U.S. Food and Drug Administration
FDA Consumer magazine
March-April 2002
Table of Contents

Overweight, Obesity Threaten U.S. Health Gains

Health problems resulting from overweight and obesity could reverse many of the health gains achieved in the United States in recent decades, according to former Surgeon General David Satcher.

A report issued in December titled The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity outlines strategies that communities can use in helping to address the problems. Options include requiring physical education at all school grades, providing more healthy food options on school campuses, and providing safe and accessible recreational facilities for residents of all ages.

"Overweight and obesity may soon cause as much preventable disease and death as cigarette smoking," says Satcher, whose term expired Feb. 13. "People tend to think of overweight and obesity as strictly a personal matter, but there is much that communities can and should do to address these problems."

About 300,000 U.S. deaths a year are associated with obesity and overweight (compared to more than 400,000 deaths a year associated with cigarette smoking). The total direct and indirect costs attributed to overweight and obesity amounted to $117 billion in 2000.

In 1999, an estimated 61 percent of U.S. adults were overweight, along with 13 percent of children and adolescents. Obesity among adults has doubled since 1980, while overweight among adolescents has tripled. Only 3 percent of all Americans meet at least four of the five federal Food Guide Pyramid recommendations for the intake of grains, fruits, vegetables, dairy products, and meats. And less than one-third of Americans meet the federal recommendations to engage in at least 30 minutes of moderate physical activity at least five days a week, while 40 percent of adults engage in no leisure-time physical activity at all.

"Overweight and obesity are among the most pressing new health challenges we face today," says Tommy G. Thompson, secretary of Health and Human Services. "Our modern environment has allowed these conditions to increase at alarming rates and become a growing health problem for our nation. By confronting these conditions, we have tremendous opportunities to prevent the unnecessary disease and disability they portend for our future."

While the prevalence of overweight and obesity has increased for both genders and across all races and ethnic and age groups, disparities do exist. In women, overweight and obesity are higher among members of racial and ethnic minority populations than in non-Hispanic white women. And, Mexican-American men have a higher prevalence of overweight and obesity than non-Hispanic men, while non-Hispanic white men have a greater prevalence than non-Hispanic black men. Members of lower-income families generally experience a greater prevalence than those from higher-income families.

Already, these trends are associated with dramatic increases in conditions such as asthma, and in type 2 diabetes among children. Satcher says failure to address overweight and obesity "could wipe out some of the gains we've made in areas such as heart disease, several forms of cancer, and other chronic health problems."

In preparation of the report, Satcher convened a listening session in December 2000 and held a public comment period to gather ideas from clinicians, researchers, consumers and advocates. The sessions generated a number of community-based strategies that were subsequently reviewed for their proven scientific effectiveness.

The strategies include:

Ensure daily, quality physical education for all school grades. Currently, only one state in the country-Illinois-requires physical education for grades K-12, while only about 1 in 4 teen-agers nationwide take part in some form of physical education.
Ensure that more food options that are low in fat and calories, as well as fruits, vegetables, whole grains, and low-fat or non-fat dairy products, are available on school campuses and at school events.
Make community facilities available for physical activity for all people, including on the weekends.
Create more opportunities for physical activity at work sites.
Reduce time spent watching television and in other sedentary behaviors. In 1999, 43 percent of high-school students reported watching two hours of television or more a day.
Educate all expectant parents about the benefits of breast-feeding. Studies indicate breast-fed infants may be less likely to become overweight as they grow older.
Change the perception of obesity so that health becomes the chief concern, not personal appearance.
Increase research on the behavioral and biological causes of overweight and obesity. Direct research toward prevention and treatment, and toward ethnic/racial health disparities.
Educate health-care providers and students in health professions on the prevention and treatment of overweight and obesity across the life span.

The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity is available at: www.surgeongeneral.gov/topics/obesity.

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