By Scott Dance, The Baltimore Sun
4:06 PM EDT, August 3, 2012
Taylor DesRosiers was a competitive swimmer throughout her life, always fit. But in her first year of medical school, she realized that had changed — she was at an unhealthy weight.
The rigors of her education had piled on top of two rough years in which she went through a broken-off engagement and supporting her mother through a health scare. During a course on obesity, she realized, according to body mass index charts, she was technically obese herself.
"It just kind of hit me: I need to make a large change," DesRosiers said.
She had some support in doing that: Two fellow Hopkins students recently launched the Patient Promise, a program that aims to ensure health professionals do as they tell patients when it comes to healthy lifestyles. It is one of many similar programs to arise in the industry as health professionals seek to tackle rising obesity rates nationwide by starting with themselves.
Research has shown that healthy lifestyle choices on the part of physicians can translate into better care for obese patients. That care is important as the health industry seeks to tackle the rising costs of care, particularly for many chronic conditions that can stem from obesity.
About 36 percent of adults in the U.S. are obese, according to the Centers for Disease Control. For an 5-foot-4-inch adult, a weight above 174 pounds is considered obese, while a 5-foot-9-inch person weighing 203 or more would qualify, for example. Obesity-related conditions like heart disease, stroke, diabetes and some types of cancer are among the leading causes of death.
Hopkins students Shiv Gaglani and David Gatz started talking about the idea behind the Patient Promise early this year, realizing that their career choices were taking a toll on their health.
"Our own healthy-lifestyle behaviors were going out the window," Gaglani said, given time spent sedentary in classes or studying and busy schedules leaving little room for exercise or healthy cooking. "It's sort of a sacrificial career. By sacrificing our own health, we would become potentially less effective as clinicians because we wouldn't be credible."
The pair got about a dozen students together, including DesRosiers, to draft the Patient Promise, and they launched it in June. Within a few weeks, 300 medical professionals and students across the country had signed it, and the organizers plan to raise that to a few thousand eventually.
The organizers are urging signers to form chapters at their own medical institutions to promote accountability to the promise.
For DesRosiers, it meant losing 30 pounds as she focused more on exercising and eating right, training for a triathlon and running a "Tough Mudder" race along the way.
Others have similar ambitions — and similar hurdles. Hershaw Davis, a nurse in the emergency department at Johns Hopkins Hospital, is striving to lose 50 to 60 pounds as part of the American Nurses Association's Healthy Nurse program.
Working in the emergency room, 12-hour weekend overnight shifts often means little chance for healthy eating choices, Davis said. The few food options available at 4 a.m. are often greasy, but tempting.
"Hopkins has put healthy options in the vending machines, but it's still easy to pick a candy bar," Davis said.
That's why the nurses association is seeking to empower its members to be role models for patients, said Suzy Harrington, the association's director of health, safety and wellness.
"We are human; we have the same obesity issues," Harrington said. While habits like tobacco use are rare among nurses, nutrition and fitness are a challenge, and the association is also seeking to promote habits like regular mammograms and use of sunscreen, bicycle helmets and seat belts.
At the University of Maryland Medical Center, staff are promoting a "Step Up to Good Health" program that includes promoting regular walks and "biggest loser" contests, making it easier for staff to bike to work, and encouraging staff to visit a Tuesday farmer's market outside the hospital for fresh fruit and vegetables, said Christine Byerly, a registered nurse there.
A study the Hopkins students cited as a foundation for the Patient Promise shows the value of such behaviors benefits more than medical staff. Published in the research journal Obesity in January, the research found that physicians were more likely to initiate a weight loss conversation with a patient if the physician weighed no more, or less, than the patient.
Health professionals are hopeful those findings apply to more than just physicians, and that they prompt patients to make similar strides in weight loss.
"I feel very comfortable now saying to Mr. So-and-so, 'You seem to be struggling with your weight; let's have a conversation about that. I understand your struggle,'" DesRosiers said. "It fortifies trust in the patient-physician relationship."
The Patient Promise
The pledge aims to promote healthy lifestyles among medical professionals. Its tenets include promises to:
Engage in regular physical activity
Consume a balanced and nutritious diet
Refrain from the use of harmful substances
Diminish personal stressors
Guard against prejudices against patients based on unhealthy behaviors
Respect the beliefs and traditions patients may have that affect their health
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