There's no doubt about it: obesity—especially for children—has become a critical and costly problem in the United States, said Health and Human Services Secretary Kathleen Sebelius at the Centers for Disease Control and Prevention's first conference on the "Weight of the Nation" in Washington Tuesday. And it's a problem that needs to be part of the healthcare reform debate, she noted.
Currently, more than two-thirds of American adults—and almost one out of every five American children—are obese or overweight, Sebelius said. A report released the day before observed that obesity costs the American health system as much as $147 billion a year, a number that has nearly doubled since the CDC last calculated the rate in 1998.
"To put that figure in perspective, the American Cancer Society estimates that all cancers combined cost our healthcare system $93 billion a year," she said. "So ending obesity would save our healthcare system 50% more dollars than curing cancer."
But while this picture is bleak, there is hope—especially at school, community, and federal levels—that obesity can be tackled. A new report released Tuesday on school district wellness policies finds that the mission to promote better health "won't be easy," she said. But steps can be taken toward "developing a national blueprint for how to get Americans to slim down while trimming a significant chunk of our healthcare costs at the same time."
The report, prepared by researchers at the University of Illinois at Chicago and supported by the Robert Wood Johnson Foundation, examined policy opportunities that emphasize wellness to improve a child's quality of life, such as:
- Improving the nutritional quality of school meals.
- Reviewing standards for competing foods and beverages (such as sodas and snacks in vending machines) sold outside the school lunch programs
- Restricting food marketing and advertising
- Continuing to strengthen physical activity provisions
- Expanding policies to address physical education
These suggestions emphasize "transforming our healthcare system from a sickness system to a wellness system," she said. If the government wants people to start eating healthy food, "we need to start serving it," she said. That means offering more nutritious meals—not just in public schools, but in child care centers, recreation centers, senior centers, and other government buildings.
"And we need to serve these healthy meals at a price that people can afford. Some people say that if kids don't want to eat healthy, they're not going to no matter what," she said. "But there are a handful of high school cafeterias around the country that would disagree. They cut the prices of fruits and carrots and sales started to rise."
Another target area is to give people more healthy options in their own neighborhoods. "Many rural Americans and urban Americans have the same problem: they don't have any supermarkets that sell fresh produce where they live," she said.
"When you can't buy fresh produce, it's hard to eat healthy," she said. One study found that the amount of fruits and vegetables eaten in African American neighborhoods actually went up by a third for each supermarket that was added.
"This isn't rocket science. People want to eat healthy diets, but they tend to eat whatever's convenient and affordable, Sebelius said. "If we want to reduce obesity, we need to make eating fruits and vegetables convenient and affordable for all Americans."
Sebelius' comments came on the second day of the conference. The day before, CDC Director Thomas Frieden, MD, told the audience that the average American adult is now 23 pounds overweight—representing about 4.5 billion pounds of excess weight nationally.
He also stated that the incidence of childhood obesity has tripled in one generation. To tackle obesity, the country will probably have to take notes from the earlier national campaign to reduce tobacco use—taking aim at food costs, exposure to food ads, and availability of junk food.
Former President Bill Clinton said on Monday that the issue of childhood obesity "cannot be dealt with entirely within the confines of a medical office."
To change this, "we have to change what goes on at home and in the community and in the neighborhood and in the schools," Clinton said. He noted how his foundation has been involved with getting vendors in some schools to stop selling high-caloric and heavily sugared drinks to children attending those schools.