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BMI: The elephant in the exam room

BY Susan M. Cooley

Elevated body mass index, or BMI, has been called the “elephant in the exam room” because often it is overlooked by clinicians, despite overwhelming evidence suggesting that weight loss reduces risk factors for diabetes and cardiovascular disease. Obesity is a complex chronic disease, and BMI is a useful, objective measure to identify patients whose weight puts them at risk for such health problems as hypertension, Type 2 diabetes, heart disease, stroke and certain cancers.

Most electronic medical records automatically calculate BMI once height and weight measures are inputted. BMI appears in the vital signs section of the medical record and is an objective indicator. In the same way that few retail clinicians rarely would fail to discuss an elevated blood pressure reading with a patient, abnormal BMI should be addressed similarly.

Obesity is a complex chronic disease affecting an estimated 100 million American adults. BMI classifications are as follows:  BMI less than 18.5 indicates a person is underweight; BMI between 18.5 and 24.9 indicates a person is within the normal range; BMI between 25 and 29.9 indicates a person is overweight; BMI between 30 and 34.9 indicates a person is obese; BMI between 35 and 39.9 indicates a person falls within the obesity II range; and a BMI greater than 40 indicates extreme obesity. For various reasons, including the social stigma associated with obesity, often it is a difficult topic for clinicians to discuss with patients, thus it is an overlooked opportunity to intervene and help patients reduce their morbidity/mortality risk.

Research indicates that patients are three times more likely to engage in behavior change when the advice comes from a trusted healthcare provider. A majority of patients who utilize retail health operators report that they do not have a consistent primary health provider. This makes each retail health visit an important opportunity to impact the patient’s health status above and beyond the presenting complaint. Healthcare providers hold a unique role in the lives of patients. Retail clinicians should acknowledge that their expertise and accessibility, coupled with trust, put them in a unique position to influence change.

With practice, clinicians can develop strategies to address issues around overweight and obesity in the same matter-of-fact manner with which one addresses other vital signs that are out of the normal range. Once the elevated BMI is acknowledged in a non-judgmental way, the conversation can begin about barriers and strategies to affect the necessary lifestyle changes.  Many excellent patient teaching tools exist. Exam room posters and brochures can be utilized along with direct clinician/patient interaction. 

Patients with elevated BMI need our help. Even small changes in behavior and weight can lead to significant health improvements. Retail health providers must get on board and give our patients the chance to succeed.

 

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Safeway launches holiday food drive

BY Michael Johnsen

PLEASANTON, Calif. — Safeway on Thursday announced the launch of its Help Us End Hunger (Every Bag Counts) food drive to help make the holidays brighter for people who rely on the assistance of food banks.

The company is joining with customers, Kraft, local food banks and broadcast partners to collect food donations at Safeway stores through Christmas. 

To make the donation process easier, a specially produced Every Bag Counts shopping bag filled with the items food banks need the most will be available for $10 at all Safeway stores. 

Kraft will provide a special holiday gift in the form of a $1,500 grant to 100 food banks across the country, making for a total donation of $150,000.

Safeway is a long-time supporter of hunger relief effort, donating $119 million in food to the cause in 2012 alone, the grocer stated. 

 

 

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Target Q3 earnings decline as Canadian segment sees lower-than-expected results, but U.S. segment shows strength

BY Alaric DeArment

MINNEAPOLIS — Target Corp. posted sales of $17.3 billion in third-quarter 2013, a 4% increase over the same period last year, and a $341 million profit, down by 46.4% from a year ago, the mass merchandise retailer said Thursday.

The results from the quarter reflected a earnings-per-share dilution of 29 cents related to the chain’s new Canadian segment. Same-store sales in the U.S. segment grew by 0.9%, near the low end of the company’s fiscal 2013 guidance, while total sales were $16.9 billion, up 2% from third-quarter 2012’s $16.6 billion.

The Beauty Concierge program, which the chain recently rolled out to 95 new stores for a total of nearly 300 throughout the chain, has helped sales in the beauty and personal care category, exceeding sales goals in cosmetics, skin care and hair care. Need-based categories like food and health care have seen growth that outpaces the overall same-store sales growth for the chain. As the holiday shopping season approaches, the company expects a highly competitive, promotional environment.

"Target’s third-quarter financial results reflect continued strong execution of our U.S. segment in an environment where consumer spending remains constrained," Target chairman, president and CEO Gregg Steinhafel said.

In a conference call with investment bank analysts Thursday morning to discuss the results, Steinhafel said the company expected better results from the Canadian segment in 2014. "While initial sales and profits in Canada have not met our expectations, we remain confident about the long term," Steinhafel said. He also noted that Canadian stores opened early on had seen much stronger sales than those more recently opened. "It’s still very, very early, but we like what we see in some of those early-cycle stores," he said. Target expects to reach its goal of 124 Target Canada stores in operation by the end of the year.

The chain’s digital channel has seen strong growth as well. Cartwheel, part of its mobile app, has nearly 3 million users, most of whom access it exclusively on their mobile devices and, according to the company, have saved $14 million since it was launched about six months ago. Meanwhile, digital traffic has seen double-digit growth, while mobile traffic has seen growth in the triple digits, EVP merchandising and supply chain Kathryn Tesija said during the call.

In late September, Target rolled out a subscription service that allows customers to order baby items on a regular schedule, and the company plans to expand the service to include such items as coffee, paper towels, toilet paper and personal care products. A newly improved baby products section, which the chain was recently testing in the Chicago area, will also be rolled out to 20 stores around the country. Meanwhile, Target Ticket, an online DVD rental and movie streaming service, has seen millions of page views and new account signups that exceeded the company’s expectations, Tesija said.

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