Obesity in America is a runaway train.
According to C. Everett Koop, former U.S. Surgeon General, in only 10 years obesity has increased from 24 percent to 34 percent in our country's adults. That means 58 million men and women are overweight enough to trigger other serious health problems.
Obesity causes up to 97 percent of adult onset diabetes, up to 70 percent of coronary heart disease, 11 percent of breast cancers, 10 percent of colon cancers, a third of hypertension and 70 percent of gallstones.
The price tag is $100 billion annually.
These weight-related conditions are the second-leading cause of death in the United States, taking 300,000 lives annually. (First place goes to smoking, responsible for 500,000 deaths per year.)
This morning, Dr. Koop will launch his own foundation's program "Shape Up America!" to slow the runaway train. Designed to place healthy weight and physical activity high on the national agenda, he will bring to bear all the fierce determination with which he attacked smoking 20 years ago. The project will involve industry, medical, health, nutrition and physical fitness organizations in the battle of the bulge.
Dr. Koop's announcement comes hard on the heels of last night's release of the National Academy of Science's (NAS) guidelines for what it calls ". . . waging a successful war against the worsening epidemic of obesity."
NAS would like us all, including doctors and other health-care providers, to start with an attitude adjustment. Historically, obese people have been seen as weak-willed, morally bankrupt or simply unwilling to fix themselves. Our annual national investment of $33 billion in weight-reduction products and services shows that idea is false and tells us something about the difficulty of losing weight and keeping it off.
If we're going to make any headway, we have to face the truth. In NAS's words, obesity is "a chronic, degenerative disease that debilitates individuals and kills prematurely."
Despite the recent discovery of the "ob gene" responsible for obesity in laboratory rats, there is no readily available cure for fat. Anyone who has been on a diet knows that. Losing weight and keeping it off is just hard work, forever. In fact, much of the discouragement and futility faced by overweight people arises from the false promises of fast-buck weight-loss charlatans, ever ready to pick the pockets of the desperate.
NAS recognizes this and encourages research in every direction, including drugs and surgery for the severely obese, so we'll know what really works. It emphasizes a new and hopeful reality: A small loss of only 10 percent to 15 percent of body weight is all it takes to reduce chronic disease risks.
So NAS suggests evaluating weight-loss programs before signing up again, based on realistic program results. "Specifically, the goal should be refocused from weight loss alone, which is aimed at appearance, to weight management, achieving the best weight possible in the context of overall health."
However, the academy reminds dieters that they and the program are responsible for what happens.
Last year, registered dietitian Ann Fletcher published "Thin for fTC Life," in which she interviewed 160 people who had lost weight and kept it off from two to 20 years. The one common thread that led to their success was that at some point, they all came to terms with the fact that they had a problem, and that it was their problem to manage (not cure).
Obesity appears to be a problem not unlike alcoholism, with recognizable genetic, psychological and physiological components. Sufferers deserve all the help the medical and scientific community can give them, as well as understanding and kindness from family, friends and society. But with all that help, they'll still have to work awfully hard to lose that 10 percent and keep it off.
It should be easier with the weight of the nation behind them, instead of working against them.
Colleen Pierre, a registered dietitian, is the nutrition consultant for the Union Memorial Sports Medicine Center and Vanderhorst & Associates in Baltimore.