Childhood Obesity: Attacking a Crushing Epidemic

Carla, one of my patients, stands 5 feet 4 inches tall and weighs just over 250 pounds.

She finds it difficult to walk more than 50 feet without extreme shortness of breath.

Her weight has brought on diabetes, requiring insulin shots. It has made it so difficult for her to breathe while asleep that she needs a breathing machine at night to keep her airway open.

She is ashamed of her appearance and dreads being around her peers. She is isolated and cannot enjoy activities most people take for granted.

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Carla is 15 years old. She is just one of my young patients who are overweight or obese.

As most people know, the United States is in the midst of an epidemic of overweight and obesity. In fact, two thirds of American adults are either overweight or obese.

And that is just adults. Unfortunately, this epidemic also affects children like Carla.

This week, the White House Task Force on Childhood Obesity released its report on how we as a society can attack this enormous challenge.

The future they outline -- and which they hope to prevent -- is scary. Today, one third of all children ages 2-19 are overweight or obese. The authors point out that most of these children will end up with diabetes sometime during their lifetime.

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The costs of obesity, even today, are staggering. About 112,000 Americans die each year due to obesity-related diseases. Care for overweight- and obesity-induced conditions bring on $150 billion in health care expenditures each year, a figure that is bound to increase.

The generation of children born in 2000 will likely live shorter life spans their parents. Economic productivity of this generation will probably be less than their parents as well. Indeed, an obese adult adds $1,400 excess health care costs annually compared with his or her non-obese peers.

And these figures represent only the economic costs.

Obesity among youth impacts military readiness, for example. And it exacts a tremendous emotional toll the individual -- adult or child.

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Like Carla, whose name has been changed to protect her privacy.

Action Needed to Stem Childhood Obesity

As bad as all this sounds, there are steps we can take as a society to reduce, if not eliminate, the impending calamity.

Many of these steps suggested by the Task Force involve societal action.

Starting in 2011, for example, the Patient Protection and Affordable Care Act will require nutritional information to be listed on chain restaurant menus. This can promote healthier food choices.

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The federal government can also work to limit children's exposure to marketing of junk food and sugary cereals and drinks.

Federally sponsored school lunch and breakfast programs can offer a greater selection of lower-fat, lower-sugar foods.

The federal government, at the national level, can also tax sugar-sweetened beverages. This action is something the beverage industry, including Coca Cola and Pepsi, have vigorously fought against.

Local and state governments can also join the fray.

School boards might reinstate physical education programs, for example. Or eliminate vending machines in schools. Municipalities can lay out walking paths, or make it easier (and safer) for children to walk to school.

In many of these activities, organized medicine should take the lead.

One glaring example would be for the American Academy of Family Physicians -- the professional organization to which I belong -- to rescind its sponsorship by the Coca Cola Company for "health education."

The AAFP's patient website, familydoctor.org, recently received a grant "in the strong six figures" to promote "education" on sweetened beverages and hydration. All supported by Coca Cola, which, coincidentally, is fighting against a beverage tax.

In 2007, the AAFP supported a similar tax policy -- a tobacco tax to reduce smoking and to help pay for the State Children's Health Insurance Program.

(Editor's note: Following the publication of this column, the president of the AAFP, Dr. Lori Heim, responded that the organization does, in fact, support a tax on sweetened beverages.)

Childhood Obesity a Societal Problem

Other national organizations can also take the lead. One outstanding example is the Campaign for Commercial-Free Childhood, which has already been tackling the problem of unhealthy marketing to children.

In the final analysis, though, it all comes back to individual patients with names, faces, parents and siblings. Families that often struggle with weight-related conditions together, in cultures that promote unhealthy lifestyles.

Emotions aside, we literally cannot afford to forget children like Carla.

Dr. John Spangler is director of tobacco intervention programs and a professor of family medicine at Wake Forest University School of Medicine in North Carolina.

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