The unexpected loss of Dr. Marilyn Sperling on May 16 has left all of us grieving the absence of a dear friend, trusted colleague and compassionate doctor. She was deeply committed to making a difference one person at a time and that dedication helped so many people find a new path forward. Our deepest sympathies are with her family and friends, and our hope is that happier memories will displace the sadness of her absence as time passes.

Dr. Sperling’s group sessions here at the National Center for Weight and Wellness will continue as normally scheduled, led by Dr. Maria Foley.

If you have any questions or concerns about your transition, please contact Dr. Scott Kahan at (202) 223-3077.

Dr. Robyn Osborn was invited to present her research findings at the International Conference on Eating Disorders in Austin, Texas.  Her research which investigates weight gain and disordered eating among minority populations.  She will present a summary of her research on Thursday, May 3.

Title: An Academic-Community  Partnership to Reduce Disordered Eating and Excessive Weight Gain in Racial/Ethnic Minorities:  Preventing
Weight Gain and Enhancing Relationships in Underserved Populations (POWER-UP)

Authors: Robyn Osborn,Ph.D., Omni Cassidy, BA, Anna Vannucci, MS, Lauren Shomaker,Ph.D., Juliette McClendon-Iacovino, MS, Denise Wilfley,Ph.D. James Heimdal,Ph.D., Beatrice Nelson,RN, Tracy Sbrocco, Ph.D. & Marian Tanofsky-Kraff, Ph.D.

I often talk with patients about the distorted images about our bodies that industry and the media widely propagate. It’s hard to live in our society and yet avoid thinking that we all need to look like Brad Pitt or Angelina Jolie in order to be attractive.

This is particularly true for women: I recently read research suggesting that only 12% of U.S. women are very satisfied with their attractiveness and only 2% describe themselves as beautiful.

In many discussions I have with patients, we ultimately come to the conclusion that the only people who look like Brad Pitt or Angelina Jolie are…Brad Pitt and Angelina Jolie. And that we don’t have to look like them to be healthy, happy, or attractive.

But, as the video below suggests, not even Brad or Angelina actually look like the unattainable, air-brushed, make’d-up versions that we see on TV, billboards, and magazines!

I just found this video, but you may have seen it back in 2006 when it was created as part of a marketing push by Dove called the Campaign for Real Beauty. While their goal was to sell Dove products, it is a testament to them that they shed some light on this (and a shrewd marketing campaign).

I’d like to stop this post now, but can’t help but add one more thing: if you now go to www.CampaignForRealBeauty.com, you get to a website owned by Medifast, the commercial diet company, which sells the typical “weight loss at all costs” message (and products).

Dr. Scott Kahan will speak at the Rayburn House Office Building at a Congressional Briefing on February 7th.

The event, hosted by the nonprofit Sister-to-Sister Women’s Heart Health Foundation, is a briefing for Congressional staff on heart health, nutrition, and obesity.

The event is moderated by Elizabeth Kucinich, wife of Congressman Dennis Kucinich. Joining Dr. Kahan are:

• Congresswoman Eleanor Holmes Norton
• William Bestermann, MD, President, COSEHC Cardiovascular Centers of Excellence and Director, Medical Home Quality, Holston Medical Group
• Frederick Lough, MD, Clinical Director, Cardiac Surgery Program, George Washington University Hospital
• Edward J. Roccella, PhD, MPH, Former Coordinator, National High Blood Pressure Education Program, National Institutes of Health
• Janet Wright, MD, Executive Director, Million Hearts
• Bob Honigberg, MD, Vice President of Medical Affairs and Chief Medical Officer, LipoScience

We plan to post a summary of the Briefing soon after the event!

Georgia’s recent campaign highlighting childhood obesity, which has received lots of recent press, is an example of what not to do to help this public health problem.

This campaign, called Strong4Life, was created with the hope that a “in your face” commentary on childhood obesity would move parents and kids to lose weight and get healthy. You can see the videos here.

This is an example of an uninformed, anti-fat-person campaign. It is exceptionally shaming, and pitches precisely the opposite approach to what is needed to build community recognition and action on this very important problem.  Centrally, the approach levies a negative, alarmist, critical light on a problem that needs understanding, not shame – a problem that needs an encouraging and affirming light that leads to positive appreciation and engaged attention aimed at what will be gained, rather than trumping on a kind of kick-in-the-butt attack.

The latter may produce quick action, but there is no evidence that it will produce anything but a burst of shame-based energy that will get washed over when that burst exhausts.

Published in The Huffington Post on September 18, 2011.

The CDC’s recent report of the top 10 Public Health Achievements of the past decade overlooked one of the most important: progress in the fight against obesity.

