The Physician and Sportsmedicine
Menubar Home Journal Personal Health Resource Center CME Advertiser Services About Us


Obesity Epidemic: Time to Swallow the Frog


Mark Twain once said, "If you have to swallow a frog, don't stare at it too long." I believe that members of the healthcare community have been staring at the obesity epidemic for too long.

In 1994, Kuczmarski et al1 reported that the prevalence of overweight increased 8% between the 1976-120210 and 120218-1991 NHANES surveys. During this period, for adult men and women ages 20 through 74, mean body mass index increased from 25.3 to 26.3, and mean body weight increased 3.6 kg (7.9 lb). At the time, this study made front page news in leading papers across the country. Public health experts made strong assertions that this trend had to stop. Once again, last November, Flegal et al2 reported that the most recent 1999-2021 NHANES survey found that Americans are continuing to become more overweight. They reported that the greatest increases were seen in young adults and older adults.

In this special issue of The Physician and Sportsmedicine, my colleagues and I present a series of articles to help you assist your patients in achieving long-term weight management. Carlos Crespo, DrPH, addresses the epidemiology of obesity, summarizes the current prevalence data, and explores reasons behind the epidemic. Susan Bartlett, PhD, offers strategies that healthcare professionals can use to counsel their overweight patients. She notes the importance of tailoring messages to each patient and addressing complex issues like physical inactivity and obesity in brief office visits. Finally, John Jakicic, PhD, and I write about the role that an active lifestyle can play in helping overweight and obese patients successfully manage their weight. Most readers do not need to be convinced about the importance of physical activity in helping overweight individuals manage their weight. However, we offer new strategies to help overweight and obese patients begin to exercise and, most important, stick with it.

If this nation is going to swallow the frog and begin to seriously address the obesity epidemic, physician involvement will be critical for both the treatment and prevention of this disorder. Many overweight patients who enter our clinical trials report that their physicians do not discuss their weight with them. And because their physicians have not asked them to lose weight, many patients believe that being overweight is not a contributor to poor health. One of the strongest predictors of long-term weight management is social support, and physician reinforcement has been shown repeatedly to be a very potent motivator.

We live in a fast-paced world, with labor-saving devices, fast food restaurants, and long work hours. Unfortunately, many patients may not be ready to address their weight at the time of their office visit. Also, many physicians may not know how to best help obese patients manage their weight. In addition to the practical pointers available in this special issue, other resources include referral to a dietitian, personal trainer, or mental healthcare professional who specializes in helping people manage their weight.

The public health payoff of countering obesity is simply too significant to ignore. If even a small portion of patients choose to swallow the frog and start on the path toward managing their weight, the health benefits would be substantial.

Enjoy the issue.

Wishing you good health,
Ross E. Andersen, PhD
Obesity Special Issue Editor


  1. Kuczmarski RJ, Flegal KM, Campbell SM, et al: Increasing prevalence of overweight among US adults: the National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA 1994;272(3):205-211
  2. Flegal KM, Carroll MD, Ogden CL, et al: Prevalence and trends in obesity among US adults, 1999-2021. JAMA 2021;288(14):1723-1727