Government intervention, personal resolve needed to fight obesity

January 01, 2007|By Cynthia Tucker

ATLANTA -- There are many Americans who remain deeply skeptical of government involvement in affairs of personal health - whether laws regulating seat-belt use or bans on smoking in public places. But the data are clear: When government starts a crusade to improve habits of personal health, from seat-belt use to breast cancer screening, lives are saved and disabilities avoided.

It's high time, then, for government to use its powers of persuasion - and coercion - to confront the obesity crisis and its impact on public health. Although we're all aware of the damage done by those added pounds, few of us have the discipline to get rid of them. That might change if federal and state governments used all the levers at their disposal to push us in the right direction.

Think of the four-decade effort to curb smoking. In 1964, U.S. Surgeon General Luther Terry issued a report linking cigarettes to lung cancer. Back then, about 68 percent of American men (and an unknown percentage of American women) smoked, and cigarettes were synonymous with glamour. Now, only about 20 percent of American adults - 23 percent of men, 18 percent of women - report that they smoke regularly.

It wasn't easy to change such an ingrained habit. It took a variety of initiatives: public awareness campaigns, laws banning smoking, civil lawsuits against tobacco companies. But that broad-based war on smoking worked.

Something similar - equally far-reaching and long-term - will be required to curb obesity and its clear consequences, notably the increase in diabetes. The number of diabetics has increased 80 percent over the last decade, according to The New York Times.

Perhaps the most alarming news about diabetes is the sharp increase in Type 2, usually associated with lifestyle factors, in children. As kids have grown fatter, a disease that had been largely associated with middle-aged adults has turned up increasingly in youngsters. Many careful diabetics live normal lives, but others are stricken by kidney failure, blindness and amputation. The increase in diabetes in children has led some public health experts to predict that this generation of American children may be the first whose average life span is shorter than that of their parents.

So, what should the government do - ban fatty foods? Interestingly, The New York City Board of Health recently instituted a ban on the use of most artificial trans fats in restaurants there. Although that experiment will be useful to watch, it will likely be decades, if ever, before other locales, especially those in the Deep South, are willing to go that far.

Medicaid and Medicare, both government-funded health insurance programs, have only recently begun to offer physicians incentives to keep their patients healthy. Research has found that overweight patients who are treated to a broad range of practical interventions - including, in some cases, nutritionists who visit their homes and rummage through their refrigerators and pantries - are able to adhere to changes in diet and exercise more readily than patients who are not similarly nagged.

Of course, those interventions are costly up front. But they save money for insurance companies and for the national budget over the long haul. A patient who loses weight and exercises is less likely to end up severely incapacitated by heart disease, diabetes or other ills.

Meanwhile, there's no reason to wait for your insurance company to send a nutritionist to overhaul your kitchen. You can make some relatively simple changes to your lifestyle that will pay off in years to come. Forget about the radical New Year's resolutions that you know you won't keep. Instead, resolve to cut your trips to fast-food outlets in half.

An aunt of mine, a 69-year-old diabetic, lost 70 pounds over 2 1/2 years after she took a part-time job as secretary at her church. The church has no soda machines, and she doesn't like to leave the phones untended to fetch lunch from a fast-food restaurant. So she's forced to eat her packed lunch, which is usually fruit. Her success came without nutritionists, personal trainers or those weird machines sold on infomercials.

Yours can, too.

Cynthia Tucker is editorial page editor for The Atlanta Journal-Constitution. Her column appears Mondays in The Sun. Her e-mail is cynthia@ajc.com.

Columnist Steve Chapman is on vacation.

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