I bet you’re surprised to read this.  While there are many “no brainers” on the CDC’s list, such as tobacco control, motor vehicle safety, and heart disease improvements, scary statistics and media reports suggest that we’re losing the obesity fight.

To be sure, obesity rates only increased over the past decade, continuing the epidemic rise that has progressed over the past half-century. But hidden underneath the scary statistics is quite a bit of good news:

• Today, we have a national dialogue on obesity.  This is a very recent shift.  A decade ago, we weren’t talking about obesity (except to call fat people “lazy” and “stupid” and the like). There is now regular discussion about this epidemic, both in terms of improving the evidence base for individual treatments and how to mount an effective population-level approach.
• We now generally accept that obesity is a serious health problem, rather than simply a cosmetic issue. In a study that my colleagues and I currently have in press, we show that a number of key public health messages are penetrating society. The vast majority of Americans we surveyed recognize that their weight can affect their health. The vast majority of physicians polled acknowledge that they have a responsibility to help their patients with weight management.
• More information is now available than ever before. The internet is chock full of great resources for individuals, parents, kids, schools, teachers, doctors, and others to learn more about weight and health (of course, the reliable resources are awash in a sea of nonsense – caveat emptor, as always, still applies…feel free to email me and I’ll do my best to point you in the right directions).  Schools are beginning to teach skills for healthy nutrition and physical activity.  Workplace wellness opportunities are growing.  Calorie labeling in restaurants will help millions to make healthier choices while dining out.
• Practitioners are slowly moving beyond simply lecturing patients to “eat less, exercise more,” and thinking about the underlying causes and contributors of individuals’ weight problems. Recent research has shown that primary care doctors can effectively implement comprehensive strategies to help their patients manage weight.
• The public and private sectors are on board. Governments, communities, schools, organizations, and even the food industry are working to address the policies, settings, contexts, and environments that set the stage for weight gain and obesity. Sure, each of these stakeholder groups can, and must, do more.  But to have all of them working toward some common goals is a small victory in itself.
• Significant research, advocacy, and policy discussions about weight bias are now occurring daily. Though the level of vitriol has seemingly increased (as evidenced, I’m sure, by the hateful and inhumane anti-fat comments that will likely appear below this post), we’re now having real and informed discussions about the obesity epidemic, how to address the societal drivers of weight gain, how to support persons who have obesity, and where to go from here.

We certainly have a long way to go, and the surface stats don’t add up – yet. But progress has to start somewhere.

I believe that in the past decade we set the stage for a revolution in the way we approach obesity, both clinically and on a population level.  When rates begin to decline, we’ll look back at this decade as having sown the seeds for success. It’s not going to be easy, but I like our chances.

And I look forward to CDC’s next report – due in 2021 – in which I’m confident obesity treatment and prevention will claim a prominent ranking.

HHS officials released their end-of-decade assessment of progress made toward the Health People 2010 goals. If you’re not familiar with Healthy People, see here.

This public health program aims to identify the nation’s health improvement priorities, and provide measurable objectives and engage multiple sectors and stakeholders toward achieving these priorities. It’s redone every 10 years as a set of public health goals for the coming decade.

The final review was positive in many ways. Americans are living longer. Fewer are dying from cancers, including breast, colon, and prostate. And we continue to make progress in the fight against tobacco.

One area that seems futile to many is the obesity epidemic. But as I’ve written previously, and as I discussed in an article published on WebMD today (and pasted below), I believe we’ve actually taken many important steps forward that set the stage for a productive decade ahead.

Later today, researchers from Yale University will present an important new study at this year’s American Public Health Association conference. Their research study shows that food companies continue to aggressively market sugary drinks and other junk foods to young children, despite prior pledges to improve child-directed advertising.

Nearly 600 products from 14 beverage companies were studied. Few of their beverages were nutritionally sound, though many presented misleading health claims – such as claiming “all-natural” or “high in antioxidants” on a high-calorie soda or “low sodium” on drinks that are essentially all sugar.

From 2008-2010, kids’ exposure to ads for sodas doubled, and their marketing has become particularly aimed at low-income and minority populations.

Decades of social science research has shown that marketing strongly affects our preferences and choices. Kids are particularly vulnerable to marketing; they are essentially “sitting ducks” for advertisers.

A recent study that I’ve repeatedly discussed showed that marketing can essentially define what kids like to eat. When kids see a licensed character (such as Shrek or SpongeBob) on a packaged food, they say that the food tastes better than the exact same food packaged without the character. All else being equal, in a “taste test” between the exact same food in a similar packaging, but one of the packages simply has a picture of a fun character on it, kids say that the one with the character tastes better (and, of course, they are more likely to choose it). I’ve spoken and blogged about this.

