Obesity and overweight. An epidemic. Check out the Centers for Disease Control's obesity maps if you don't believe it. The biggest negative impact on chronic disease. Preventable. But what can we do about obesity and overweight—not just in any one person, but as a society? Who is responsible?
Renewed finger pointing has lit up the media. Is it the government’s job to control what we eat? New York City Mayor Bloomberg believes that local government has at least some responsibility. He tried to pass a law limiting the sale of sugary drinks to 16oz or less. Mississippi, in response to Bloomberg’s attempt, passed its own law that the government can never restrict what drinks are sold to the public. The federal government is partnering with many groups to bring healthier food choices into underserved neighborhoods.
See what Washington State is doing about obesity.
I tend to think that primary responsibility for obesity rests on the individual. I suspect (especially in developed countries), obesity more often reflects a person’s unbalanced relationship with food rather than an underlying health problem. I have the authority to think such a thing, because I am someone who admittedly struggles herself. I really enjoy food. I like to bake, cook and eat out. My body mass index (BMI, the magic ratio that describes our height and weight) used to be 23, right within the normal range. Today after 3 kids and 15 years it is 28, in the middle of overweight. I try to eat fewer calories than I need to fuel my body, to make healthy food choices 90% of the time, to exercise and not to obsess about food. But that is easier said than done. When my kids are in bed for the night, my brain sort of shuts off; then the chocolate peanut butter ice cream or Loaded Baked Potato chips start calling me—worse yet, I bake some decadent goody from my childhood comfort food list. That’s the hard part I have yet to consistently overcome. Here is where my responsibility comes in: I can choose NOT to buy those trigger foods at the store; I can choose healthy portions of the food that calls my name; I can come up with a food plan before the kids go to sleep; I can keep my hands busy with crafts or knitting. I can just close my mouth. Or can I?
Psychology says that the food industry works hard to create addictive foods and lure us in with advertising. Check out the compelling book, Salt, Sugar, Fat and accompanying NPR story. Our bodies weren’t designed to consume the processed foods we consume says food-science experts who are “painting an increasingly grim picture of the public’s ability to cope with the industry’s formulations — from the body’s fragile controls on overeating to the hidden power of some processed foods to make people feel hungrier still.” The same NYT article offered this memorable quote from Yale University professor of psychology and public health, Kelly Brownell: “As a culture, we’ve become upset by the tobacco companies advertising to children, but we sit idly by while the food companies do the very same thing. And we could make a claim that the toll taken on the public health by a poor diet rivals that taken by tobacco.”
The most promise comes from collaborative efforts between scientists, non-profits, K-12 schools, public health funding, employers and insurers who together affect individual behavior and access to good choices. INTERESTED YET? ADD YOUR OWN VOICE TO THE TOPIC AT OUR MAY 21 COMMUNITY CONVERSATION and check out more resources below:
What are pharmaceutical companies and supplement makers doing to help with healthy weight? Drugs are available over the counter and by prescription to either curb appetite or prevent calorie absorption by our bodies. Read more at http://en.wikipedia.org/wiki/Anti-obesity_medication
How about doctors and the public health community? Public health professionals are working with community and government groups to affect policies and develop programs to improve nutrition and exercise (http://depts.washington.edu/uwcphn/schoolhealth/index.html). But is the needle moving? Are these large collaborative efforts making an impact or are they too unwieldy to create change?
Scientists at the University of Washington are working to understand obesity, especially at a local level with their Seattle Obesity studies (http://depts.washington.edu/uwcphn/work/uwcor.shtml)
Get paid to lose weight? Reality television programming around weight loss, like Biggest Loser, have won support. Now weight loss games are coming online. In many of these games, individuals or groups of people can actually win money for losing weight. Check out http://www.healthywage.com, http://www.dietbet.com and http://www.healthyloser.com.
The practice of incentivizing healthy lifestyles and penalizing unhealthy lifestyles is gaining popularity.
Some employers incentivize their employees through carrots and sticks for maintaining a healthy lifestyle. This practice is gaining popularity, up 58% from 2011 to 2012 among U.S. employers with at least 1,000 employees.
The Patient Protection and Affordable Care Act (PPACA) raised the limit on financial incentives tied to a health standard from 20 to 30 percent of the cost of health plan coverage, effective in 2014. Research shows that this approach can increase healthy lifestyle program participation, but there is still a lack of understanding about the impact of financial incentives on long-term behavior change. And what does this mean for employee privacy?
Medicare now covers 6 months of weight loss counseling for obese clients, 13 million of whom are Medicare-eligible. But is counseling enough? “The problem is there’s no real incentive for the insurance industry to pay for better prevention and treatment, because the costs are immediate while the benefits are long-term,” said Dr. David Ludwig, director of the new Balance Foundation Obesity Prevention Center at Children’s Hospital, Boston. “Although reducing the prevalence of obesity is one of the most profitable investments the healthcare system could make, it doesn’t make a lot of sense for individual plans when families change policies every three to five years.”
Resources for combating obesity
