Addressing Obesity, Associated Chronic Diseases

Addressing Obesity, Associated Chronic Diseases

Na Pu’uwai News Release

Na Pu’uwai is reaching out in partnership to help address one of the most pressing health concerns facing our Moloka’i community — obesity and its associated chronic diseases.

In the United States, 41.9% of adults are living with obesity, with annual healthcare costs directly attributable to obesity estimated at $147 billion. Obesity is a major risk factor for cardiovascular disease, type 2 diabetes, certain cancers, and all-cause mortality, with risk increasing in a dose-response fashion: the higher the BMI, the greater the risk. 

Although Hawai’i as a state has a lower obesity rate than the national average, Molokai has the highest rate in the state at 34.4% compared to the state average of 26.1%, and Native Hawaiian/Pacific Islanders have a significantly elevated obesity rate at 51.7%.

The good news is that evidence shows lifestyle-based interventions can have both significant health benefits and strong healthcare cost savings. Other community-based weight-loss programs for obese individuals demonstrated a return-on-investment of $16.70 for every $1 invested. This finding supports the value of community-driven lifestyle programs which address not just weight loss, but also the behaviors, support systems, and cultural context that make long-term change possible.

National guidelines from the U.S. Preventive Services Task Force (USPSTF), Centers for Medicare & Medicaid Services (CMS), and the American Heart Association/ American College of Cardiology/The Obesity Society (AHA/ACC/TOS) recommend that adults with a BMI 30 be offered or referred to intensive, multicomponent behavioral interventions. These interventions include dietary changes, increased physical activity, and behavioral coaching delivered in a respectful, culturally sensitive manner that emphasizes patient self-efficacy and focuses on meaningful health goals, not just weight loss.

At Na Pu’uwai, we have integrated these evidence-based recommendations into our PILI+ Program, a culturally adapted, three-month workshop series designed to promote lasting weight loss and reduce chronic disease risk. Our approach is based on the proven PILI Lifestyle Program, created through collaboration among community, academic, and state organizations serving Native Hawaiian and Pacific Peoples.

What makes PILI+ unique is our interdisciplinary workshop facilitation team, which include the following:

• Registered Dietitian
• Behavioral Health Therapist
• ChefCoach
• Lomilomi practitioner
  

Over the course of eight workshops, participants gain practical skills in nutrition, exercise, goal setting, problem-solving, and culinary medicine with the following outcome targets:

• Achieve up to a 5% weight loss within six months
• Increase physical activity by up to 150 minutes per week
• Empower participants to meet their self-selected health goals

Due to the high-touch nature of this program, we have the capacity to accommodate 12 in-person participants for our Fall 2025 cohort, with additional participation available for those who want to join remotely. Our next cohort begins September 18, 2025, with a referral deadline of September 8, 2025.

We invite you and your team of providers to partner with us in this effort through your patient referrals. Na Pu’uwai would be honored to provide an in-service program overview at your clinic, where we can share:

• The latest science and guidelines in lifestyle medicine and obesity care
• How to identify and refer patients
• The cultural and practical elements of the PILI+ Program that make it unique

Mahalo for your commitment to the healthcare delivery on Moloka’i. Together, we can make meaningful progress in promoting healthy body composition and lifestyle while supporting the health of the community we serve.