We know that in Minnesota, one out of every 10 children and one out of every three adults struggles with obesity. And it's no secret that the world has been facing an obesity epidemic for many years. But what a lot of us don't know is that there's work being done to battle this epidemic happening right here in Minnesota at the University of Minnesota Medical School. Dr. Megan Bensignor is a big part of that.

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Every Wednesday morning at 8:30 CST, Jill Riley (with, this week, guest host Sean McPherson) connects with experts and local personalities for some real talk about keeping our minds and bodies healthy — from staying safe in the music scene, to exercising during a pandemic, to voting and civic engagement. Looking for more resources and support? Visit our friends at Call to Mind, MPR's initiative to foster new conversations about mental health. Subscribe to Wellness Wednesday as a podcast on Spotify, Apple, RSS, Radio Public, Stitcher, or Amazon Music.

Sean McPherson: How do we define obesity?

Megan Bensignor: So, in the most simple clinical science, we use BMI or body mass index as our kind of strict clinical criteria, fully recognizing that everyone comes in different shapes and sizes, and body mass index doesn't always get at the core of who has obesity, or who is unhealthy or not. For kids, that's a BMI greater than the 95th percentile for age and sex; and for adults, that's a BMI greater than 30.

Can we talk a little bit about this thing that is being called an epidemic of obesity? I gotta say, as an obese person myself, sometimes I struggled to hear this thing being referred to as an epidemic when I'm like, it's me, I'm a human. How do you define this as an epidemic, and then what is your research and your work doing to address it?

Yeah, you bring up a really good point. The way our focus is at the Center for Pediatric Obesity here at the U, is that obesity: we use it sort of as not someone who is obese, but someone has obesity, and kind of using an a frame as a chronic disease. And that's not using it as a sort of a character descriptor, but in a very clinical sense. Looking at the amount of stress the body has [due to] excess weight: the blood pressure is too high, or they're starting to show signs of diabetes or pre-diabetes or, for a kid, does this mean abnormalities in the hips and knees coming from the extra stress or pressure?

A lot of your focus is on obesity and children. I assume that brings some unique difficulties, some unique challenges, and obviously some unique opportunities. Can you tell me about your work with children in Minnesota?

Sure. I am part of a multidisciplinary research team at the Center for Pediatric Obesity Medicine, as well as a clinician at the Pediatric Weight Management Center at University of Minnesota Fairview Children's Hospital. We have the Center for Pediatric Obesity Medicine, also an interdisciplinary team that is with Ph.D.s, and these dieticians and research coordinators that are really trying to discover new, effective, and safe treatments that improve both physical and emotional health [for children] and teenagers who are affected by obesity and obesity related diseases.

I'm glad that you brought up the emotional health thing, and I think we've probably got a lot of people listening who might have some some misgivings or some apprehensions about being in environments like this, and also about the research that comes out environments like this. Growing up, I remember sitting with a nutritionist, and they laid out the growth chart and then the nutritionist was pointing to the front of the desk and they were like, now here's where your son is, he's completely off the charts. And I remember having nurses giggle at the scale when I got on to get weighed in high school, and these things that are so painful. I know that so many professionals have turned a page but so much of [that] is about making sure that people are comfortable coming in? How are you making obese children, boys and girls, coming in comfortable and helping in that thing, where sometimes going to a doctor even though it's the right thing to do can make your lived experience worse? How are you addressing that?

Yeah. First of all, I'm so sorry you went through that absolutely horrible experience. As you point out, weight stigma and weight bias are very real and very traumatic for our patients and anxiety and depression are pretty common amongst children and adolescents with obesity for a whole host of reasons.

The medical field has come a long way, [but] we have a long way I think to go in really addressing the disease: that obesity is not someone's fault. It's not a matter of willpower, it's not a matter of nutrition education. Our focus is really addressing the biological mechanisms and just trying to get the body healthier in terms of not number on a scale, but those obesity-related kind of diseases that go with it.

One of the things we do within research, and also within the clinic, is really explaining to our patients, once they're in the door, that every person, the shape and size we are is based on genetics and biology, which is pretty much out of our control. So when I meet patients [I] kind of sit down with them, and sort of explain how our bodies are designed to keep weight on when we lose weight in our body. [When] we lose weight, the hormones that control our appetite get changed. So we get hungrier through our brain saying, "Oh, no, we're starving, we don't know where their next meal is coming from." So our hunger hormones go up. We use calories less efficiently, and our bodies are designed to keep weight on. So we kind of go through the whole gamut, but really trying to empower patients and families to find what's best for them, and for them to feel comfortable.

Well, that is that is music to my ears, and really wonderful to hear. What can we as individuals do to stay healthy without subjecting ourselves to toxic diet culture and all this stuff?

Yeah, I think not to look at it as a diet or big changes. It's all in small, incremental, healthy changes. Diets aren't great, and losing weight suddenly isn't great. Your body kind of goes into a yo-yo effect trying to hold on to calories, and it makes it harder to lose weight — or rebound weight gain happens very quickly. So I would advise listeners really to avoid kind of fad diets and losing a lot of weight quickly. It's not about dieting, it's just about healthy incremental changes. Also, finding medications for obesity or severe obesity [that] are right. Talking to your doctor about them or finding a doctor that you feel comfortable seeing if medication will be helpful for you.

Wellness Wednesday is hosted by Jill Riley (with, this week, guest host Sean McPherson), and produced by Christy Taylor and Jay Gabler. Our theme music is a portion of the song "F.B. One Number 2" by Christian Bjoerklund under the Non Commercial Share Alike 3.0 International License. This week's photo is by buck82 (CC BY-NC 2.0). The image was altered: it was cropped, filtered to greyscale, and supplemented with a logo.