Obesity alert: there’s a little too much of us to love these days

The worst and latest of the epidemic of American epidemics is the epidemic of obesity among our children and adolescents. As epidemics go, this one would seem pretty benign in comparison to the plagues of sex, drugs, rock ‘n’ roll, Hollywood award shows, anthrax, etc. The truth, however, is far more chilling, because obesity in childhood or adolescence is directly linked to obesity as a cause of death in adulthood.

The relationship, unfortunately, goes like this: obesity is now the most common health problem in children and adolescents, one-quarter of obese children and one-half of obese adolescents will become obese adults, and obesity is now the second most common cause of death among American adults. It kills an estimated 300,000 Americans each year, second only to the pestilence of cigarette-related illnesses that kills about 500,000 Americans annually.

This epidemic might still be easy to ignore but for several alarming features. First, the obesity epidemic is on a roll. The rate of obesity among children and adolescents has doubled in the last 30 years, now hovers around 15 percent and is increasing. By 2000, 22 percent of preschool children were overweight and 10 percent were obese.

Second, some effects of obesity previously seen only in adults — high blood pressure, adult onset diabetics (Type 2), etc. – are now being seen in obese adolescents. A recent New England Journal of Medicine study of significantly obese adolescents found that one in four had the characteristic abnormalities in blood-sugar metabolism that precede adult onset diabetes, and 4 percent of them already had adult onset diabetes.

Talk about growing up too fast. The early onset of these diseases in teens will probably translate to earlier onset of coronary artery disease, kidney and eye disease, and other complications of diabetes.

Third, we cannot afford the health care costs of more unhealthy children, or more unhealthy young adults. Heck, we cannot even afford the chronic illnesses of our current adults, never mind a new generation of Americans that is sick even before it gets old. We are not just raising many obese children, but too many future health care costs.

Fourth, we will be hard-pressed to lead our children to better health from a parental position on the couch. In the final analysis more of our children are eating too many calories and moving less than the refrigerator door does because adults around them are doing the same. A recent study in the Journal of the American Dietetic Association found that (surprise!) the healthy fruit and vegetable intake of girls modeled that of their parents. The hardest part of getting our children healthier will be that we will have to get healthier ourselves.

Fifth, getting our children and teens healthy will also involve a fight for their hearts and waistlines with some of America’s biggest industries, especially its fast food, snack and entertainment industries. The simple truth is that Americans cannot get to healthier weights without eating fewer calories/less junk, and exercising more, and those are the last things these industries really want us to do. They spend billions on advertising that urges us to eat more of their food, watch more of their television, play more of their video games, etc.

Fast-food restaurants, for example, aggressively market to children, with techniques that include larger portions, playgrounds and sophisticated ads showing beautiful babies clutching their first french fries. The snack industry and the fast-food industry are also aggressively plying their high calorie wares in the vending machines and cafeterias of America’s schools, and schools and their boards are co-conspirators in this junk-food assault.

Finally, despite the urgency needed to address the issue, it is important for parents to approach the issue of a child’s obesity with great care, as an issue of overall health, not simply an issue of weight, and by more activity and better diet, not simply fewer calories. The job is best done with the help of a health care team and a change in the entire family’s lifestyle. It must be remembered that weight loss to the extreme is no better than obesity, and that the morbidly skinny are no more healthy than the morbidly obese.

There are many community steps to take, such as kicking junk food out of our public schools and ending the shameless sale of our children’s health for the sake of a few greasy dollars for school budgets. The Centers for Disease Control Web site www.ccdc.gov is full of useful information on how communities can raise healthier children.

Whatever the steps, we need to get on with the job. The clock is ticking, the scales are tipping and the blood sugars are climbing. We cannot afford to leave this generation of children our legacy of unhealthy lifestyles resulting in their obesity, because obesity for children is not simply a disease; it is often a life sentence of ill health.

Erik Steele, D.O. is a physician in Bangor, an administrator at Eastern Maine Medical Center, and is on the staff of several hospital emergency rooms in the region.