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Weight Epidemic
With Obesity Reaching Crisis Levels, Government Calls for Action
By Melinda T. Willis
Dec. 13
— Citing an epidemic of obesity, Surgeon General Dr. David Satcher today called on communities and schools to help children and adults lose weight and stay healthy.
Satcher identified schools as central to efforts to prevent and decrease excess weight problems, and recommended they improve physical education programs and provide healthy food alternatives. Communities also must offer safe places to exercise, he urged.
"Many people believe that dealing with overweight and obesity is a personal responsibility," Satcher states in the forward to the report. "To some degree they are right, but it is also a community responsibility."
Obesity Growing Across Age Groups
An estimated 300,000 deaths may be attributed to obesity in the United States each year, and more than 60 percent of adults in 1999 could be classified as overweight or obese, according to the new report from the surgeon general.
But the problem is not just a concern for adults. The prevalence of obesity for adolescents has nearly tripled in the past two decades, making early intervention all the more critical.
According to the report, in 1999, 13 percent of children between the ages of 6 and 11 and 14 percent of those aged 12 to 19 were overweight.
"Whereas one time obesity was a condition that usually afflicted more middle-aged women, now it has swept across the entire age span, even down to several years old," says Dr. Steven Heymsfield, deputy director of the New York Obesity Research Center at St. Luke's Roosevelt Hospital in New York.
And the younger a person begins to carry excess weight, the greater the potential impact on their future quality of life. Weight gain and obesity are major contributors to poor health, increasing the risk of a number of medical conditions including heart disease, diabetes, arthritis, asthma, and even certain cancers.
According to the report, obese individuals have a 50 to 100 percent greater risk of premature death from all causes compared to individuals without excess weight.
"When you take a 5-year-old who is obese and you think forward 60, 70, 80 years, that person's life is shortened by their excess weight," says Heymsfield.
Schools Called to Act
Among the surgeon general's "calls to action" is that physical education be provided for all children in grades K through 12, an idea supported by many educators who feel that PE should be mandatory.
"I definitely think that PE and recess should be required in schools, not only to fight obesity, but because our minds and bodies work together," says Nancy Martin-Finks, a guidance counselor at South River Elementary School in Grottoes, Va. "Schools should be required to supply physical education along with academics."
Some educators feel that the scope of physical education should go above and beyond exercise. "PE should be more than running around a track," says Rani G. Hawes, assistant principal at George C. Marshall High School in Falls Church, Va. "It should include how to live healthy, how to develop and exercise program and eating nutritious food."
The surgeon general's report also emphasizes the importance of healthy food and beverage options on school campuses and at school events. And experts agree that the availability of vending machines in many schools plays an important role in feeding the obesity epidemic.
"The school has become an adverse environment for children to go to," says Dr. Francis Kaufman, head of the division of endocrinology at Children's Hospital in Los Angeles. "Not only are we serving fast food [in schools], we're encouraging children to drink soda. The soft drink industry is bidding for our children and we're selling them."
Other recommendations for action include reducing the amount of time spent in sedentary behaviors like watching television, and building physical activity into regular routines. Children should get at least 60 minutes of moderate activity on most days of the week and adults should get at least 30.
Making children's health a priority shouldn't be difficult, say experts.
"This isn't going to cost zillions of dollars," says Kaufman. "We're not looking to reinvent something. We're looking to bring back what most of us had when we were growing up."
ABCNEWS' Monika Konrad contributed to this report.
Alarming Trend
Study: American Kids Just Keep Getting Fatter
The Associated Press
C H I C A G O, Dec. 12
— American children are getting fatter at an alarming rate, with the percentage of significantly overweight black and Hispanic youngsters more than doubling over 12 years and climbing 50 percent among whites, a study shows.
By 1998, nearly 22 percent of black children ages 4 to 12 were overweight, as were 22 percent of Hispanic youngsters and 12 percent of whites, according to researchers who analyzed data from a national survey.
In 1986, the same survey showed that about 8 percent of black children, 10 percent of Hispanic youngsters and 8 percent of whites were significantly overweight.
"Prior studies show it took 30 years for the overweight prevalence to double in American children," said Dr. Richard Strauss, a pediatrician at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School. This study should be "a call to action," said Strauss, who conducted the research with Harold Pollack of the University of Michigan.
