Wednesday, October 27, 1999
Obesity epidemic is killing thousands
Studies find U.S. citizens getting fatter
BY ROBERT JABLON
The Associated Press
Obesity is a U.S. epidemic that has surged in the past decade and now affects nearly one in five adults, killing some 300,000 a year, a collection of new studies suggest.
The studies, in today's Journal of the American Medical Association, are the latest to spread the warning that Americans are getting fatter — and that fat kills.
“Obesity is a major cause of mortality in the United States,” one of the surveys concluded.
Another predicted that if weight prevention isn't addressed seriously, “the health-care system will increasingly be overwhelmed with individuals who require treatment for obesity-related health conditions.”
It's happening already, one Cincinnati physician said.
“We're probably at that point right now,” said Dr. Conrad Harper, internal medicine specialist with Alliance Primary Care in Forest Park. “I see it all the time.”
Patients often understand the connection between their weight and common health problems such as heart disease, high blood pressure, diabetes
and joint pain, Dr. Harper said, “but many times, for whatever reason, they are not doing anything about it.People suffer from being overweight, and there are situations where people could be off medications if they would just lose some weight. It would save them money, save them time, save them the long-term effects of obesity later on.
“But some people, quite frankly, just don't want to.”
Because some of the JAMA findings are based on surveys that asked people to divulge their own weight and height, researchers think Americans may be even fatter than the studies indicate. Why? Most people, when asked, underestimate how much they weigh.
Cincinnati-area health experts cite several factors for the ballooning of America. Among them: bigger and bigger portions of fast- and packaged food, the yo-yo effect of fad diets, less physical activity among adults and children and even a spiritual vacuum that sends people to readily available food for comfort.
“I love food,” said Diana Spillman, associate professor of dietetics at Miami University, “but I've found that food isn't necessarily going to give me the happiness I'm looking for. It's time that people get serious and take a lot of the responsibility for their own health into their own hands.”
One of the JAMA studies, by the U.S. Centers for Disease Control and Prevention (CDC), showed the number of Americans considered obese — defined as being more than 30 percent over their ideal body weight — soared from about one in eight in 1991 to nearly one in five last year. In 1991, four out of 45 participating states had obesity rates of 15 percent or higher, while the figure for 1998 was 37 states, according to the study.
Another study found 63 percent of men and 55 percent of women are overweight or obese.
A state-by-state breakdown shows that from 1991-98, the prevalence of obesity jumped from 14.9 percent to 19.1 percent in Ohio, 14.8 percent to 19.5 percent in Indiana and 12.7 percent to 19.9 percent in Kentucky.
Genetics may play a factor, Ms. Spillman said, because evolution has favored a human body that readily stores fat for times of famine. Modern-day America, however, has more than enough food, much of it laden with the fats and sugars that contribute to obesi ty.
People also are eating bigger portions of food, evidenced by 20-ounce colas (vs. the once-standard 6-ounce bottles or 12-ounce cans), jumbo sandwiches and bags of snacks that actually amount to several servings of a particular food.
“Everything today is super-sized. I always think to myself, "Super-sized fries means super-sized thighs,'” said Lisa Cicciarello, community dietitian with the Greater Cincinnati Nutrition Council.
“I also think it's a lack of responsibility. People think they can take a pill or pop some sort of supplement or try a fad diet, and the fat's joing to melt off. It doesn't work that way.”
Dr. Michael Wizer, psychologist with the Franciscan Holistic Health Center in Mount Airy, said many people eat out of habit without really thinking about it — while watching TV, talking on the telephone or staying up late, for example.
“It's somewhat escapist or soothing,” he said, “but the flip side of that may be that people's lives are not rich enough socially, or there's not enough sensual pleasure or joy in their lives, and food is sort of filling that gap.”
The obesity data, which was to be announced today at the American Medical Association's annual Science Reporters Convention, was based on telephone surveys of more than 100,000 participants each year between 1991 and 1998.
Younger adults, people with some college education and Hispanics showed the most drastic increases, but “a steady increase was observed in all states; in both sexes; across age groups, races, educational levels; and occurred regardless of smoking status,” the study found.
Overall, the population of obese men and women increased from 12 percent in 1991 to 17.9 percent last year, according to the CDC survey, which said that figure might be conservative.
Other recent research has found more than 50 percent of Americans are overweight and 22 percent are obese, even though weight-loss products and services are a $33 billion-a-year industry.
Being overweight has been strongly associated with greater risk of certain illnesses, including heart disease, high cholesterol and blood pressure, diabetes, stroke and some cancers.
Another study in this week's JAMA issue on obesity — all of the studies involved Americans at least the age of 18 — attributed an estimated average of about 280,000 deaths a year to being overweight, but said the figure could be more than 374,000 when the numbers are calculated differently.
The figures were adjusted for sex, age and whether the subjects smoked, but did not factor in chronic disease or family histories that might indicate a predisposition to an illness.
An editorial accompanying the obesity issue of JAMA calls for developing a comprehensive national strategy to prevent obesity.
Dr. Mary Ann Barnes, assistant director of St. Elizabeth Family Practice Center in Northern Kentucky, points some of the blame at the medical profession, which continues to offer “treatments” for obesity that are ineffective and even counterproductive, including drugs and surgeries.
“I think all the treatments for obesity lead patients into a false sense of well-being,” Dr. Barnes said. “They think that something is going to be done to them and they don't have to work to lose the weight.”
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