Federal agencies address obesity epidemic

Obesity has become an epidemic, posing a threat to personal health, the economy and national security, according to data presented at the 2012 Weight of the Nation Conference: National Response to Obesity: Leveraging Resources Across Sectors.

Leaders from federal agencies, such as Thomas R. Frieden, MD, MPH, director of the CDC and administrator of the Agency for Toxic Substances and Disease Registry, reported on actions taken since 2009 to address the obesity epidemic and outlined actions necessary to achieve goals set for 2020.

“The obesity epidemic has gotten worse faster than many, or perhaps any, of us could have imagined. Until now, half of all children and two-thirds of all adults are overweight or obese,” Frieden said. “The costs are enormous.”

Each year, an individual who is overweight or obese costs about $1,400 more to care for than someone who is not, Frieden said. Moreover, a patient with diabetes costs $6,600 more per year to care for than someone without the disease.

He said the health care system spends nearly $500 million per day caring for patients with obesity.

Recent data published in Pediatrics, however, has provided a glimmer of hope, despite the grim statistics.

According to researchers, the prevalence of obesity in children aged younger than 6 years decreased by more than 20% in 5 years in eastern Massachusetts. In New York City, prevalence of diabetes in children aged 5 to 14 years decreased by 6%, and in younger children aged 5 to 6 years, the prevalence decreased by 10% across a 5-year period.

“We’re going to need to work across the lifespan, starting with a healthy pregnancy, with promotion of breast-feeding, with healthy food and physical activity in childcare and schools and workplaces,” Frieden said.

Providing perspective on obesity’s effect on national security, Jonathan Woodson, MD, assistant secretary of defense for health affairs with the US Department of Defense, and director of TRICARE Management Activity, said the epidemic has led to the discharge of 1,200 first-term enlistees at a cost of $60 million due to failure to meet height and weight standards.

Woodson reported that 27% of young adults aged 18 to 24 years are now unfit to serve in the US military. To allay this problem, the military recently updated its dining menu for the first time in 20 years to offer healthier choices, he said.

“We have a legal and moral responsibility to do our part to maintain the health and well being of everyone in the military community. And so it is about the community, it is not just about the health care system,” Woodson said.

Kathleen Sebelius, secretary of the Department of Health and Human Services, spoke of the steep rise in obesity seen during the past 30 years, describing what has become a “carb culture,” flushed with technology and inactive lifestyles.

“In 1985, no state had an obesity rate above 15%. By 2010, 38 states had obesity rates over 25% of their population. That’s an enormous increase in a relatively short period of time, and that rise has left millions of Americans at risk for diabetes, heart disease and a host of other health problems obesity is known to cause,” she said.

Sebelius said first lady Michelle Obama’s “Let’s Move!” campaign brought “a historical level of attention” to the obesity epidemic.

New guidelines developed by federal agencies, partnerships with businesses for workplace wellness programs and prevention programs have changed the conversation of health and fitness, Sebelius said.

“A study presented here … showed that if we don’t keep up our current efforts, we could see the obesity rate in American climb to 42% by 2030, and we absolutely cannot afford to have that happen,” she said.

The issue should be tackled by taking an “all of the above approach” with emphasis on research and a continuation of proven programs, Sebelius said.

Howard K. Koh MD, MPH, assistant secretary for health at the HHS, highlighted the efforts of the “Healthy People 2020” campaign — a 10-year agenda for improving the nation’s health that was initiated in 2010.

“We have a number of targets and objectives for nutrition and fitness. For example, in the fitness area, we have specific objectives to raise physical activity for adults and kids; to have more physician office visits that involve counseling and education for physical activity; to raise standards for childcare settings, and the list goes on and on,” Koh said.

Kevin Concannon, US Department of Agriculture undersecretary for food, nutrition and consumer services, said there are three basic ways to engage against obesity: 1) provide critical nutrition education for all Americans through dietary guidelines; 2) target nutrition education for specific groups and subgroups within the population; and 3) set nutrition standards for which the USDA is the payer. – by Samantha Costa

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Presented at: the 2012 Weight of the Nation Conference: National Response to Obesity: Leveraging Resources Across Sectors; May 7, 2012; Washington, D.C.