Fast Food and TV Games
Among the reasons given for the increase: Children are spending much more time watching television, using computers and playing video games, and busy parents are relying more on fast food to feed their families.
Also, black and Hispanic youngsters are more likely to live in poor neighborhoods where outdoor exercise may be unsafe and where the quickest, easiest foods may not be the most nutritious, Strauss said.
The study was based on data from the National Longitudinal Survey of Youth, which followed a nationally representative sample of 8,270 youngsters from 1986 to 1998. The findings appear in Wednesday's Journal of the American Medical Association.
Overweight was defined as having a body-mass index higher than 95 percent of youngsters of the same age and sex, based on growth charts from the 1960s to 1980s. By some criteria, that would be considered obese. Body-mass index is a measurement of weight relative to height.
'Enormous Public Health Implications'
Disturbing trends also were seen in the number of children who had a body-mass index higher than 85 percent of their peers. In 1986, about 20 percent of blacks, Hispanics and whites alike were in that category. By 1998, those figures had risen to about 38 percent of blacks and Hispanics alike and nearly 29 percent of whites.
"These trends carry enormous public health implications, because of the known effects of excess body weight on the risk for type 2 diabetes, heart disease and other complications," said Dr. David Ludwig, director of the obesity program at Children's Hospital in Boston.
Dr. Rebecca Unger, a pediatrician and nutrition specialist at Children's Memorial Hospital in Chicago, said small changes in children's diets can make a big difference.
"If we can catch a 3-year-old who's still on a bottle, drinks tons and tons of juice, and goes to McDonald's five times a week, we can stop the bottle, cut out the juice, eat at McDonald's only two times a week — and you will see a tremendous difference in growth pattern," Unger said.
Round Numbers
The Math Behind the Growing Number of Obese Americans
Commentary by John Allen Paulos
Jan. 4
— Now may be a good time to remind ourselves that many of us are beginning to physically resemble the new palindromic year, 2002: wide, round, and symmetric-looking. A little arithmetic helps in assessing how heavy we've become.
American children, in particular, are fat and rapidly getting fatter. Furthermore, their fatness will likely lead to innumerable health problems as they age. These are the conclusions of a large study published last month in the Journal of the American Medical Association by Richard Strauss, a pediatrician at the Robert Wood Johnson Medical School in New Brunswick, N.J.
Oddly, the report also found that over 20 percent of minority children and approximately 12 percent of white children were at or above the 95th percentile in body mass (the definition of the body mass index, or BMI, appears below) and hence considered obese.
Fat Children and Bulging Percentiles
Given the children's heft, it is particularly intriguing to imagine how 20 percent of them could be shoehorned into 5 percent of the distribution of body mass (or any other measure). That is, how is it that fully 20 percent of the minority children in the study weighed more than 95 percent of minority children? (Similarly, 12 percent of white children in the study weighed more than 95 percent of white children.) This seems to be a variant of the situation in Lake Wobegon where all the children are above average.
The mini-mystery about the maxi-children is resolved when one realizes that the percentile rankings were based on body mass charts compiled decades ago. Twenty percent of today's minority children are as heavy as the heaviest 5 percent of minority children were between 1960 and 1980 (12 percent for white children).
Movement to Stop the Weight Gain
Resolving this seeming paradox underscores how serious the problem of childhood obesity is. Among the causes for its dramatic increase are the prevalence of junk food, lack of exercise, and excessive television and video watching. (Poverty is also a factor. Happily, the Segway Human Transporter is prohibitively expensive, but the new X-box promises countless hours of immobility.)
Among the consequences of obesity are increased rates of heart and circulatory disease, obstructive breathing disorders, and diabetes-related kidney, nerve, and vision problems. Furthermore, because of their youth, fat children have 40 years or more to develop these health problems.
Of course, this latest report doesn't reveal much more than a glance at the children standing around the local school playground. Having taken such a glance, Surgeon General Dr. David Satcher has called on schools to help children lose weight by improving physical education programs, instituting health awareness modules, and providing healthy food choices. (If so many schools weren't having enough trouble insuring basic literacy and numeracy, I might be less wary of this idea.)
Fat Adults and Round Numbers
And it's not just kids, of course. A trip to Europe or Asia, say, or a visit to the American heartland (perhaps stomachland is the more accurate term) makes our increasing rotundity quite clear.
