Public Health Experts Make Recommendations For Obesity Prevention

Public Health Experts Make Recommendations For Obesity Prevention

By John Reichard, CQ HealthBeat Editor

An optimist might say America is about to turn the corner in its battle against obesity. It isn’t because things are getting markedly better. It’s that there may be a growing realization that the obesity epidemic could easily get worse. With that recognition, action may follow.


An intense round of meetings and briefings on obesity in recent days and new reports appeared to heighten that awareness. The experts involved said that nothing less than a culture change is required to counter the health threat. And every level of society must be involved.


The message to Congress: Do not shirk your role in addressing the many influences that foster obesity. Schools, employers, health care providers, insurers, families and individuals cannot afford to do so either.


Anchoring a week’s worth of events was the May 8 release of a 478-page report by the Institute of Medicine. It predicted that people will act when they know the facts. “Once awareness of the catastrophic nature of the obesity problem is understood and felt and the need for diverse and numerous leaders is recognized, all will share the moment of saying to themselves, ‘I can do something about this, and I want to play a role.’ ”


Americans have slowly but surely modified their behavior to cope with other public health threats. They have significantly reduced their use of tobacco, for example. But the Institute of Medicine report’s prediction may be based more on faith than reality, judging from the difficulty of turning back the tide of obesity.

A Bad Neighborhood

The institute report described the powerful influences that promote obesity by talking about “environments” relating to physical activity, food, beverages and messages. It says in effect that Americans live in a bad neighborhood when it comes to avoiding obesity. Adults and children have ready access to cheap, high-calorie foods that come in super-sized portions and are heavily promoted on TV. Physical education classes, once the norm in schools, are no longer offered or have been curtailed. Children play computer games by the hour. In inner cities, where obesity rates are highest, the “built environment” conspires against activity with limited access to exercise areas and high concentrations of fast-food outlets.


“People have a very tough time achieving healthy weights when inactive lifestyles are the norm and inexpensive high-calorie foods and drinks are readily available 24 hours a day,” said Dan Glickman, who chaired the institute panel that produced the report. Glickman, a former Kansas congressman, was Agriculture secretary in the Bill Clinton administration.


Without successful anti-obesity efforts, the percentage of obese adults will reach 42 percent in 2030, up from 33 percent now, according to projections released by the Centers for Disease Control and Prevention at a “Weight of the Nation” conference the agency sponsored in Washington May 7 to 9. That will add $550 billion over the next two decades to the nation’s health care tab. Treating illnesses related to people being obese or overweight costs $190 billion a year, the institute report said. Two-thirds of adults and a third of children are either obese or overweight.


Experts worry especially about the young. Type 2 “adult-onset” diabetes brought on by obesity and inactivity now accounts for half of new diabetes cases in adolescents, compared with 3 percent a few decades ago.


“We are learning that type 2 diabetes is a more aggressive disease in youth than in adults and progresses more rapidly,” said Philip Zeitler, a researcher at Children’s Hospital in Aurora, Colo. The longer a person has type 2, the greater the chances that blindness, stroke, heart and kidney failure will occur.


Widespread media coverage of these and other alarming findings adds to the drumbeat of press reports in recent years on obesity. The institute suggests that awareness eventually will reach a point where the “bold, widespread and sustained action” called for by the study begins to occur. “Funding for implementation is likely to become available as the seriousness of the obesity threat is understood,” the report says.


To help coordinate action the report offers dozens of recommendations to reach five goals: make schools the heart of anti-obesity efforts; make physical activity a daily part of everyone’s lives; offer healthy foods and beverages in all settings; change food marketing; and involve employers, doctors and hospitals in the effort. Congress, it says, should consider taxing soft drinks. And within two years it should legislate marketing standards if industry does not act voluntarily before then to promote healthier nutrition.


But the going will be slow before any tipping point is reached. A major finding calls for 60 minutes a day of physical education through grade 12 — tough to achieve given tight budgets and school testing demands. Industry blocked a soda tax during the health law debate and has resisted federal marketing guidelines. Lawmakers are raiding the multibillion dollar health law fund created to prevent obesity and other costly conditions.


That’s “not a very good priority choice when health care is the fastest growing part of our national budget and the whole focus is on debt reduction,” Glickman said.