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Obesity Rates Rise 90% in 17 States Since 1995, Adding Cost

Waistlines and Health Bills Bulge as South Gets Fatter
Bigger servings and portions that can be consumed on the go are driving the trend towards higher obesity rates, according to public health researchers. Photographer: Matthew Staver/Bloomberg

Obesity rates climbed at least 90 percent in 17 states from 1995 to last year, gains that have a direct bearing on U.S. health spending, according to a report.

Nine of the 10 states with the highest obesity rates are in the U.S. South, led by Mississippi at 34 percent, Alabama and West Virginia, according to the report today by the Trust for America’s Health and Robert Wood Johnson Foundation. Those states also lead the nation in diabetes and high blood pressure, the report found. Michigan was listed as 10th at 31 percent.

Medicare and Medicaid, the public health plans, each spend more than 20 percent of their budget to treat illnesses related to obesity and smoking, avoidable medical risks. The report’s authors called on U.S. lawmakers to refrain from cutting programs to fight the condition.

“We can’t afford to ignore the impact obesity has on our health and corresponding health-care spending,” said Jeff Levi, executive director of the Trust for America’s Health, in a statement accompanying the report.

The survey’s authors dubbed a swath of 644 counties in 15 mostly southern states the “diabetes belt,” as reported in the Journal of Preventive Diseases. Colorado, the slimmest state with a 20 percent obesity rate, had the second-smallest rise since 1995, though its rate is still higher than Mississippi’s was at that time, according to the study.

Bigger Servings

Obesity is defined as having a body mass index above 30. A six-foot-tall adult man weighing 221 pounds (100 kilograms) or more is considered obese, as is an adult woman standing five feet, six inches tall weighing 186 pounds or more, according to the U.S. National Institutes of Health. People with obesity are at higher risk for diabetes and hypertension, according to the U.S. Centers for Disease Control and Prevention.

Bigger servings and food that’s consumed on the go aren’t helping, said Steven Gortmaker, a professor at the Harvard University School of Public Health in Cambridge, Massachusetts.

“It’s gotten easier and easier to consume lots of foods at more times of the day,” he said in a telephone interview. “That’s been the biggest shift in the last 20 years.”

U.S. lawmakers have considered using tax policy to influence eating habits. A tax on sugar-sweetened beverages, including products made by Coca-Cola Co. and PepsiCo Inc., was discussed and eventually rejected during debate on the 2010 health-care law.

Obesity Costs

Colorado Director of Prevention Services Chris Lindley said that while his state is the slimmest, it has still lost ground. “Just like the rest of the country, we’re continuing to grow,” he said in a telephone interview. Obesity-related health conditions cost the state more than $1 billion a year, he said.

Children get half their daily calories in school, said Robert Wood Johnson Foundation Senior Vice President James Marks in discussing the report.

In response, Colorado and at least 34 other states have made school and childhood nutrition a priority. Colorado requires 30 minutes of physical activity a day for children, encourages schools to buy locally grown food and make healthier meals, and has hospitals encourage mothers to breast-feed during the first six months of a baby’s life.

Lindley’s state is among the nation’s most physically active, he said. “A lot of people move to Colorado to be active and stay active, and that helps us out,” he said of the state’s low obesity ranking.

Overweight Children

Similar efforts are taking place elsewhere in the U.S. The nonprofit Partnership for a Healthier America in Washington works with companies including Wal-Mart Stores Inc. to sell healthier food at the same cost as regular fare, and is helping Bain Capital Inc.’s day-care company Bright Horizons make sure children get exercise and don’t eat unhealthy foods.

The group also is involved with First Lady Michelle Obama’s “Let’s Move!” campaign to reduce childhood obesity.

The first lady has made fighting childhood obesity a top priority. She’s pushed companies to make food labeling easier to understand, reduce food advertising to children and to increase exercise levels. The “Let’s Move” campaign, launched in 2010, also seeks to get healthier meals in schools.

Levi, the study author, emphasized that it will take years to get the obesity epidemic under control. “This is not a national diet that will be over in a couple of months,” he said on a conference call discussing the report. The goal is to get Americans’ weight back to where it was in the 1970s, when researchers started studying the country’s newly bulging waistlines, he said.

Healthier Choices

A combination of fewer calories, healthier foods and more physical activity is needed to start cutting pounds. Drastic solutions like weight loss surgery and prescription drugs are costly, last-ditch efforts meant only for people already suffering complications from their weight, not a society-wide solution, said Levi.

Instead, Americans need to be able to easily make healthier choices, he and Gortmaker said. To that end, a food labeling provision incorporated into the 2010 health-care overhaul requires chain restaurants with more than 20 U.S. locations to list calorie counts for items they serve. A 2008 rule in New York City required restaurants to add calorie counts to menus.

Restaurants fought the New York rules, and movie theater chains that serve snacks and drinks fought being included as well. A serving of popcorn at the theater contains as many as 1,460 calories.

$833 Million in Cuts

The report’s authors urged lawmakers to restore $833 million in federal budget cuts in fiscal year 2011 to programs designed to improve nutrition in child-care settings and nutrition assistance programs.

Other recommendations include protecting the Centers for Disease and Control budget from cuts that would hurt obesity prevention, implementing suggested U.S. Department of Agriculture rules for school health programs and the National Physical Activity Plan, a program that includes a grassroots advocacy effort.

“The overriding desire is to make the healthier choice the easier choice,” said Larry Soler, the chief executive officer of the anti-obesity group Partnership for a Healthier America, by phone.

Soler said his organization is working with retailers to get more fresh fruit and vegetables available in locations without large grocery stores.

The easiest solution for many people is to simply eat less, said Gortmaker. He recommends replacing soda and other sugared drinks with water, especially for children.

To change a child’s balance between calories expended and consumed during the day by 150, the child may either spend almost two hours walking, or drink one less soda. “That’s one of the easiest changes to make,” he said.

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