From: Ms. Santa Henriquez [office@am-coll-nutr.org] Sent: Tuesday, November 18, 2003 2:57 PM To: FDADockets@oc.fda.gov Subject: FDA Obesity Statement To: Ms. Jeanie Butler Via e-mail: FDADockets@oc.fda.gov Date: November 18, 2003 From: The American College of Nutrition, 300 South Duncan Ave., Suite 225, Clearwater, Fl 33755. Phone: 727-446-6086. Fax: 727-446-6202. Website: www.am-coll-nutr.org. Betty Wedman-St. Louis, Ph.D., RD, CNS, Executive Director. The American College of Nutrition (ACN) has a Task Force on Medical School Nutrition Education whose goal is to promote the inclusion of nutrition into the curriculum of all schools of medicine and osteopathy in the US. Members of the ACN Task Force have been involved in the Nutrition Academic Awards (NAA) curriculum guide development funded in 1997 by the National Heart, Lung and Blood Institute of the NIH. Task Force members continue to be involved on the efforts of NAA to improve the nutrition content on the National Board of Medical Examiners licensing examinations. The ACN believes that the failure of medical schools to adequately address nutrition content in their curriculum is an urgent problem that needs to be addressed. Physicians must be more knowledgeable in nutrition in order to help patients prevent weight gain and address the obesity epidemic. The ACN believes that body weight is an issue that needs to be addressed with every patient seen by the healthcare team, especially the physician. The Nutrition Curriculum Guide for Training Physicians from the National Heart Blood and Lung Institute contains 25 practice areas for nutrition in medical education written by a consortium of 21 medical schools. Specific learning objectives in obesity and obesity prevention are listed with content areas, knowledge, skills and attitudes in the sections of Metabolic and Endocrine Systems, Diabetes Cardiovascular Systems and Pediatrics. The topic of obesity is addressed 16 times within the curriculum document. As the prevalence of obesity among children and adults in the US increases rapidly, the ACN believes intensive efforts related to prevention, education and treatment are required. All healthcare professionals should counsel individuals about the health risks of overweight specifically the increased risk for diabetes, hypertension, and coronary heart disease. Severely obese adults should be counseled to achieve intensive treatment with a medically supervised behavioral program. Obesity increases medical costs. Employers and insurers have excluded management of obesity from health insurance coverage despite the cost of comorbid conditions – coronary heart disease, diabetes, etc. The ACN believes that weight management prevention and treatment needs to be included in health insurance coverage. Prevention and management of obesity starts in childhood. Nutrition education by the healthcare team, including physicians, can have lasting impact on individuals and the family. References Nutrition Curriculum Guide for Training Physicians. Nutrition Academic Award Program. National Heart Blood And Lung Institute. 2003. http://www.nhlbi.nih.gov/funding/training/naa/curr_gde/index.htm Anderson, JW, Kendall CWC, Jenkins DJA. Importance of Weight management in type 2 diabetes: review with Meta-analysis of clinical studies. JAM Coll Nutr 2003; 22:331-339. Wolf AM, Codlitz GA current estimates of the economic Costs of obesity in the United States. Obes Res 1998, 6:97-106.