According to some measures, more than 60 percent of American adults could be classified as either overweight or obese. Satcher estimates that because of the increased rates of the aforementioned diseases and conditions associated with it, obesity kills 300,000 Americans each year and rivals smoking as the leading cause of preventable death.
Statistical Sticking Points
Before the round number of 300,000 gains currency by being incessantly repeated, some arithmetical caveats regarding it should be raised. It is no doubt dependent on a variety of debatable assumptions.
What proportion of deaths from stroke, for example, ought we to attribute to obesity? How about deaths from diabetes? And how old, on average, are the people who die from obesity-aggravated diseases? What if one is obese for 20 years, permanently loses a lot of weight, and then dies from a heart attack 15 years later? What percentage of that death ought we to chalk up to obesity?
Different answers to these questions lead to widely different estimates of the number of deaths from obesity.
Problems with the definition of obesity are also difficult.
Do we use weight alone, historical charts, the body mass index or BMI (defined below), direct measurements of fat? And where do we place the cutoff lines without being too arbitrary? What about the special problems of defining early childhood obesity? How do we take into account a person's sex? Body-frame? Are there strong medical or normative reasons for our decisions? Is there any element of demonization of the obese present? Of cultural bias?
Obesity is an increasingly serious problem that can hasten death and lessen quality of life. Our response to it should be to lose our stomachs, not our heads.
Professor of mathematics at Temple University and adjunct professor of journalism at Columbia University, John Allen Paulos is the author of several best-selling books, including Innumeracy and A Mathematician Reads the Newspaper. His Who’s Counting? column on ABCNEWS.com appears every month.
What Is Body Mass Index?
One's body mass index, which takes into account one's height, is a better measure of health risk than is weight alone.
The BMI is defined to be equal to one's weight in pounds times 704.5 divided by the square of one's height in inches. (The square of a number is that number multiplied by itself. The odd number arises because the original definition was given in metric units.)
There are no definitive guidelines for what is healthy, but a BMI between 21 and 25 is generally considered ideal, 26 to 29 is overweight, and over 30 is obese.
The index was developed in the 19th century by Belgian statistician Adolphe Quetelet who stated that a BMI over 30 constituted obesity, a judgment still sound today.
With Obesity Reaching Crisis Levels, Government Calls for Action
By Melinda T. Willis
Dec. 13
— Citing an epidemic of obesity, Surgeon General Dr. David Satcher today called on communities and schools to help children and adults lose weight and stay healthy.
Satcher identified schools as central to efforts to prevent and decrease excess weight problems, and recommended they improve physical education programs and provide healthy food alternatives. Communities also must offer safe places to exercise, he urged.
"Many people believe that dealing with overweight and obesity is a personal responsibility," Satcher states in the forward to the report. "To some degree they are right, but it is also a community responsibility."
Obesity Growing Across Age Groups
An estimated 300,000 deaths may be attributed to obesity in the United States each year, and more than 60 percent of adults in 1999 could be classified as overweight or obese, according to the new report from the surgeon general.
But the problem is not just a concern for adults. The prevalence of obesity for adolescents has nearly tripled in the past two decades, making early intervention all the more critical.
According to the report, in 1999, 13 percent of children between the ages of 6 and 11 and 14 percent of those aged 12 to 19 were overweight.
"Whereas one time obesity was a condition that usually afflicted more middle-aged women, now it has swept across the entire age span, even down to several years old," says Dr. Steven Heymsfield, deputy director of the New York Obesity Research Center at St. Luke's Roosevelt Hospital in New York.
And the younger a person begins to carry excess weight, the greater the potential impact on their future quality of life. Weight gain and obesity are major contributors to poor health, increasing the risk of a number of medical conditions including heart disease, diabetes, arthritis, asthma, and even certain cancers.
According to the report, obese individuals have a 50 to 100 percent greater risk of premature death from all causes compared to individuals without excess weight.
"When you take a 5-year-old who is obese and you think forward 60, 70, 80 years, that person's life is shortened by their excess weight," says Heymsfield.
Schools Called to Act
Among the surgeon general's "calls to action" is that physical education be provided for all children in grades K through 12, an idea supported by many educators who feel that PE should be mandatory.
"I definitely think that PE and recess should be required in schools, not only to fight obesity, but because our minds and bodies work together," says Nancy Martin-Finks, a guidance counselor at South River Elementary School in Grottoes, Va. "Schools should be required to supply physical education along with academics."
