Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Half Baked


Your monthly dose of comic relief from William Osler's long lost cousin Wilma Ferthler.

Physicians all over our country are dealing with many types of addiction. Obesity is of course another huge problem in America and in this month’s CLOSLER piece from your rural medicine contributor in Vermont, I’ll share a story related to a patient of mine with another obsession.


Mr. G is a 34-year-old security guard who married his high school sweetheart six months ago. After watching his weight leading up to the wedding, marital bliss has been associated with a 55-lb weight gain – he saw me last week and weighed in at 295 lbs with a BMI of 42.3 kg/m2.  In discussing this change, he admitted to having an addiction to Ben & Jerry’s ice cream.


While consuming B&J ice cream is viewed favorably in these parts and it is how many of us do our part to support the local economy, Mr. G’s description of his behaviors show that he has gone too far. While asking questions to quantify his consumption, he also revealed the following details:


1.) He has tried all of their flavors.

2.) He prefers specific flavors depending on the weather and his emotional state.

3.) He confirms that ‘Chocolate Therapy’ is better than any psychologist he has ever seen.

4.) He has read all about B&J and knows lots about both founders, like the fact that Jerry graduated from Oberlin but was unable to get into medical school despite applying multiple times, and that Ben worked as both a Pinkerton security guard and taught arts and crafts at a private school.


Addiction to ice cream may not have the potential to kill by overdose quickly, but it’s killing Vermonters slowly.  Obesity rates in VT were amazingly low in 2000 (17%), but the rate is now up to 27%.


Curiously, at the same time that the rate of obesity has skyrocketed in the state of Vermont, the state’s birth rate has declined. I think this is more than a coincidence. It turns out that Vermont’s birth rate has steadily declined in the 21st century and – believe it or not – the number of births in Vermont this past year in our state is lower than it was in 2000 or in any year since the Civil War! So as the prevalence of obesity has increased from 17% to 27% since 2000, the number of live births has decreased by about 15%. An article in the Burlington Free Press highlighted this birth rate trend. 


While the state has established policies to keep our population skinnier than the rest of the nation, I am proud of the creative personalized counseling and guidance that I’ve given Mr. G:


1.) Throw out all spoons.

2.) Drive home by another route so as not to pass by the B&J flagship store.

3.) If any frozen treats are needed, must be Halo Top, and no more than twice a week.


I think these three recommendations are pretty good, and I wrote them in my After Visit Summary (AVS) in the Epic electronic medical record. There was another salient piece of advice that I gave Mr. G – one that I was a little too embarrassed to include in the AVS. In light of the rising rate of obesity and the falling birth rate, and considering Mr. G’s recent marriage, I’m sure you can guess what that was!


Beautiful green hills landscape