This is particularly important because we live in a new world in which chronic, often nutrition-related, health problems are the most common causes of disease and death in the U.S. This is a stark change from just a few decades ago, when acute diseases, such as infections like tuberculosis, were the biggest killers.

We would never let our kids be attacked by advertisements for germ-infested products that would make them sick or tobacco products that would give them cancer – yet this is what’s happening right now. Sugary drinks and other junk foods contribute to the unhealthy eating and obesity that is killing as many Americans as tobacco.

And this study shows that things are getting worse, despite the pledges of many food and beverage companies to regulate their advertising to young kids.

This article was published in The Huffington Post on September 23, 2011.

My initial reaction to last week’s announcement of a new Michigan policy to track kids’ weight was emotional and negative. Indeed, so many recently publicized policies and prescriptions regarding weight seem to be uninformed and often stigmatizing toward people who have obesity. For example, there have been calls for taxes levied against people with obesity and proposed laws against serving food to people with obesity, not to mention doctors who systematically refuse to treat patients who are heavy.

So when I heard that Gov. Rick Snyder would mandate doctors to report their patients body mass index (BMI), I jumped to the conclusion that this was yet another example of punishing people for their weight in a society that strongly pushes overeating and weight gain.

But let me explain why this is a good public health measure: It’s a core, essential step in our approach to the childhood obesity epidemic. That is, as long as it’s done right.

Some argue that this is a case of the government legislating what we eat. Not true. This policy simply asks pediatricians to measure and report kids’ height and weight to the Michigan public health system, just as they routinely do for other health measures, such as immunizations, certain infections and other health measures.

This is called public health surveillance. It is the first step in the systematic process of understanding public health problems and implementing solutions. Surveillance is information gathering: collecting, analyzing and interpreting data. Without understanding the scope, magnitude, distribution and other facets of the problem, finding appropriate solutions would essentially be just “shooting in the dark.”

Some argue it’s a bad idea because BMI is an inaccurate measure of body fat. True, BMI doesn’t distinguish between fat and muscle, so some muscular people are inappropriately labeled as overweight (and even more thin-appearing people actually have body fat percentages that put them in the overweight range). For many reasons, I don’t depend on BMI in my clinical obesity practice.

But in this case, it isn’t being used for individual purposes. All the BMI measurements will be tallied and averaged to understand the distributions of weight and height in the population as a whole. For population assessments, BMI is well studied, effectiveand affordable.

Others believe the policy will stigmatize overweight kids. That’s an important consideration, especially given the stigma we have toward obesity in general. But in this case the policy is right on. The BMI data is collected by pediatricians during annual check-ups and reported anonymously to a public health database. This is no different from how we report immunizations or other health measures. It’s “public health 101.”

In contrast, imagine how this policy could have gone wrong. What if the policy required measurements to be done at schools — i.e., kids line up in gym class, shirts off, to be weighed. Few things could be more shaming than this. Some policymakers actually think that a nice ancillary benefit would be the inevitable mockery of the fat kids, which might encourage them to lose weight. It wouldn’t. It’s a fallacy and a tragedy to think that shaming people will motivate them. As is, kids with obesity experience worse emotional quality of life than kids with cancer.

Sure, this won’t solve the obesity problem — it’s not supposed to. But it’s an initial step in a tried-and-true public health process that will ultimately help us address this health problem over time.

I hope that it leads to other well-meaning and appropriate interventions. While this policy prompts physicians to measure BMIs, it doesn’t give them the knowledge and training to productively and empathically partner with patients to manage their weight. I hope that educating physicians about clinical strategies for weight management and health behavior change will soon be a policy priority.

Right now, medical students and residents are taught almost nothing about obesity, nutrition or behavior change counseling. It shows, as doctors are often disrespectful toward patients with obesity, and they admit to having little knowledge to help their patients. I recently created the first-ever course on obesity at the George Washington University School of Medicine. It was very well received by students and the administration, but it should have been a core part of the curriculum years, if not decades, ago. Indeed, it’s one of exceedingly few such courses in the country.

For now, this policy is a fine start to help Michigan understand their childhood obesity epidemic and monitor the effect of future obesity measures. If properly implemented, it should be copied by other states. It’s just plain good public health practice.

A patient of mine recently alerted me to this exciting NY Times article that describes the admission process of Virginia Tech‘s medical school. Rather than the traditional interview questions about test scores and grades, this process is more like “speed dating,” in which candidates are randomly exposed to 8 standardized patients (actors) who each present a difficult clinical/ethical situation. Applicants are assessed based on their ability to productively and humanely interact with the “patients.”

Originally published in The Huffington Post.