Doctor Feel Good

Rajiv Kumar is a man on a mission: to help Rhode Islanders become the biggest losers (of weight, that is) and, in the process, get hooked on healthy living.

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Kumar got accepted to Brown’s Program in Liberal Medical Education, an eight-year commitment that combines undergraduate and medical degrees. He majored in economics as an undergrad but took his share of pre-med classes. An aspiring MD’s true test, however, happens outside the classroom.

Last July Kumar started his med school rotations, as a resident at Miriam Hospital in Providence, gathering information about psychiatric patients, a notoriously difficult group. The trick, says Jeffrey Burock, a psychiatrist and clinical assistant professor at Brown Medical School, is to establish a rapport with the patients.
Many of the med students appeared to lack bedside manner. Most were intimidated, others afraid. Kumar, however, was a natural. “He was the most confident third-year medical student I’ve had,” says Burock, who has overseen dozens of medical school rotations at Miriam. “Most third-year students are pretty awkward in their first rounds. You could tell [Kumar] was no stranger to being a doctor.”

Burock gave Kumar honors, the highest clinical grade. “He’s been focused on medicine since birth or something,” Burock remarks. “He’s been preparing for this his whole life.”

What Kumar wasn’t prepared for was a lecture by a medical researcher, Rena Wing. It was fall 2005, and Kumar had just begun medical school. Wing is an obesity expert and director of the Weight Control and Diabetes Research Center at Miriam Hospital. In her talk, she said obesity was a growing public health danger. She showed a series of maps of the United States to illustrate her point. The first map, from 1985, showed nearly two dozen states shaded blue, which meant between 10 percent and 14 percent of the population was obese. The maps in the following years showed more states acquiring the blue hue, as if ink had been spilled on the map. This indicated more states, and more people had become obese. In this century, two more colors—orange and red—have appeared on the map. They represent states in which the obesity percentage had reached a staggering 25 percent or 30 percent of the population.

The maps showed clinically and unflinchingly that more and more Americans are getting fat. Wing then told the students that obesity is linked to life-threatening illnesses such as Type 2 diabetes, cancer, heart disease, strokes, respiratory problems and osteoarthritis.

“I was blown away,” Kumar tells me as we sit in his office, a converted storage room in a building in Providence’s Jewelry District. “It was visually powerful to see that in twenty years, we have seen states that have gone from 10 percent prevalence for obesity to 30 percent. That’s unheard of for a disease—unless it’s an epidemic—to grow at that rate.”

Wing’s presentation draws from data compiled by the federal Centers for Disease Control and Prevention, which reported three years ago that 33 percent of the adult U.S. population was obese. That’s 70 million Americans. Perhaps even more troubling, the fat trend has taken hold in children: The CDC says that the number of overweight kids (there is no obesity category) aged two to five has nearly tripled in the last quarter century (ending in 2004) to 14 percent. For those aged six to eleven, the number has spiked during that same time from 6.5 percent to 19 percent; and for twelve- to nineteen-year-olds, it has risen from 5 percent to 17 percent.