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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.

The Problems With Prevention continued...

But analogies to other public health efforts can only go so far, and obesity looks to be a difficult opponent. "Personally, I think that obesity may be the toughest social issue that we have ever faced," says Hill, "even more so than smoking."

Part of the problem is that the message about eating well is necessarily more complicated than the messages of other health campaigns. The recommendations for preventing tobacco-related illnesses are pretty straightforward: Don't smoke. But given that "don't eat" is not an option, there isn't such a concise recommendation for eating well and staying fit. It's more like, "Eat plenty of these, and not so much of that or those, and remember to exercise a lot."

And despite the increasing amount of attention paid to obesity in the media, recognizing and talking about it is difficult. Obesity can be a sensitive subject to discuss, given how stigmatized overweight people can feel. While no one would take offense if her doctor said she had high blood pressure or heart disease, she might very well be offended if her doctor said she was obese, since the word can sound like a moral as well as a medical judgment. According to anecdotal evidence, Dietz says that even people with severe obesity tend to think of the word as applying only to people much heavier than they are.

"I think that the American public still views obesity as a cosmetic problem," says Dietz. "The challenge is to get the public to recognize that this is a health problem and it's one that they can do something about." He also stresses that we need to come up with a different way of talking about obesity that won't make people feel stigmatized.

Defeating Obesity

While it would be swell if every American woke up tomorrow and decided to exercise regularly and eat healthily, it's not going to happen and it's not that simple. "The trend in overweight is related to a lot of cultural, economic, and environmental factors," says Ogden, "and we need to work together to figure out what to do about it."

"The focus needs to be on environmental and policy solutions rather than individual behavior change," says Dietz. "Because it's changes in the environment that caused this problem and it's changes in the environment that will solve it."

The campaign against obesity will have to be massive, and it will have many fronts on a local and national level. Doctors need new ways to talk to their patients about obesity, says Dietz, and schools need new programs to encourage physical activity. Restaurants and fast food chains need to be encouraged to develop healthier foods. Nestle argues that concerned parents should try to reduce the amount of food advertising that their children are subjected to, and, if necessary, to lobby against school systems that serve soft drinks and fast food for lunch.

Dietz believes that beating obesity may even require a recasting of our entire healthcare system, since obesity needs to be prevented rather than treated after it happens. "We can't afford to treat obesity and its consequences," Dietz says. "So this begs the question whether it's time to move from a disease-care system to a real healthcare system."

Although all of these changes may seem radical, Dietz believes that they may be necessary to stop a potential health catastrophe. "We can't afford to think in traditional terms about obesity," he says.

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