Forum on Public Policy Obesity and the Healthcare Professions: Cooperation or Assimilation?

Disclosure: Lonnie Lowery is currently a member of the Board of Directors for the American Society of Exercise Physiologists and is a registered dietitian. Evelyn Taylor is a registered dietitian. Both authors are members of the American Dietetic Association. Obesity is an epidemic in developed countries. Its ramifications range from cardiovascular disease to cancer to musculo-skeletal disorders. The causes of obesity are not solely biological, as the brief time frame toward the current epidemic has been insufficient to allow for adequate alterations in the gene pool. It has been estimated that variation in body fat is approximately 25 % genetic (Bouchard 1998), with 45 % of the remaining variance explained by lifestyle factors. Additionally, in the United States, an ageing population of “baby boomers ” will compound the need for chronic disease prevention and treatment. No single health discipline/profession can solve the growing obesity-chronic disease problem. Thus, there is a need for “intellectual civility ” (Boone 2002) among the individuals and the governing bodies of central paramedical professions such as nutrition, exercise physiology and physical therapy. Unfortunately, overlapping scopes of practice can lead to legal contests and an expanding number of certifications that could leave the increasingly at-risk overweight public with inferior care when evidence-based interventions and standardized referral are needed. This presentation will address examples of scope-of-practice competition (attempts at “assimilation”), and collaboration and submit referral guidelines for discussion