Some educators feel that the scope of physical education should go above and beyond exercise. "PE should be more than running around a track," says Rani G. Hawes, assistant principal at George C. Marshall High School in Falls Church, Va. "It should include how to live healthy, how to develop and exercise program and eating nutritious food."
The surgeon general's report also emphasizes the importance of healthy food and beverage options on school campuses and at school events. And experts agree that the availability of vending machines in many schools plays an important role in feeding the obesity epidemic.
"The school has become an adverse environment for children to go to," says Dr. Francis Kaufman, head of the division of endocrinology at Children's Hospital in Los Angeles. "Not only are we serving fast food [in schools], we're encouraging children to drink soda. The soft drink industry is bidding for our children and we're selling them."
Other recommendations for action include reducing the amount of time spent in sedentary behaviors like watching television, and building physical activity into regular routines. Children should get at least 60 minutes of moderate activity on most days of the week and adults should get at least 30.
Making children's health a priority shouldn't be difficult, say experts.
"This isn't going to cost zillions of dollars," says Kaufman. "We're not looking to reinvent something. We're looking to bring back what most of us had when we were growing up."
ABCNEWS' Monika Konrad contributed to this report.
Alarming Trend
Study: American Kids Just Keep Getting Fatter
The Associated Press
C H I C A G O, Dec. 12
— American children are getting fatter at an alarming rate, with the percentage of significantly overweight black and Hispanic youngsters more than doubling over 12 years and climbing 50 percent among whites, a study shows.
By 1998, nearly 22 percent of black children ages 4 to 12 were overweight, as were 22 percent of Hispanic youngsters and 12 percent of whites, according to researchers who analyzed data from a national survey.
In 1986, the same survey showed that about 8 percent of black children, 10 percent of Hispanic youngsters and 8 percent of whites were significantly overweight.
"Prior studies show it took 30 years for the overweight prevalence to double in American children," said Dr. Richard Strauss, a pediatrician at the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School. This study should be "a call to action," said Strauss, who conducted the research with Harold Pollack of the University of Michigan.
Fast Food and TV Games
Among the reasons given for the increase: Children are spending much more time watching television, using computers and playing video games, and busy parents are relying more on fast food to feed their families.
Also, black and Hispanic youngsters are more likely to live in poor neighborhoods where outdoor exercise may be unsafe and where the quickest, easiest foods may not be the most nutritious, Strauss said.
The study was based on data from the National Longitudinal Survey of Youth, which followed a nationally representative sample of 8,270 youngsters from 1986 to 1998. The findings appear in Wednesday's Journal of the American Medical Association.
Overweight was defined as having a body-mass index higher than 95 percent of youngsters of the same age and sex, based on growth charts from the 1960s to 1980s. By some criteria, that would be considered obese. Body-mass index is a measurement of weight relative to height.
'Enormous Public Health Implications'
Disturbing trends also were seen in the number of children who had a body-mass index higher than 85 percent of their peers. In 1986, about 20 percent of blacks, Hispanics and whites alike were in that category. By 1998, those figures had risen to about 38 percent of blacks and Hispanics alike and nearly 29 percent of whites.
"These trends carry enormous public health implications, because of the known effects of excess body weight on the risk for type 2 diabetes, heart disease and other complications," said Dr. David Ludwig, director of the obesity program at Children's Hospital in Boston.
Dr. Rebecca Unger, a pediatrician and nutrition specialist at Children's Memorial Hospital in Chicago, said small changes in children's diets can make a big difference.
"If we can catch a 3-year-old who's still on a bottle, drinks tons and tons of juice, and goes to McDonald's five times a week, we can stop the bottle, cut out the juice, eat at McDonald's only two times a week — and you will see a tremendous difference in growth pattern," Unger said.
Round Numbers
The Math Behind the Growing Number of Obese Americans
Commentary by John Allen Paulos
Jan. 4
— Now may be a good time to remind ourselves that many of us are beginning to physically resemble the new palindromic year, 2002: wide, round, and symmetric-looking. A little arithmetic helps in assessing how heavy we've become.
American children, in particular, are fat and rapidly getting fatter. Furthermore, their fatness will likely lead to innumerable health problems as they age. These are the conclusions of a large study published last month in the Journal of the American Medical Association by Richard Strauss, a pediatrician at the Robert Wood Johnson Medical School in New Brunswick, N.J.
