Do you weigh what you did in high school?

By Suzia van Swol, University of New Mexico-Talk Radio News Service
“Pollution begins at your lips; you are what you eat, and from the Kagen point of view, you ought to weigh today what you did as a senior in high school,” stated Congressman Steve Kagen (D-Wa.) at the House Agricultural Committee hearing on obesity in America. Kagen said that America is overweight and that there is no question about it. He pointed out that, “if it tastes good, it’s probably not good for you.”

Congressman Jeff Fortenberry (R-Neb.) said that obesity is affecting economics, health, and the well-being of our people. “Obesity is contributing to rising healthcare costs, the loss of productivity in the workplace and various life threatening conditions such as diabetes, cardiovascular diseases as well as stroke,” stated Fortenberry. The congressman said that he believes access to good nutrition and nutritional education is the key.

Congressman Joe Baca (D-Calif.) said that, “statistics indicate that more than 1/3 of our population is considered obese.” He explained that he is troubled by the economic consequences our nation faces due to obesity. “We can continue to work together to fight obesity and create a healthier nation,” said Baca.

William Dietz, director of the Division of Nutrition, Physical Activity, and Obesity Prevention at the Centers for Disease Control and Prevention, said that a recent paper suggests that “the deaths for obesity in adolescents are approximately equivalent to those deaths attributable to smoking.” According to Dietz obesity related disease is accounted for 25 percent of the increase in medical costs between 1997 and 2001. He said that we have a choice: we can pay for the care of these diseases or we can choose to prevent these diseases.

Dietz stated that, “60 percent of adults are overweight or obese, 30 percent of children and adolescents are overweight or obese. that far exceeds the capacity of the medical system.” He went on to say that people must make good choices, but also pointed out that they must have good choices to make. He said that children in suburbs can’t walk to school because of a lack of sidewalks, and inner-city populations are surrounded by fast good restaurants.

New York City has implemented regulations in childcare programs such as requiring children 12 months or older to participate in 30-60 minutes of physical activity, restricts television viewing to 60 minutes, and prohibits the availability of sugar-sweetened beverages. Dietz said that there are already states that are taxing snacks and sugar sweetened beverages.

Dietz said there seems to be a connection between television and obesity, “the more television a child watches the more likely they are to consume foods while watching television, and the more likely it is those are foods are foods advertised on television.”

Kagen posed the question, “is it a form of child abuse to continue to feed children things that are not good for them?” Dietz said that it is an odd form of abuse because it comes from giving too much rather than giving too little.

The high cost of health

According to Paul Ginsburg, the President of the Center for Studying Health System Change, the rising costs of health care can be attributed to advancements in technology, declinations in the population's health status due in part to obesity, and an overall lack of productivity in the delivery of care.

To combat this growth in spending, Ginsburg suggests that policy makers should attempt to pass provider payment reform, engage in programs to stop obesity, and better focus the use of new medical technology on those who will benefit the most.

"Technology, there is a consensus in the literature, probably accounts for a third or two-thirds of the growth in health care spending. It affects spending really in two ways...by substitutions of new approaches for existing approaches and by expansion meaning approaches to treat things that couldn't be treated before," said Ginsburg.

"A great deal of this technology is highly welcomed by all, it makes a great contribution to people's health care, it is high value, but some technology does not provide sufficient value...some of it is applied too broadly. " However, there are questions over whether policy makers should target technologies, since stopping their progress may pose a risk to the overall health in the United States.

"In this new century of the life sciences we're developing so much fundamental knowledge of disease and the roots of disease and the roots of the processes in the human body and the likelihood of much more stunning medical progress in this century is very, very high," explained Senior Executive Vice President of the Advanced Medical Technology Association David Nexon, Ph.D. "It's a tremendous policy imperative to make sure we don't inhibit those breathtaking opportunities for progress."

Health Policy and Strategy Associates President Robert Laszewski doubts broadening the general population's insurance coverage or ending obesity will do anything to lower health care spending. Lazewski noted that insuring the 45 million uninsured Americans will lead to a spending increase similar to when medicare was introduced in the 60's and that any costs saved by ending obesity will be negated by people living longer.

"If we can improve productivity 20 percent over the next ten years, this would abruptly close the gap between spending growth and GDP over that period...the only way we can bring our costs under control is to improve productivity," said Lazewski.

Obesity is everyone’s problem

The Senate Health, Education, Labor and Pensions Committee held a hearing today on “Childhood Obesity: The Declining Health of America’s Next Generation.” Sen. Christopher Dodd (D-Conn.), called the “champion of children” by Sen. Thomas Harkin (D-Iowa), presided over the hearing and said that the childhood obesity epidemic is one of the most urgent threats to American children. Dodd explained that “our children’s generation” may be the fist in the modern era to live shorter, less healthy lives than their parents. He also said that nearly one out of every three American children are obese or are at risk of becoming obese and children are increasingly being diagnosed with type 2, “adult-onset” diabetes, high blood pressure, and high cholesterol.

Dodd said that childhood obesity is a problem that “affects all of us,” and “we’re all going to be paying the bill.” He explained that the obese spend thirty six percent more on health care and seventy seven percent more on medications. According to Dodd, everyone - parents, schools, governments, employers - needs to see the rising childhood obesity rates for what they are: a medical emergency.

Jeffery Levi, the Executive Director for Trust for America’s Health, said that approximately twenty three million children are obese or overweight in the U.S., and rates of obesity have nearly tripled since 1980. He explained that the U.S., as a nation, needs a cultural shift in which healthy environments, physical activity and healthy eating become the norm. Francine Kaufman, a past national president of the American Diabetes Association, said that obesity has reached epidemic proportion in the U.S. Kaufman also said that during the mid-1990s, type 2 diabetes in youth increased ten-fold and mirrored the childhood obesity epidemic. She explained that there is no doubt that obesity in youth, along with its associated medical conditions, is the major health challenge of this century, and more needs to be done to combat it.

Margaret Grey, dean and professor of the Yale School of Nursing, said that this obesity epidemic in youth threatens not only the future of children with chronic diseases and a decreased lifetime, but the epidemic is multi-faceted and will ultimately affect the workforce and thus the economy. Grey explained that obesity and diabetes have physical complications - cardiovascular disease, kidney disease, blindness, and amputations - as well as complications related to quality of life - depression and academic achievement. She also said that this generation of youth cannot survive if Congress continues to pay for the care of their heart attacks, but not for the intensive behavioral care that it will take to reverse the epidemic.