Archived Q&A with Dr. Samuel Klein

• Q

  

  WeightOfTheNtn

  Thanks to Dr. Klein for joining us today. How do you feel about the response to The Weight of the Nation so far?

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  Dr. Samuel Klein says:

  I think that this 4-Part series has really developed into a call to action to do something about obesity which is now the #1 public health problem in the US and in many countries worldwide.

• Q

  

  beckyayay

  How can I find out what my optimal caloric intake is?

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  Dr. Samuel Klein says:

  That's a very difficult question because it varies from person to person. There are machines that can measure metabolic rate, but they're not readily available. There are formulas available online that help you determine what your daily caloric needs are based on your sex, body weight and age. But those equations will be an estimate of what you should eat to maintain your current body weight. If you want to lose weight, you'll need to eat less.

• Q

  

  Nancy Ratliff

  I have lost 25 pounds. I have 100 more to go. I cut out fast food. Sugars and now I go for walks. I have horrific joints. What could I do for exercise that would help me out?

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  Dr. Samuel Klein says:

  One is to see a physical therapist if possible to develop an exercise program that will allow you to do physical activity without hurting your joints. One would be non-weight bearing activity such as swimming or depending on which joints might be involved, bicycle riding. And you can do aerobic kinds of exercise while sitting in a chair, moving your upper body and increasing your heart rate from stationary activities. Exercise is important for your health, but the key to getting your weight off is diet. So more strenuous activity may need to wait until you lose weight to reduce that stress on your joints.

• Q

  

  Robin Swartz

  What suggestions do you have for a parent who wants to approach their child's school regarding their food and exercise programs?

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  Dr. Samuel Klein says:

  This is a complicated problem as well because the food and exercise programs are regulated and they also have financial implications. The best approach would be to get together with other parents and try to meet with the school principal to discuss those issues. But before doing that, you really need to have a good understanding of what the school's programs involve with some deep thinking about what you think needs to be changed. For some good ideas, reference hbo.com/theweightofthenation on how to speak to your school.

• Q

  

  Kerry Foley

  Hi, I am a healthy weight and and have good blood pressure. But I eat way too much salt. Tell me why that's not ok.

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  A

  

  Dr. Samuel Klein says:

  There are two aspects to a healthy diet: one is to eat a diet that allows you to maintain a normal body weight, the other is to consume a diet that has the proper nutritional content to reduce your risk of chronic diseases. High sodium intake is associated with an increased risk of high blood pressure. If you're at a lower blood pressure, you're a lower risk of cardiovascular complications like stroke and heart disease. If a high sodium diet doesn't change your blood pressure at all then there's no problem with the diet you're ingesting, but if you find that if you lower sodium intake and your blood pressure gets a few points lower, then that's a sign you would do well on a lower sodium diet.

• Q

  

  Peggy Hubbard

  Have there been studies on the long term effects of artificial sweeteners being harmful or actually not beneficial ?

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  Dr. Samuel Klein says:

  There are no good studies that I'm aware of of the long-term effects of artificial sweeteners that have adequately evaluated long-term risk. In rodent models, the use of artificial sweeteners have actually resulted in weight gain rather than weight loss, which is very confusing and tells us we don't know everything we think we know about artificial sweeteners.

• Q

  

  AimeeMorenoRD

  what do you perceive as being the biggest obstacle for most people for weight loss? How do you think that we, as clinicians, can best address these obstacles?

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  Dr. Samuel Klein says:

  The biggest problem in people losing weight is that it requires lifestyle changes within an environment and a genetic structure and a social architecture that makes it very difficult to maintain long-term lifestyle changes - to eat less calories and be physically more active. Many people are able to lose weight in the short term, but all of the pulls that made them eat more calories in the first place are usually still there, including their genetics, stress, personal life issues, social interactions, etc all contribute to a return to earlier lifestyle behaviors.

• Q

  

  Mya Martin-Glenn

  What do you think is an acceptable obesity prevalence rate for the United States?

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  Dr. Samuel Klein says:

  Not all obese people have the metabolic and medical complications of obesity, and that is probably about 25% of obese people. So it would be great to aim to reduce the obesity prevalence by 2/3, to 10%.

• Q

  

  katellington

  What do you suggest for physical activity in work places where there's long hours, no breaks and high stress? Is policy change possible in the work place? I work in medicine

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  Dr. Samuel Klein says:

  Absolutely. Employers are now realizing that improving the work environment actually will help productivity, and improving the health of employees will reduce their health care costs. What we need are effective programs that can be implemented in the work place that can improve productivity and people's health and reduce the medical costs to employers.

• Q

  

  Rebecca Greer

  Hi! I am a Registered Dietitian & I'm wondering what you think about the non- diet, intuitive eating approach for weight loss?

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  A

  

  Dr. Samuel Klein says:

  Most data suggests a very structured meal plan and organized approach where the patient monitors everything they put in their mouth is most likely to result in long-term success.

• Q

  

  Katia Na'Iylah Powell

  What is the best way to convince people to change and choose healthier options? Im PhD student in Health Policy and sometimes I find it very difficult convincing people that "Their health is worth the battle"

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  Dr. Samuel Klein says:

  This is the billion dollar question. People are not going to invest in their health until they're ready to make those lifestyle changes need to do so. So it's very important to try to convince people to make their health a priority and that their quality of life, their ability to interact with people they care about, to help those and to be around them is not possible unless they are in good health. Translating that into action is extremely difficult and often requires some kind of a trigger that's outside of an interaction with a clinician but comes from some other source, like a family member, to have a greater impact.

• Q

  

  Toni Lear

  Is there a simplified way to explain the "set point" theory?

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  A

  

  Dr. Samuel Klein says:

  The set point theory is the concept that people have a predetermined weight that has both genetic and environmental influences. The fact is that most people really have a set range in body weight that can be very variable depending on their environment. For example, studies have shown that thin people who move to the US from Asian countries often gain weight to similar levels as their American neighbors. This tells us that the environment has a very important effect on influencing our body weight and it's not simply all genetics.

• Q

  

  Sara Kaufman Greenberg

  Good afternoon..one question I have is relative to pediatricians and their knowledge and training in the subject. My experience with our large, and reputable practice has been that physicians are not giving direction to parents on specific diets.

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  Dr. Samuel Klein says:

  One of the limitations of medical education in this country and probably most other countries around the world is the gap in training regarding nutrition and obesity. Many of our physicians today are simply not equipped to effectively manage the problem of obesity in their busy clinical practices. To fix this problem, we need to restructure medical training and also provide incentives for physicians to spend the time needed to provide effective obesity therapy.

• Q

  

  WeightOfTheNtn

  That’s it for our live chat with Dr. Samuel Klein. Thanks again for joining us today, Dr. Klein. Is there anything else you’d like to say before we sign off?

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  A

  

  Dr. Samuel Klein says:

  Thanks to those of you who have watched The Weight of the Nation. This film signals the need to make some serious changes in our country to address this problem. And these changes range from personal changes at home to public policy and political changes throughout the country. We can all stimulate these changes by letting our political leaders know that it's time to address this problem.