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Kaplan & Licitra: Congress Can Help Fight Obesity

If Washington wants to address rising U.S. health care costs in a meaningful way, Congress needs to help tackle one of the largest drivers of those costs: America’s obesity epidemic. And it must do so not just with rhetoric, but with a multifaceted, comprehensive strategy.

[IMGCAP(1)]One way to do that is reflected in legislation introduced this week by Rep. Ron Kind (D-Wis.) and a bipartisan group of Members of Congress — the Healthy Choices Act of 2010, which is the first such measure to be introduced in the House. The Kind bill focuses on changes in federal policy in three vital, related areas: food and nutrition, accessibility of physical activity, and treating obesity as a serious medical condition through the health care delivery system itself. This bill addresses each of the challenges outlined here and provides a viable means for Congress to help Americans on the journey to a healthy weight.

Millions of American adults and children struggle with the effects of obesity every day. Obesity or overweight now afflicts two-thirds of adults, and nearly one in three American children is overweight or has obesity. The odds are particularly stacked against Latinos, African-Americans and Native Americans.

According to the Centers for Disease Control and Prevention, obesity accounts for at least $147 billion each year in U.S. medical expenses, and that figure doesn’t take into account the substantial other costs of obesity — on workforce productivity, wages and emotional well-being. These alarming trends, coupled with the fact that obesity triggers more than 60 other chronic and often life-threatening diseases — including heart disease, diabetes, osteoarthritis, stroke, dementia and many forms of cancer — put our children at risk of becoming the first generation in American history whose life expectancy is shorter than that of their parents.

Leaders in health care, business, our local communities and Congress have an opportunity and a collective obligation to equip all Americans with the tools to reach and maintain a healthy weight and bring our “energy balance” back into real balance. These tools are needed to help all of us eat fewer and healthier calories, become more fit through a physically active lifestyle, and reduce the stress brought about by unequal opportunities and unhealthy environments. Addressing each of these concerns and providing all Americans with appropriate treatment and prevention options will be necessary to combat obesity effectively.

From improving the quality of school lunches to enabling the use of more understandable food labels that accurately reflect the nutritional composition of packaged foods; from reducing the barriers to local food cooperatives to enabling small businesses in low income neighborhoods to get healthier produce — Congress has an opportunity to make healthier food available to all Americans, help us to know what we are eating and help us all understand how it affects our bodies. Equally important, we need to give doctors the tools to diagnose and treat obesity and researchers the resources to develop new and more effective treatment and prevention strategies.

Congress can also do more to make an active lifestyle not only the right choice, but the easy one. In an earlier time, we walked or rode our bicycles to school. Today, with too few safe and efficient bike and pedestrian paths between our homes and schools, less than one in six of our children does the same. In times past, we played in fields and yards and neighborhoods — but today, opportunities for outdoor play are more limited, and pursuing them is often difficult if not actively discouraged.

As Congress thinks about rebuilding the nation’s infrastructure, it should also put resources into building safe and attractive places for children to play, safe routes for them to travel to school and more places within their local communities for kids and adults to be active. Finally, with children facing the health and social tolls of obesity in every community in our nation — and with 23 percent of young adults unfit for military service because of excess weight — our schools must make physical activity a staple of the school day.

For adults, with many Americans spending more time at work than ever, incentives for workplace wellness programs are critical. Similar efforts are needed to encourage healthy lifestyles at home and in the rest of our lives. Each of us, working together, must do what we can to ensure that Americans recognize when they or their children are at an unhealthy weight. As with other vital signs and risk factors, measuring body mass index provides a quick and easy means of identifying an important threat to health (obesity), determining its severity and following the effectiveness of prevention and treatment strategies.

Many, if not most, of us pay close attention to other critical health numbers — blood pressure, body temperature and cholesterol levels — but far fewer of us monitor or even know our BMI. BMI should be treated like any other vital sign by patients, physicians and other health care providers. It should be measured and monitored frequently, including at each patient encounter, to help prevent the development of obesity or stop it from getting worse.

Over the past generation, as the national rate of obesity has skyrocketed, we have placed the burden of its control on the individuals suffering with the disorder. While each of us has a responsibility to pursue a healthy lifestyle, history has clearly demonstrated that obesity is a medical problem that goes far beyond the ability of individuals to control on their own. We need to improve the “obesogenic” environment, and it is time for federal policymakers to stand up and tackle this epidemic head-on. The efforts of Rep. Kind and his colleagues to promote an effective obesity policy are important steps in this direction. We hope that they will succeed, helping all of us make progress on the path toward reaching and maintaining a healthy weight.

Lee Kaplan is director of the Weight Center and obesity research program at Massachusetts General Hospital and an associate professor of medicine at the Harvard Medical School. Karen A. Licitra is a company group chairman for Johnson & Johnson and worldwide franchise chairwoman for Ethicon Endo-Surgery Inc. They are founding board members of the Campaign to End Obesity.

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