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Nurse's view: Overeating 'is a slow, killing addiction'

With holiday festivities complete, gaining and losing weight is a central concern for many of us who care about our appearance and fitness and health.

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Dave Granlund / Cagle Cartoons

With holiday festivities complete, gaining and losing weight is a central concern for many of us who care about our appearance and fitness and health.

Most of us are aware that obesity and being overweight raise the risk of diabetes, joint disease, and heart disease. New research finds that being overweight also raises the risks for cancers of the esophagus, liver, gallbladder, colon, stomach, pancreas, uterus, ovary, kidney, and thyroid. In fact, nearly half of all cancers in people under 65 are associated with being overweight or with obesity.

With more than 35 percent of U.S. adults obese and 34 percent more overweight, physicians agree that weight is a public-health catastrophe. The $64 billion weight-loss industry is evidence that people are motivated to lose weight but that commercial programs and clinical medicine are not stemming the rising tide of weight problems and obesity.

There are people who love food and still manage their weight with conscious control of their eating. But what about those individuals who repeatedly have tried to control their weight and have failed? Many of these eaters live with obsessive cravings for food. Resisting these cravings every waking hour of the day is a full-time and exhausting preoccupation. Some compulsive eaters control these urges by working hard all day only to collapse into snacking all night. Others stash food in their homes and offices to have something to eat all day. Despite their best efforts, they end up eating. Repeated failure fuels their hopelessness and steals their dignity.

A doctor who sees only the physical aspect of this problem - the increased risk of chronic diseases and cancer - misses the point. For many overeaters, the problem is more than behavioral; it is a slow, killing addiction.

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Public-health experts have urged doctors to spend more time consulting with patients about their weight. But how can a physician with no awareness of this inner struggle address this debilitating disease? Doctors have had little to no training in how to counsel patients who need to lose weight.

At the same time, some physicians report being afraid to address obesity for fear that patients won't come back. An online survey revealed that overweight people feel stigmatized and belittled by medical terms like "obese" and "morbidly obese."

Medicare has offered free weight-loss counseling to obese patients since 2011. Interestingly, though, only 1 percent of obese patients take advantage of this benefit. This suggests that weight gain cannot always be treated with behavioral or educational approaches; overall failures outweigh success. Stomach stapling, drastic though it is, is seemingly the only approach in the clinical toolkit.

Physicians have the opportunity to suggest the same approaches to a food addiction that have proven effective with other addictions like addictions to alcohol, drugs, and gambling. Peer support from fellow sufferers is key to most successful approaches. Inpatient and outpatient treatment centers, church-based recovery groups, and 12-step programs rely on social, emotional, and spiritual group support for recovery from addiction. Church programs and 12-step programs such as Overeaters Anonymous, Bulimics Anonymous, and Food Addicts Anonymous are free and offer support through face-to-face and telephone meetings.

Physicians and public health officials can help by referring patients to these programs. There is help. There are solutions for this painful, emotional, and physical condition.

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Doris Malkmus

Doris Malkmus of Duluth is a former registered nurse with more than 35 years of experience with outpatient and group programs for compulsive eaters. Regular program attendance has enabled her to reach and maintain a normal weight for 34 years.

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