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Where Healthcare Meets Policy

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The Real Story Behind Obesity

Obesity Is an Urgent Epidemic, But Current Solutions Are Adaptive Instead of Prescriptive: 

Obesity Is an Urgent Epidemic, But Current Solutions Are Adaptive Instead of Prescriptive 2003: andgt;103,000 gastric bypass surgeries 7% complication rate Sources: U.S. Department of Health and Human Services. The Surgeon General's call to action to prevent and decrease overweight and obesity: what you can do; 2001. Centers for Disease Control and Prevention. Prevalence of Overweight and Obesity Among Adults: United States, 1999-2002. Available at: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/obese/obse99.htm. Accessed October 13, 2004. Newman C. Why Are We So Fat? National Geographic. August 2004. 1. Intervention continues to trump prevention 2. Diseases are siloed as if unlinked by physiologic and pathophysiologic processes 3. Disease burden segregates by gender and race In our health care system:

Many Measures Signal the Acceptance of the Inevitability of Obesity: 

Many Measures Signal the Acceptance of the Inevitability of Obesity Puget Sound ferry: seat width 18'  20' Colorado ambulances: hydraulic winch can lift 1,000-pound human Indiana caskets: 38' width option Source: Newman C. Why Are We So Fat? National Geographic. August 2004.

The Science of Obesity Is Complex and in Its Infancy: 

The Science of Obesity Is Complex and in Its Infancy 1994 – Leptin was discovered at Rockefeller University 'We like to think that eating is a voluntary act. But the amount you eat is controlled in part by how much fat you have.' – Dr. Michael Schwartz, University of Washington Researchers and scientists took a fresh look at obesity – was it more than a reflection of greed and weak will? Sources: Rockefeller Researchers Clone Gene for Obesity. December 1, 1994. Available at: http://www.healthpolitics.com/home.asp?show=all. Underwood A, Adler J, Hand K, Ulick J. What You Don’t Know About Fat. Newsweek. 2004;144:40-47.

The Fat Cell Is a Veritable Endocrine Factory: 

The Fat Cell Is a Veritable Endocrine Factory Leptin Adiponectin Resistin Angiotensinogen IL-6 TNF-Alfa Cortisol Stored Triglycerides Fat cells are continually absorbing or releasing substances in response to the body’s energy needs Fat cells are better adapted to preserving calories than shedding them Source: Underwood A, Adler J, Hand K, Ulick J. What You Don’t Know About Fat. Newsweek. 2004;144:40-47. Fat Cell

Obesity Is an Increasingly Common Childhood Condition: 

Obesity Is an Increasingly Common Childhood Condition Age 6 to 11: 4%  13% Age 12 to 19: 5%  14% Growth in Childhood Obesity Over Three Decades If obese at age 6  50% chance of life-long obesity If obese at age 13  75% chance of life-long obesity Blacks Mexican Americans Age 6–19 50% more likely to be obese than whites Sources: National Center for Health Statistics. 1999 National Health and Nutrition Examination Survey (NHANES). Hyattsville, MD: U.S. Department of Health and Human Services. 1999. Moran R. Evaluation and treatment of childhood obesity. Am Fam Physician. 1999;59:758, 761-2. Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KF. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. JAMA. 2004;291:2847-2850.

Obesity Loves Inequity: 

Obesity Loves Inequity BMI andgt;40: Morbidly Obese Male 60% 29% 4% Female 78% 50% 15% BMI andgt;30: Obese BMI andgt;25: Overweight Obese 27% 23% 21% 16% Diabetic 13% 8% 8% 6% Black Mex. Amer. Male 74% 29% 2% Female 72% 40% 6% White Male 68% 28% 3% Female 58% 31% 5% College Some College High School No High School Sources: American Obesity Association. Obesity in Minority Populations. Available at: http://www.obesity.org/subs/fastfacts/Obesity_Minority_Pop.shtml. Accessed October 26, 2004. 2001 Obesity and Diabetes Prevalence Among U.S. Adults by Selected Characteristics. CDC. Nutrition and Physical Activity. Obesity Trends. Available at: http://www.cdc.gov/nccdphp/dnpa/obesity/trend/obesity_diabetes_characteristics.htm. Accessed October 13, 2004.

Obesity Virtually Guarantees Bad Health: 

Obesity Virtually Guarantees Bad Health Diseases Tied to Obesity 'For most of evolution, getting enough to eat was a driving force for survival. How many individuals were lost to morbid obesity?' – Dr. Bruce Spiegelman, Harvard Medical School Hypertension Type 2 diabetes High lipids Cardiovascular disease Gallbladder disease Osteoarthritis Stroke Respiratory disease Some cancers Sources: U.S. Department of Health and Human Services. The Surgeon General's call to action to prevent and decrease overweight and obesity: what you can do; 2001. Underwood A, Adler J, Hand K, Ulick J. What You Don’t Know About Fat. Newsweek. 2004;144:40-47.

To Address Obesity, Target the Molecule, Cell, and Population; Not the Individual: 

To Address Obesity, Target the Molecule, Cell, and Population; Not the Individual 'In the human body, as in the world, if you control fuel resources, you influence a lot of other things as well.' Molecular/Chemical Level Population  prosperity :  calories since 1971 + 335 cal/day for women + 168 cal/day for men  technology:  exertion  indoor entertainment:  sedentary behavior  marketing of poor food: poorer nutrition Fat Cell Not a by-product of individual greed and guilt An active organ in its own right Sources: U.S. Department of Health and Human Services. The Surgeon General's call to action to prevent and decrease overweight and obesity: what you can do; 2001. Newman C. Why Are We So Fat? National Geographic. August 2004. Underwood A, Adler J, Hand K, Ulick J. What You Don’t Know About Fat. Newsweek. 2004;144:40-47. – Dr. Gökhan Hotamisligil, Harvard School of Public Health

What’s the Real Story Behind Obesity?: 

What’s the Real Story Behind Obesity? Before investing more in the problem, rather than the solution, consider: Scientists experimenting with the lipid cell Decreasing quantity and increasing quality of our diets Getting outdoors Why are children, women, and minorities targets? Are the current investments really the way to go?

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The Real Story Behind Obesity Where Healthcare Meets Policy Release Date: 11/10/2004 www.healthpolitics.com