Yes, I said it. Santa Claus is morbidly obese. I know it’s not the most popular thing to point out, especially this time of year. Jolly, generous, fun - these are the adjectives we would rather focus on when it comes to Old Saint Nick. And with the several million-cookie diet and minimal amount of physical activity he gets (with elves providing most of the cheap labor these days, and why walk when you can sleigh?) it only stands to reason that Kris Kringle has gotten a bit rotund. Don’t believe me? Ask Donner, Blitzen, and the bunch: gifts aren’t half the load they’ve been pulling around, and Cupid will be lucky to be off short-term disability for his most recent slipped disc in time for Christmas Eve. Still don’t believe that Father Christmas may be a little too stout? That bowl full of jelly is starting to take its toll, with Papa Noel now rumored to be currently treated for osteoarthritis, diabetes, hypertension, high cholesterol and sleep apnea. (I would tell you more but I am afraid I might be committing a HIPPA violation, and if the elves won’t respect Santa Claus’ privacy, at least I will.) Please do not misunderstand me, a skinny, bony-kneed Santa would just not be the same as the one we all know and love, but when it comes to body types, his is not one to wish for this or any other Christmas.

So if Santa’s body type is not the one to wish and work for, which is? Defined strictly in terms of Body Mass Index (BMI), the answer is less than 25 and greater than 18.5. The Body Mass Index is calculated by taking one’s weight in kilograms and dividing by height in meters squared. You can calculate your own BMI at http://www.nhlbisupport.com/bmi/bmicalc.htm. While it is true that the BMI may be inaccurately high for the extremely athletic owing to increased muscle mass and may be incorrectly low in many elderly and others who have lost muscle mass, the formula can be applied to most men and women. Waist circumference is also a significant measurement when estimating obesity. In short, risk is increased for women with a waist circumference greater than 35, and for men with a waist circumference greater than 40. For purposes of this article we will focus primarily on BMI. A BMI between 25 and 30 is considered overweight, and a BMI greater than 30 is considered obese. (I am guessing here, but I would say Santa’s BMI is somewhere between 40 and 43, conservatively.)

The Naughty List:

• We all know the obesity-related health consequences: High blood pressure, high cholesterol, diabetes, fatty liver, certain types of cancer, joint pain, arthritis, heart disease, sleep apnea…the list goes on.

• Social consequences are harder to quantify, but estimates of lost job productivity and increased direct and indirect healthcare spending nationwide are astounding. A 1998-2000 study attributed 5.1% of Delaware’s healthcare expenditures directly to obesity. (http://www.cdc.gov/obesity/causes/economics.html)

• In some cases, a picture truly is worth 1,000 words: I would strongly encourage all readers to go to http://www.cdc.gov/obesity/causes/economics.html in order to get a better grasp of the increasing rate of obesity in our country.

• Delaware’s obesity rate is 27%.

• We are potentially facing the first generation in our country’s history with a lower life expectancy than their parents, as childhood obesity rates continue to skyrocket.

The Good List:

• A 5-10% weight loss can dramatically reduce the risk of progression to nearly all of the obesity-related maladies listed above.

• Through her “Let’s Move” campaign, our First Lady, Michelle Obama, has made it a national priority to end childhood obesity within a generation.

• Mandated changes in menu labeling will make it easier for consumers to identify healthy food choices.

• A significant amount of federal funding is allocated in the healthcare reform legislation for health and wellness grants, which hopefully will lead to increased attention paid to obesity from your healthcare team.

• Grassroots initiatives such as those in our local school cafeterias are encouraging children to make better food choices by offering them fruits, vegetables, and foods that may not have otherwise been made available in the past. How to get there:

• Investigate other potential causes of obesity. See your family doctor and discuss whether a further workup is indicated. Consider genetic, environmental, and endocrine causes of weight gain such as Cushing’s disease, medications such as steroids, and hypothyroidism.

• There are significant genetic and likely environmental factors that contribute to weight gain; however, simply put: calories out must be equal to calories in to maintain weight, and calories out must be greater than calories in for any successful weight loss.

• Go slow, and make lifestyle changes that are sustainable. A commonly accepted rate of weight loss is one pound per week. Set short-term goals, rather than focusing on the total amount of pounds needed to achieve your ideal weight. Remember the benefit that comes from making healthy food and lifestyle choices.

• Nemours Health and Prevention Services is leading an outstanding campaign in our great state known as 5-2-1-Almost None. 5 servings of fruits and vegetables daily, no more than 2 hours of screen time (computer, TV, video games, texting, etc.) daily, 1 hour of physical activity daily, and almost no sugary beverages daily.

• Some additional excellent and comprehensive resources can be found at http://www.aafp.org/online/en/home/publications/news/news-now/obesi....

I would highly encourage further reading and education on this topic which affects nearly every family in our country. If we are to improve upon and eventually reverse the obesity epidemic, a comprehensive and multifaceted solution is in order. I do not pretend to have all the answers; however, I do believe that the answer exists within us as individuals and as a community. Our continued and future well-being and that of our children and grandchildren depends upon it.

So on Christmas Eve, as you hug your family and send the little ones off to bed, consider leaving Santa Claus just one cookie (the reindeer will thank you), and have a happy and healthy holiday season. •

P. S. Frosty the Snowman’s BMI is 45! Whew!

Scott A. Hammer, M.D. of Southern Delaware Medical Group is accepting new patients of all ages. The phone number is 302-424-3900. Dr. Hammer practices and lives with his family in Milford.

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