Fat ... and getting fatter

For years, the average weight of Americans has crept resolutely upward despite widespread warnings from health officials that the costs associated with the ominous trend are enormous. A new report issued by the Centers for Disease Control and Prevention indicates just how fat Americans have become. It also calculates the direct and indirect costs of the nation's weight gain. The numbers truly are alarming, particularly for Tennesseans.

The weight-gain phenomenon is especially troublesome here. Tennessee (32.3 percent) is one of nine states in which the obesity rate was above 30 percent in 2009. Only Mississippi (34.4 percent) and Louisiana (33 percent) had higher rates. The crossing of the 30 percent threshold is grave news. No state, according to the CDC, had an obesity rate above 30 percent in 2000 and only three reached the 30 percent level in 2008. The understandable fear is that the upward trend will continue.

The rising number of obese Americans will be accompanied by significant medical costs. Obesity has long been associated with major health problems, including cancer, cardiac ailments, strokes and diabetes. Excess poundage also cuts mobility and contributes to breathing and sleeping disorders. It also can make it difficult for women to become pregnant and it can complicate pregnancies. The aggregate costs are astronomical.

The CDC estimates that obese individuals spend about $1,429 more annually in medical costs than people of normal weight. The national bill for obesity-related medical costs is estimated to be about $147 billion a year. Reducing obesity and related medical costs, then, could help the United States cut health care expenses that already are wrecking private and public budgets.

Identifying and quantifying U.S. obesity is not hard. Addressing it is.

Most people, kids included, don't exercise enough. Most eat too much and consume the wrong kinds of food. The typical U.S. diet contains too many high-calorie foods filled with sugar and fat rather than the fruits and vegetables that are essential to health. Yet changing U.S. exercise and dietary habits will be difficult.

Indeed, it will take an extraordinary national effort, buttressed by state and local programs to reverse the obesity epidemic. Communities must plan better - safe sidewalks, trails, playgrounds etc. - so individuals can walk and exercise rather than rely on a vehicle for every activity. Schools, even in tough financial times, should expand nutrition and PE classes. And individuals, business and industry and government must work together to create a mindset that supports healthy eating choices and an active lifestyle.

Useful programs are beginning to gain a toehold. Some local governments - including Hamilton County, where about 27 percent of adults are obese - have instituted broad-based efforts to inform the public about the dangers of obesity and about effective ways to combat it. Businesses, including some here, now provide fitness centers to employees at no cost. That's a start. Much more needs to be done.

Obesity is a complex, increasingly common, serious and costly problem with national ramifications. The best way to address it is to create and promote policies and programs at home, at school, at work and in the community that provide individuals with the information and the opportunity to make healthy lifestyle choices. That's easier said than done, but failure to do so likely will lead to a nation that is increasingly fat and unhealthy and that spends an unnecessarily high percentage of its income on medical care.

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