According to the Institute of Medicine (IOM), obesity in America is a crisis that threatens national security and it demands urgent action.
The IOM plans to change the way Americans approach exercise and nutrition. Released Tuesday at the Centers for Disease Control and Prevention's “Weight of the Nation” conference, the report outlines critical goals that must be put in place to address the complex and unrelenting problem of obesity. Daniel R. Glickman is the chair of the IOM committee that issued the 478-page plan. Glickman, former secretary of agriculture under President Bill Clinton, is executive director of congressional programs for the Aspen Institute.
“When you have a national epidemic of this size, it is in the hands of every individual to make this happen,” Glickman said today in a presentation to the CDC's Weight of the Nation Conference in Washington, D.C.
“When people understand the consequences of not taking action, they will understand,” IOM committee member Christina Economos, of Tufts University, said at the meeting. “This will require bold actions from all sections of society.”
The IOM report “issues a blunt, strong challenge that the obesity threat is imminent and enduring to our children and to our nation. It holds everyone accountable,” said James Marks, senior vice president for health at the Robert Wood Johnson Foundation, which funded the IOM study. The estimated cost of obesity is $190 billion a year in the U.S., Marks said at a news teleconference. And part of the threat is that the two-thirds of Americans who are overweight or obese are at risk of diabetes, cancer, and early death.
The IOM plan speaks of the detailed, extensive, and expensive plan. The plan calls for individual, community, school, and workplace action. It also calls on government to confront entrenched interests in revising agricultural subsidies, restricting the advertising of sugared beverages and fast foods, and regulating restaurants that offer calorie-dense foods to children.
“These things all must be done and done now if we are going to roll back this problem,” Glickman said. “The question used to be, 'Can we reverse the obesity epidemic?' The question now is, 'Will we?'”
The committee reviewed more than 800 obesity prevention recommendations. Some of the strategies which they said might be most effective include requiring schools to provide 60 minutes of physical education or activity per day, implementing industry-wide guidelines on what food and drinks can be marketed to children as well as how and expanding on-the-job wellness programs and getting restaurants to make lower calorie, healthier kid meals available.
The IOM plan is simple. There are five main goals. These include making physical activity an integral and routine part of life, creating food and beverage environments that ensure that healthy food and beverage options are the routine and easy choice, change messages about physical activity and nutrition, expand the roles of health care providers, insurers, and employers and make schools a national focal point.
“Obesity is both an individual and societal concern, and it will take action from all of us - individuals, communities, and the nation as a whole - to achieve a healthier society,” said IOM President Harvey V. Fineberg.
The Center for Science in the Public Interest (CSPI), a group that advocates strongly for nutrition and health policy, is urging the recommendations be implemented immediately. “The IOM report provides an excellent blueprint for solving America's costly obesity problem. But policy makers will have to invest both money and political capital to convert the advice into reality,” said Michael Jacobson, CSPI executive director.
CSPI nutrition policy director Margo Wootan said the country has begun to address the issue, but more progress is needed. “It's unconscionable that we are still doing so little to help the two-thirds of American who are at risk of costly and debilitating obesity-related problems like heart attack, stroke, amputations, blindness and cancer,” Wootan said.
Glickman is optimistic. “We have reached a tipping point,” he said. “You see the federal budget deficit, and the biggest part of the problem is health care costs. We can't sustain that...We have enough good ideas now about what the right things are to do. And we need to do them all, not just focus on one thing.”
The Weight of the Nation initiative includes a four-part HBO documentary series that examines the epidemic through case studies, interviews with families who are struggling with obesity and leading national experts.
“People have heard the advice to eat less and move more for years, and during that time a large number of Americans have become obese,” IOM committee member Shiriki Kumanyika of the University of Pennsylvania School of Medicine told Reuters. “That advice will never be out of date. But when you see the increase in obesity you ask, what changed? And the answer is, the environment. The average person cannot maintain a healthy weight in this obesity-promoting environment.”
Shortly after the report was released, the Center for Consumer Freedom, which is funded by restaurant, food and other industries, condemned the IOM as joining forces with the nation's “food nannies.” The Center said the IOM recommendations would “actively reduce the number of choices Americans have when they sit down to eat” and emphasized that “personal responsibility” alone was to blame for the obesity epidemic.
According to guidelines drawn up by the health watchdog NICE in the UK, anyone who is dangerously overweight should merely be urged to try to 'achieve a healthier weight'.
The guidance tells officials to “carefully consider the type of language”' they use when designing posters and leaflets preventing them from calling people “fat” or “obese” outright. It says, “For example, it might be better to refer to a "healthier weight" rather than "obesity" – and to talk more generally about health and wellbeing or specific community issues.” It added that certain language might be seen as 'derogatory'. Ironically, the advice is contained in a paper entitled “Obesity: Working With Local Communities”.
Ministers are giving town halls £5billion a year to tackle a range of public health issues, which also include binge-drinking, smoking and teenage pregnancies. It is hoped this money will be spent on providing better sports facilities, more green space and on campaigns encouraging the public to be healthy.
Tam Fry, spokesman for the National Obesity Forum, said, “They should be talking to people in an adult fashion. There should be no problem with using the proper terminology. If you beat around the bush then you confuse people. This is extremely patronising. Obesity is a well-defined, World Health Organisation standard that everybody can understand.”
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