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The public’s appreciation of the dangers of obesity may have expanded recently, but unfortunately, Americans’ waistlines have continued to expand, too. In fact, a new study released in September forecasts that 44 percent of American adults living in 50 states will be obese by 2030, if obesity rates continue on their current trajectories. That’s nearly one out of two Americans. And in 13 states, the study projected potential obesity rates that could exceed 60 percent.Imagine the havoc that could wreak on personal health and the nation’s collective healthcare budget, with the related spike in hypertension, diabetes, heart disease, stroke and the myriad other problems linked to obesity.With the season of gluttony upon us, as we brace for holiday celebrations and the endless temptations to overeat, it seems appropriate to focus on what I see as part of the problem: the obstacles facing primary care physicians that may keep them from confronting patients about their weight.As a bariatric surgeon, I treat obese individuals every day, most of whom have tried and failed to lose weight through conventional diet and exercise programs. What I find revealing is that an overwhelming majority of my patients comes to see me of his or her own accord: few are referred by a family doctor. Most primary care providers avoid the elephant in the room while treating their patients for health problems either created by or exacerbated by their excessive weight.There are many reasons family physicians work around obesity rather than help patients focus on the underlying cause of their poor health. To begin with, some medical schools only recently have begun including issues of obesity and weight control in their curriculum. Many family doctors don’t have the education, training, tools or experience to adequately address the issue, which is much more complicated than simply suggesting a patient go on a diet or ramp up their exercise. So they schedule laboratory tests and sleep studies and other diagnostic procedures or write endless prescriptions to treat weight related medical problems. Prescription weight loss medications (or even questionable over-the-counter drugs) have not been used as frequently due to safety concerns (Fen-Phen, which was implicated in heart valve damage, and Meridia, which has been pulled from the market due to heart complications, have made people wary of taking new pills.)(Read the whole article by Einstein's Ramsey Dallal, MD, FACS on the Physicians Digest News Digest site here.)