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Obesity: Fighting the Epidemic

Posted: 09/18/08 04:05 PM ET

Recently, the head of a major hospital told me over half his hospital beds were filled with people with diabetes-related diseases -- almost all caused by obesity.

Obesity qualifies as an epidemic, according to the Centers for Disease Control. One in six children is obese, and almost all of these will develop chronic diseases such as diabetes, hypertension, and heart disease. Almost 80 million Americans have obesity-related diseases -- resulting annually in over 86,000 foot or leg amputations and 24,000 cases of blindness for diabetics. The cost to society is also crippling -- estimates of direct costs start at $100 billion annually. By 2020, at current rates, over 40 percent of the American population will be obese.

Epidemics are typically accompanied by panic and rapid reaction. Polio struck terror in the hearts of parents -- 50,000 Americans were crippled or killed by polio in 1952. When Salk's polio vaccine was declared safe in 1955, communities, and government agencies pulled together to make it cheap and accessible. By 1957, the incidence of polio in the U.S. had fallen by 85 percent.

Yet no such drive has occurred in the name of obesity, a much greater social tragedy. Part of the problem is the creeping nature of harm from obesity. Unlike polio, which struck children suddenly, almost as if they had been hit by a car, the harm from obesity occurs slowly. That makes it easier to ignore. Then there's our cultural reluctance to be judgmental -- who are we to judge these people who are "differently-sized?" Are we biased against fat people? Obesity also has hit minority populations disproportionately -- for instance, black women are 38 percent more likely to be overweight or obese than white women, putting a racial tinge on efforts to change lifestyles.

What do we do about it? Recently, 16 experts came together on NewTalk to discuss how to deal with obesity focusing on the decline in physical fitness. Here are some of the high points:

"We must avoid the argument whether obesity is due to overeating or too little physical activity -- the answer is yes. We cannot solve our practices by food alone. It is almost impossible to be as sedentary as most Americans are and maintain a healthy weight."(Professor James O. Hill, University of Colorado at Denver)

"A culture of physical fitness happens when environments make going outside on foot or bicycle the easy choice." (Jean Wiecha, Harvard School of Public Health).

"As a powerful deterrent to natural play, fear of liability ranks right behind the bogeyman." (Richard Louv, author, Last Child in the Woods)

"There is no longer any equipment in playgrounds to attract [kids over the age of 3]. Monkey bars are gone. Tall structures are gone. It goes without saying that seesaws are gone." (Hara Estroff Marano, Psychology Today)

"Risky play was normal and accepted for centuries...Now aversion to risk influences excessive safety standards, lawsuits, sedentary behavior, deletion of recess, and results in obesity and poor fitness. ... [O]ver time obesity itself becomes a cause of play deprivation and further promotes obesity." (Professor Joe Frost, University of Texas)

For solutions, the panel of experts thought this required a long-term cultural shift.

1. Putting physical activity back into schools seems essential and the place to start." (Hara Estroff Marano)

2. "[A]s Common Good has recommended, we need to establish public risk commissions to examine areas of our lives that have been radically changed by litigation. Yes, there is risk out there, but there are also huge risks to physical and mental health when we raise a generation under protective house arrest." (Richard Louv)

3. Get kids and adults out of cars: "Thirty percent of adults who use public transit achieve the recommended 30 minutes per day of physical activity by walking to and from public transportation." (Dr. William Dietz, Centers for Disease Control and Protection) Kids in Davis, California are encouraged to bike to school -- the city constructed new bike lanes and eliminated buses.

4. Focus on a cultural shift, attacking obesity the same way we have smoking. "This seems pretty daunting, but in 1960 who would have believed that we could reduce rates of smoking?" (Dr. Stuart Brown, National Institute for Play)