Childhood Obesity: Let's Act Before We Lose a Generation

Sept. 12, 2009— -- The U.S. Department of Health and Human Services has just announced another collaboration with the Ad Council to help fight childhood obesity. The latest campaign, developed pro bono by Warner Bros. pictures, features characters from the film,"Where the Wild Things Are," adapted from Maurice Sendak's classic children's book of the same name.

Public service announcements donated by radio, print, television and Internet media will attempt to convince kids and their parents that leading a healthy lifestyle is important.

We can't get enough of this message about healthy lifestyle, because the news on obesity, and especially childhood obesity, is grim. And it's getting worse. The last few months have seen a raft of reports on obesity, all sending a clear message: obesity is overwhelming us.

It's damaging us physically, leading to increases in diabetes, arthritis, heart disease and other chronic conditions. And it's breaking us financially, as our health care system buckles under the weight of the cost of treatments for these diseases.

The Centers for Disease Control and Prevention, the Trust for America's Health, and the Robert Wood Johnson Foundation proclaimed America fatter than ever in two separate studies issued in July. More than 26 percent of the population is now fully obese and two-thirds are either overweight or obese.

Three other studies that same month detailed obesity's financial impact. The Agency for Healthcare Research and Quality said spending on obese patients over five years soared more than 80 percent to exceed $303 billion in 2006, up from $167 billion in 2001. The journal Health Affairs published a study indicating that the cost of hospitalizing obese children between 1999 and 2005 nearly doubled, with twice as many children requiring such care. A third study by the nonprofit group RTI International said obesity-related diseases account for 9.1 percent of all medical spending in the U.S., reaching an estimated $147 billion dollars in 2008 alone -- double the amount of just a decade ago. The findings prompted the report's lead researcher to say, "Obesity is the single biggest reason for the increase in health care costs."

Childhood Obesity a Growing Problem

In August, yet another study in the journal Academic Pediatrics showed the rate of severe obesity among U.S. children and teenagers age 2 to 19 has more than tripled over the past three decades and risen more than 70 percent since 1994. Even here in Massachusetts, with universal health care, nearly one-third of our middle and high school students are overweight or obese.

What's frightening in these reports is what's happening to our young people. Childhood obesity is particularly insidious because the health effects of obesity at a young age can last a lifetime. If nothing changes, we'll continue to see spending rise to higher and higher levels, and we may see an entire generation burdened with the long-term effects of a condition that might have been prevented.

Adults recognize the issue. The University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health again in 2009 ranked obesity as the top child health concern of adults, outranking all other threats, including drug abuse, smoking, bullying, and Internet safety. The survey also found blacks and Hispanics rank obesity as the number one health issue for the first time.

Promotions, like those by HHS, are all well and good; they call attention to the problem and keep it before the public. But the best solutions to the problem of childhood obesity likely rest with the notions of individual responsibility and parental supervision.

Steps to a Healthier Childhood

Young people and their parents -- because parental supervision and their roles in setting examples are critical to reversing the trend -- must "take stock" of their exercise and eating habits, and a new school year presents an opportune time to do so. Let me offer the following as steps to a healthier lifestyle.

Check your body mass index, to see what a healthy weight is for your size. Visit the Massachusetts Medical Society at www.massmed.org/healthyweight or the Centers for Disease Control at www.cdc.gov/bmi.

Monitor the quality of your diet at mypyramid.gov, a U.S. Department of Agriculture site offering help on planning and evaluating food choices.

Monitor your weight regularly, either weekly or bi-weekly, to chart progress.

Limit those "fast foods" with high-calorie, low-nutrition content.

Increase portion sizes of salads, vegetables and fruits; decrease sizes of higher calorie foods like pasta and bread.

Drink more water and less juice or energy drinks.

Eat fruit or vegetables for snacks instead of chips, crackers, or cookies.

Don't skip meals, especially breakfast, because you'll only eat more later. If you're "eating on the run," drink a low-calorie, no-sugar-added, nutritional drink.

Plan exercise into your schedule, like walking, bicycling, or in-line skating. Use the stairs, take exercise breaks while studying, or walk home from school if possible.

Get more sleep, at least 8-9 hours per night. This helps avoid extra calories from late night snacking.

Include calcium in your diet, such as low fat yogurt, fat-free chocolate milk, or low fat pudding.

The equation is simple: it's calories in, calories out. If you take in more calories than you expend, you gain weight. If you take in less, you lose weight. We have to move more, eat less, and eat better. These tips need not be done all at once. You can adopt a few at a time, as small steps over time can make a big difference. Don't worry if you fall back once in a while. The important thing is to keep at it. And one final note. Those suggestions above? They work just as well for adults, too.

Denise C. Rollinson, M.D., a diplomat of the American Board of Physician Nutrition Specialists, is chair of the Massachusetts Medical Society's Committee on Nutrition and Physical Activity.