Oddly, the report also found that over 20 percent of minority children and approximately 12 percent of white children were at or above the 95th percentile in body mass (the definition of the body mass index, or BMI, appears below) and hence considered obese.
Fat Children and Bulging Percentiles
Given the children's heft, it is particularly intriguing to imagine how 20 percent of them could be shoehorned into 5 percent of the distribution of body mass (or any other measure). That is, how is it that fully 20 percent of the minority children in the study weighed more than 95 percent of minority children? (Similarly, 12 percent of white children in the study weighed more than 95 percent of white children.) This seems to be a variant of the situation in Lake Wobegon where all the children are above average.
The mini-mystery about the maxi-children is resolved when one realizes that the percentile rankings were based on body mass charts compiled decades ago. Twenty percent of today's minority children are as heavy as the heaviest 5 percent of minority children were between 1960 and 1980 (12 percent for white children).
Movement to Stop the Weight Gain
Resolving this seeming paradox underscores how serious the problem of childhood obesity is. Among the causes for its dramatic increase are the prevalence of junk food, lack of exercise, and excessive television and video watching. (Poverty is also a factor. Happily, the Segway Human Transporter is prohibitively expensive, but the new X-box promises countless hours of immobility.)
Among the consequences of obesity are increased rates of heart and circulatory disease, obstructive breathing disorders, and diabetes-related kidney, nerve, and vision problems. Furthermore, because of their youth, fat children have 40 years or more to develop these health problems.
Of course, this latest report doesn't reveal much more than a glance at the children standing around the local school playground. Having taken such a glance, Surgeon General Dr. David Satcher has called on schools to help children lose weight by improving physical education programs, instituting health awareness modules, and providing healthy food choices. (If so many schools weren't having enough trouble insuring basic literacy and numeracy, I might be less wary of this idea.)
Fat Adults and Round Numbers
And it's not just kids, of course. A trip to Europe or Asia, say, or a visit to the American heartland (perhaps stomachland is the more accurate term) makes our increasing rotundity quite clear.
According to some measures, more than 60 percent of American adults could be classified as either overweight or obese. Satcher estimates that because of the increased rates of the aforementioned diseases and conditions associated with it, obesity kills 300,000 Americans each year and rivals smoking as the leading cause of preventable death.
Statistical Sticking Points
Before the round number of 300,000 gains currency by being incessantly repeated, some arithmetical caveats regarding it should be raised. It is no doubt dependent on a variety of debatable assumptions.
What proportion of deaths from stroke, for example, ought we to attribute to obesity? How about deaths from diabetes? And how old, on average, are the people who die from obesity-aggravated diseases? What if one is obese for 20 years, permanently loses a lot of weight, and then dies from a heart attack 15 years later? What percentage of that death ought we to chalk up to obesity?
Different answers to these questions lead to widely different estimates of the number of deaths from obesity.
Problems with the definition of obesity are also difficult.
Do we use weight alone, historical charts, the body mass index or BMI (defined below), direct measurements of fat? And where do we place the cutoff lines without being too arbitrary? What about the special problems of defining early childhood obesity? How do we take into account a person's sex? Body-frame? Are there strong medical or normative reasons for our decisions? Is there any element of demonization of the obese present? Of cultural bias?
Obesity is an increasingly serious problem that can hasten death and lessen quality of life. Our response to it should be to lose our stomachs, not our heads.
Professor of mathematics at Temple University and adjunct professor of journalism at Columbia University, John Allen Paulos is the author of several best-selling books, including Innumeracy and A Mathematician Reads the Newspaper. His Who’s Counting? column on ABCNEWS.com appears every month.
What Is Body Mass Index?
One's body mass index, which takes into account one's height, is a better measure of health risk than is weight alone.
The BMI is defined to be equal to one's weight in pounds times 704.5 divided by the square of one's height in inches. (The square of a number is that number multiplied by itself. The odd number arises because the original definition was given in metric units.)
There are no definitive guidelines for what is healthy, but a BMI between 21 and 25 is generally considered ideal, 26 to 29 is overweight, and over 30 is obese.
The index was developed in the 19th century by Belgian statistician Adolphe Quetelet who stated that a BMI over 30 constituted obesity, a judgment still sound today.
