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Feb. 18, 2003 Obesity is a public health crisis, it will take more than willpower to reverse the trend

This guest opinion is by Mel Kohn, M.D., state epidemiologist in the Oregon Department of Human Services. For a photograph of Dr Kohn or an electronic version of this guest opinion, call (503) 731-4180 or e-mail bonnie.l.widerburg@state.or.us

Length: 489 words

By Mel Kohn. M.D.

The fact that Americans are getting heavier is scarcely news. Look around, and it's apparent that more than half of us are overweight. We're eating more and exercising less.

But did you know, it's a public health crisis, causing disease and early death and costing us billions of dollars? Obesity is estimated to account for more than 300,000 deaths each year in the US, and almost 10 percent of U.S. health care expenditures. Only tobacco kills more people.

And Oregon holds the distinction of being the fattest state west of the Rockies. More than 20 percent of adult Oregonians are obese and 38 percent more are overweight. Our youth are in trouble too. Rates of overweight among teens in Oregon have tripled in the past 20 years.

This obesity epidemic threatens to destroy the gains we've made in preventing heart disease, stroke and certain cancers.

It's easy to place individual blame for this unhealthy turn of events. If people would just exercise self-control, eat less and exercise regularly, there would be no problem. But the fact is, it's going to take more than willpower to reverse the current trend.

Human beings haven't become more gluttonous or lazy in recent years, but our environment has changed dramatically. Our current community conditions don't support healthy choices. For instance:

We're surrounded by low-cost, low-nutrition fast foods, given "super-sized" portions as a matter of course, and bombarded by ads for high fat, high sugar foods;
Physical activity has been engineered out of our daily lives. Work and home chores are mechanized and television and computers have taken over as entertainment;
Travel is built around the automobile, with 89 percent of all trips made in a car.

Getting this new epidemic under control requires a comprehensive approach that supports healthy eating and physical activity. Our personal commitment must be backed up by community-wide supports, such as:

Workplace and school policies that promote healthy foods such as fruit, vegetables, and low-fat milk rather than vending machines filled with soda, candy and fat-fried chips;
Neighborhoods that promote designated routes so children can safely walk or bicycle to and from school;
Daily physical education and recess in school, and after-school exercise opportunities;
Making parks and recreation facilities reachable by foot, bicycle or public transit;
Creating worksite activity programs;
Giving consumers reasonably sized food portions.

Earlier this month, the Nutrition Council of Oregon and the Oregon Coalition for Promoting Physical Activity convened "A Healthy Active Oregon" summit. They presented two statewide plans for improving nutrition and physical activity. The plans focus primarily on community action and changing the current social and physical conditions that promote poor health.

Our current unhealthy state didn't happen overnight and reversing it will take time. But we can't delay. Get involved, start practicing healthier habits and demand an environment that will reverse this public health crisis. Additional information is on the DHS Web site.

Mel Kohn, M.D., is state epidemiologist in the Oregon Department of Human Services

Page updated: September 21, 2007

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