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Obesity Epidemic "Astronomical"

The prognosis for the nation is bad and getting worse as obesity takes its toll on the health of adults and children alike.

Conflicting Recommendations

The seemingly contradictory reports in the media about what people should and shouldn't be eating almost certainly don't help things. For instance, proponents of protein diets argue that all of the accepted wisdom about eating a low-fat diet is wrong. Most experts don't agree with them, but protein diets are being evaluated in studies now.

Where mainstream nutritionists and protein diet proponents agree is that the low-fat recommendations of the 1990s didn't quite work. "People took the low-fat message and decided that it meant that as long as they ate things that were low-fat, they could eat as much as they wanted," says William Dietz, MD, PhD, the director of the division of nutrition and physical activity in the National Center for Chronic Disease Prevention and Health Promotion at the CDC. That isn't the case, since calories add up, no matter what form they come in. Even worse, many of the low-fat snacks that companies developed actually had higher calories than their regular-fat equivalents, Dietz observes.

According to Nestle, the media also have a tendency of confusing things by reporting the results of scientific studies out of context. She argues that the relative stability of the dietary and fitness recommendations over the years -- eat less fat and more fruits and vegetables, exercise regularly -- is obscured by the media, which are more interested in exciting stories about radical diets or the effects of particular "miracle" foods or vitamins.

Surgical Options

An increasingly common treatment for severe obesity is bariatric surgery, such as "stomach stapling" in which the size of the stomach is surgically reduced. It's gotten a high profile as some obese celebrities and public figures have undergone the procedure with dramatic results. It's even becoming more common among teenagers. While bariatric surgery is necessary and life-saving in some cases, is it a reasonable treatment for obesity in America?

"Surgery is an effective last resort," says Dietz, "and many people are so obese, with a body mass index over 40, that they're at the last resort stage."

However, if obesity continues to worsen, so many people will require surgery that it will become impossible to operate on all of them. "It's difficult for me to see how we'll be able or willing to perform surgery on 100 million Americans," says Hill. Instead, the only real answer is in preventing people from getting to the point of surgery in the first place.

The Problems With Prevention

As with other public health campaigns, such as the efforts to get people to stop smoking or to practice safe sex, results of the campaign against obesity will come gradually. But Dietz sees reason for hope.

"I think that in the last three years, we've seen a dramatic shift in the attitudes of policy makers toward obesity," Dietz tells WebMD. "There is now a huge amount of attention being paid to the condition," he says, and that's an important first step.

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