Weight of the Nation

A perspective article, NEJM 2012; 367: 389-391, addresses the topic of whether Americans are ready to solve the problem of obesity.  Short answer: No!

The article discusses the Institute of Medicine (IOM) report “Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation” along with the accompanying HBO documentary (HBO: The Weight of the Nation).

“The centerpiece of THE WEIGHT OF THE NATION campaign is the four-part documentary series, each featuring case studies, interviews with our nation’s leading experts, and individuals and their families struggling with obesity. The first film, CONSEQUENCES, examines the scope of the obesity epidemic and explores the serious health consequences of being overweight or obese. The second, CHOICES, offers viewers the skinny on fat, revealing what science has shown about how to lose weight, maintain weight loss and prevent weight gain. The third, CHILDREN IN CRISIS, documents the damage obesity is doing to our nation’s children. Through individual stories, this film describes how the strong forces at work in our society are causing children to consume too many calories and expend too little energy; tackling subjects from school lunches to the decline of physical education, the demise of school recess and the marketing of unhealthy food to children. The fourth film, CHALLENGES, examines the major driving forces causing the obesity epidemic, including agriculture, economics, evolutionary biology, food marketing, racial and socioeconomic disparities, physical inactivity, American food culture, and the strong influence of the food and beverage industry.”

While the IOM report identifies a need for structural changes in our environment, public opinion consistently focuses on personal responsibility.

  • 64% identify overeating, lack of exercise, and watching too much TV as the biggest causes
  • 18% identify external factors as the biggest causes, including exposure to junk food, lack of safe places to play, limited availability of healthy foods

Obstacles for addressing this problem also include the following:

  • Obesity-prevention efforts may further stigmatize individuals. The article specifically cites criticism aimed at ‘ads that aired in Georgia;’ these were pulled after concerns of increasing obesity stigma.
  • “Issue-attention cycle” problem.  “This pattern occurs when initial public alarm over the discovery of a problem and optimism about its quick resolution are replaced by the realization that solving the problem will require some public sacrifice and will displace powerful societal interests.”

Related blog posts:

Is obesity neglect?

NAFLD Guidelines 2012

Treating diabetes with surgery

Lower leptin with physical activity

Staggering cost of obesity

9 thoughts on “Weight of the Nation

  1. Kudos and thanks Jay! The post on your blog is not only timely but should make everyone on either side of the healthcare industry providers and consumers concerned! Moreover who would have thought 15 years ago that adult-onset diabetes would have to be called type 2 diabetes because so many children acquired this condition or that signs of coronary artery disease would actually begin and be found in pre-teens!
    If there isn’t a major change on culture as pediatric providers we are looking at a generation of children who will not outlive their parents.

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