Leveraging The Doctor As A Trusted Authority – Brian Klepper

I was on the phone with my good friend Bill
Bestermann MD yesterday. Dr. B, a preventive cardiologist who is
passionate about the underlying mechanics of cardiovascular disease and
the horrific toll the American diet and lack of exercise is taking on
everyday people, lives in spectacularly beautiful, rural Kingsport TN.
He told me he was driving through town, channel surfing on his radio,
and he happened upon the station that broadcasts information for the
local schools. They were announcing the menu in the school cafeterias.
He said it was appalling. "Honeybuns and processed foods. It was all
the stuff I tell my patients to avoid."

one to shrink from suggesting that other people embark on courageous
courses of action, I urged him to ask for a meeting with the School
Board to lay out what the long term effects of this diet are on the
children of the region. "Think in terms of leveraging your credibility
as a trusted authority," I advised.

Many school boards have
defaulted to whatever’s most financially expedient in their school
cafeterias. They take money from junk food companies and, in exchange,
give the firms free access to the kids with vending machines and ads.
They ignore the rising tide of obesity and chronic disease that
threatens the kids and their future.

Imagine if a doctor or,
better yet, a small army of local doctors, waltzed in and explained the
impacts of the school menu to the Board and, if possible, the
community, through the local newspapers, TV and radio stations. Then
they could make recommendations for a diet that would be acceptable to
kids while providing actual nutrition. (And while they’re at it maybe
they could explain why getting rid of gym and other physical activities
is moronically penny-wise and dollar foolish.)

shouldn’t underestimate their power in this. While physician
credibility has waned in recent years as the health care crisis has
intensified, a 2003 study by Magee found that Americans still trust their
physicians more than any other relationship outside of family.


not like this is a small problem. In my talks I flash my favorite
obesity slide, an image generated by the gifted illustrator Wellington
Grey. (When it comes up on the screen and the audience begins to absorb
it, you can always hear embarrassed laughter ripple through the crowd.)
It shows the percentage of adults over age 15 in a variety of developed
countries with a body mass index over 30 (that is, who are obese).
Americans, at 31%, are far and away the fattest people, with Mexico and
the UK trailing distantly at 24% and 23%, respectively. The French,
Austrians and Italians are at 9%, and the ridiculously trim Koreans and
Japanese are at 3%.

This slide tells us everything we need to
know about America’s future competitiveness. If obesity is a general
predictor of health, health is related to productivity and productivity
to competitiveness, we’re toast.

To turn this around, we need
leadership. If not from doctors, our most trusted professionals, then
from whom? This is really a problem that local medical societies ought
to wave the flag on. It might create the impetus for real change, and
remind people that their doctors do really want what’s best for us all.

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3 replies »

  1. I was born and raised in Europe. I think the problem is in part cultural, in part due to changing life styles (more TV, video games etc.). It is growing in Europe as well, I don’t know about Japan. Major change can happen only if obesity is widely recognized as a medical problem that needs to be dealt with, on an individual as well as collective level. The best solutions will be recognized as soon as there is the collective will. I wonder whether 20 daily minutes of physical exercise in school would work. Of course it doesn’t work if there is no collective pressure – parents will protest and opt out.

  2. I think it would be interesting to look at the weekly menu of a typical local school 30 years ago. The calories, the fat, the processed components. Then look at the obesity rate of the population at the time.
    I’m not sure the school lunch is to blame for what we’re dealing with today.

  3. This is a wonderful discussion. Working for the American Heart Association, I can tell you this is a topic that’s very important to us. We have a program that’s directly aimed at childhood obestity, Alliance for a Healthier Generation. The AHA also endorses the FIT Kids Act, which addresses this unprecedented epidemic. We’re doing what we can, and hope that doctors, the media, and other healthcare organizations can ban together with us to stop this epidemic. Today‚Äôs youth is the first generation that may not live as long as the generation before it and that, to me, is unacceptable.

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