A recent report on obesity from a group called the Trust for Public Health could be shrugged off as just more confirmation that the United States is fatter than ever, and that Americans need to eat better, exercise more, blah, blah, blah. That would be a large mistake: The connection between obesity and chronic disease and between chronic disease and early death should both alarm the public and alert policymakers that attempts to address this problem have mostly been less than successful.
The trust this week ranked states by recent data on obesity, diabetes, physical activity, hypertension and other categories, but the rankings aren’t as important as the overall trend. The nation, despite more than a decade of warnings and good intentions, is fatter than ever. (For the record, Maine ranked a respectable 33rd from the top in percentage of obese residents but that was the worst score in New England.) Thirty-three states, including Maine, show a statistically higher adult obesity rate over the last year; 22 percent show rising rates for each of the last two years. Statistics on children are depressingly similar.
The trust’s work follows countless other studies on the prevalence of obesity, but more important are its effects. For instance, a few years ago, in the largest study ever done on obesity and mortality, conducted by the American Cancer Society and published in the New England Journal of Medicine, researchers reported on the results of following more than 1 million people over 14 years. The subjects ranged from young adults to the elderly, from healthy and trim nonsmokers to those with dangerous pre-existing conditions. More than 200,000 died during that period. Deaths from heart disease and cancer – the two leading causes of death – tracked being overweight step-for-step: the slightly overweight had slightly increased death rates; the moderately overweight (say, 20 to 30 pounds over) had death rates 50 to 100 percent higher; the severely overweight had death rates up to 300 percent higher.
The trust has several suggestions for helping people make healthier choices, but they tend toward large-scale government intervention. No doubt some government action is needed – making it easier to walk in cities, for instance, or perhaps offering tax incentives for companies that provide health programs. But government’s most important role should be education: Reinforce what a healthy lifestyle includes, make it clear that their poor choices shouldn’t be paid for with other people’s taxes or insurance premiums and urge good health choices. Obviously, children should have more guidance, but there’s no mystery for adults about why an apple for a snack is a healthier choice than a candy bar.
The nation, and not only this nation, has a serious weight problem. Individuals will solve it when they begin taking responsibility for their own health, and while the government can make that easier, it can’t make the decision for them.
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