Surgeon General Issues Action Plan for Obesity

U.S. Surgeon General David Satcher yesterday released a report on the prevalence of obesity in the United States that outlined a "national plan of action" to "fight the epidemic," the Los Angeles Times reports. The study found that fewer than one-third of Americans meet the government's recommended exercise standards of 30 minutes of "moderate exercise" -- such as walking about two miles -- five times per week (Rosenblatt, Los Angeles Times, 12/14). The study found that about 60% of adults and 13% of children are overweight or obese. As the percentage of overweight and obese individuals increases, it "threaten[s]" to undo advances made against cancer and heart disease, according to Satcher (AP/Baltimore Sun, 12/14). Satcher said that the factors behind the "alarming rise" in the number of people who are "dangerously overweight," include a lack of exercise and diets filled with "fats and sugars" (Los Angeles Times, 12/14). From 1976 to 1980, 32% of Americans were overweight and 15% were obese. In 1999, 34% were overweight and 27% were obese, according to the report (Squires, Washington Post, 12/14). Satcher said that about 300,000 Americans die each year from ailments "caused or worsened" by obesity, and the condition is likely to surpass tobacco use as the leading cause of preventable deaths (AP/Baltimore Sun, 12/14). Satcher added, "This in not about aesthetics and it's not about appearances. We're talking about health" (Washington Post, 12/14).

To determine if a person is overweight or obese, "simple poundage" in no longer the standard used by the government. Instead, the government endorses a measure called the body mass index (BMI). The number is calculated by multiplying a person's weight by 703 and then divided that number by the person's height in inches. The resulting number is then dividing again by height in inches and the answer is the person's BMI. A BMI up to 24 is considered healthy, a reading of 25 to 30 is overweight, and anything over 30 is obese (Los Angeles Times, 12/14). "The prevalence of overweight and obesity has steadily increased over the years," Satcher said, adding, "... too few people are consuming the recommended daily allowances of fruits and vegetables. This is probably the most sedentary generation of people in the history of the world" (Kim, Cox News/Spokane Spokesman-Review, 12/14).

Satcher issued recommendations to fight obesity. However, as the surgeon general controls no funding, federal, state and local governments would have to implement the plan (Washington Post, 12/14). The plan recommends that schools provide daily physical education in every grade. Also, schools should "better enforce" federal rules that govern access to vending machines and provide "healthier food options." Localities should construct playgrounds, sidewalks and walking trails, and the food industry should promote healthier options, including "reasonable portion sizes" (AP/Washington Times, 12/14). The report also said that employers should give workers time to exercise and that employer-sponsored health plans should include weight management and physical activity counseling. The report also recommended that obesity be classified as a disease to encourage insurers to cover "weight-control expenses"(Washington Post, 12/14). Also, because the poor "tend to be the fattest," Satcher said communities should investigate fast food marketing practices. Satcher said fast food is "crowding out" access to healthier foods in the inner cities, much like tobacco companies "target[ed]" inner-city minority communities in the 1990s (AP/Washington Times, 12/14). HHS Secretary Tommy Thompson said, "It's time to get children, ladies and gentlemen off the couch and onto the playground. The drive must come from communities, from mothers, from fathers, from employers" (AP/Baltimore Sun, 12/14). Thompson also urged all Americans to lose 10 pounds "as a patriotic gesture." He added, "As much as we love to eat, too often we fail to consider the consequences of that love" (Los Angeles Times, 12/14).

Some industry and advocacy groups "praised" the report for shifting the subject of obesity and overweight from a "personal problem to a societal issue." Margo Wootan, with the Center for Science in the Public Interest, said, "What's unique is to have the government saying that we need to address nutrition and physical activity as a societal issue, much like we did for tobacco." Lisa Katic, with the Grocery Manufacturers of America, said the report "recognized that this is a complex issue and there are no simple solutions." However, other groups said the plan "fell short." Barbara Moore, president of Shape Up America!, said the report did not address issues such as tax policy, which could make people healthier. "I'm talking about incentives to make fruits and vegetables cheaper and for physical activity to be safer and more affordable," she said (Washington Post, 12/14). Richard Keelor, president and CEO of the Sugar Association said the report "offers little more than a patch-quilt approach of old and tired public health methods that are not likely to be ... effective." He added that the report's recommendations for the food and beverage industries "could lead to restrictions of individual choices that make the government the consumers' parent regarding food and beverage selections" (Sugar Association release, 12/13). The National Restaurant Association said the report is "simplistic" and the National Soft Drink Association said vending machines in schools are already "adequately regulated" (AP/Baltimore Sun, 12/14).