3Qs: For America, beating obesity is a complex challenge

Forty-​​two per­cent of the Amer­ican pop­u­la­tion will be obese by 2030, according to a new report in the Amer­ican Journal of Pre­ven­tive Med­i­cine. We asked Katherine Tucker, pro­fessor and chair of the Depart­ment of Health Sci­ences in the Bouvé Col­lege of Health Sci­ences, to address the rising obe­sity rates in the United States.

Katherine Tucker, professor and chair of the Department of Health Sciences, does not believe in a "magic bullet" to stem the obesity epidemic. Photo by Mary Knox Merrill

Who should be held responsible for the country’s soaring obesity rates?

This is a very complex issue and it is difficult to hold a specific group responsible. We know, however, that obesity stems from changes in the environment with designs to favor efficiency and reduced physical activity. There has also been a rapid increase in the consumption of convenience and restaurant foods. All sectors of the food industry have increased portion sizes over time, so that people are eating far more calories than they realize.

Important changes that have paralleled the development of the obesity epidemic include extremely high consumption of sweetened beverages. This is something that we can all avoid that can go a long way to reduce calories, and importantly, excess sugar, that may contribute to increased risk of fatty liver and diabetes. Some processed foods, including artificial flavors and artificial sweeteners, are being investigated for possible disruption of satiety signals, which may lead to greater hunger and, therefore, caloric intake and weight gain.

Which is more of a factor in the obesity epidemic: lacking self-discipline or living in an environment that promotes unhealthy behaviors?

There has been a lot of emphasis on blaming individuals for not following good health behavior, but it is not as simple as that. With the proportion of the population that is overweight or obese now in the majority, there are clearly complex factors at play. The food and exercise environment are critical, as is advertising and lack of awareness. In addition to improved understanding of the effects of foods and exercise, and attention to personal choices, individuals need healthy options that are convenient and affordable. There is much that can be done in the environment to make these easier.

Obesity rates in children have tripled since 1980. How do you recommend reversing this upward trajectory?

Obesity has finally received serious attention and there are many groups working on the problem, from research to interventions. It is, however, proving to be a very difficult problem. Much of the earlier efforts focused on weight loss, which is now a multibillion dollar industry. But it’s very difficult to lose weight and to maintain weight loss and results have been disappointing.

The focus for the future needs to be on multilevel interventions that involve everyone — the food industry, the media, medical professionals, teachers and community groups — to prevent weight gain. This involves a focus on healthy foods, with appropriate daily exercise. We need to get this into the public consciousness. Enhanced understanding of the importance of, and experience with, home cooking must be cultivated. At the same time, we need to acknowledge the need for convenience by increasing the availability of minimally processed healthy foods to make cooking easier.

At the community level, we need to increase opportunities for physical activity by enhancing parks, bike paths and building designs that favor stairs rather than elevators. There is no magic bullet and it will take efforts from all sectors, but I see momentum growing and I am optimistic that we will get there.

13 comments

  1. This is crazy. The problem is people. Choose what you eat, and how much of it. Choose how much exer­cise you are going to get. If you are obese, then it is your respon­si­bility to get your­self thin.

  2. We are now an unhappy people who have only wealth as an ideal. As someone said “we’re all sit­ting here stranded, but we’re all trying to deny it.” We, as a society, found the indi­vidual freedom to become eco­nomic slaves. Now we cower in uncertainty.

  3. These com­ments are good. I would like to add some ideas to these.
    People are not robots and there­fore have choice. A person dose not eat unless he decides to. Now that deci­sion may be made without thought which I think is the case in most cases but that person dose CHOSE to eat. Now there is a solu­tion on this part of the problem. If people would choose to eat two or three meals at spe­cific times the fat pan­demic would be slowed. Another solu­tion on the eating problem would to eat a smaller meal at evening and a larger break­fast. I know these will be hard choices and most people take the path of least resis­tance but it is choices that need to be made. Next would be to match the caloric intake with the caloric burn, this will be the most dif­fi­cult choice.

  4. Obe­sity is a symptom America eats too much food and does little phys­ical work, both in bal­ance. America is also over mechan­dized to eat, be part of restau­rants, con­sume soft­drinks and gen­er­ally spend money on calorie absorbing input. America does not have the habit to be more phys­ical and expend energy, espe­cially America’s chil­dren. So, get the habit : get strong, move fast, live long.

  5. No its not. You just have to eat less and exer­cise reg­u­larly. Most people would lose weight if they would stop main­lining soda 24/​7.

  6. Thank you for this well written article. Here is a link ( below) that goes into one of many serious prob­lems we face as a nation of obe­sity.
    With knowl­edge comes aware­ness. It is then a process of our higher self that will push us to the right choices that serve our higher good. A Journey were knowl­edge frees us and gives us the power to take back our life.

    http://​www​.mul​ti​cul​tur​al​fa​milia​.com/​2​0​1​2​/​0​4​/​0​9​/​t​r​u​t​h​-​i​n​-​f​o​o​d​-​l​a​b​e​l​i​n​g​-​h​o​w​-​y​o​u​-​a​r​e​-​l​e​g​a​l​l​y​-​d​e​c​e​i​v​e​d​/​#​a​x​z​z​1​u​T​U​x​w​dqT

  7. If we are to do some­thing to ‘pro­tect’ all of our cit­i­zens (and esteemed vis­i­tors to our nation), and our chil­dren, and our elderly, and our best workers, and our pro­fes­sionals, and best polit­ical ‘thought’ leaders, then we have to make a par­a­digm shift in our DHHS/​& US Public Health sys­tems. We need to have full pro­fes­sional atten­tion to, with unlim­ited Health & Human Service/​Public Health funding for, resolving each of these com­mu­nity health chal­lenges as well:
    1.) tobacco smoke, auto­mo­bile, and fac­tory pol­lu­tion,
    2.) alco­holic bev­er­ages, street drugs, and caffien­ated drinks,
    3.) animal cru­elty, dead animal (meat), ani­mals by-​​products,
    4.) junk foods, syn­the­sized foods, refined/​over-​​refined sugars,
    5.) GMO foods, sythetic fer­til­izers, pes­ti­cides, her­bi­cides, and
    6.) arti­fi­cial chem­ical addi­tives for perserving, fla­voring, and col­or­ings,
    7.) extremism, rioting, uncivil war, and military/​police actions for polit­ical dom­i­nance of coun­tries with abun­dant nat­ural resources.

  8. Who should be held account­able for the obe­sity problem? The people that are fat!! Their choice to be fat.

  9. I grew up as one of those “child­hood obe­sity” kids, it sucked, I blamed my par­ents. But you know what? At the end of the day each person decides what goes in their mouth

  10. 42% of the pop­u­la­tion will NOT be obese.
    The stan­dards for obe­sity were actu­ally changed.
    Many average-​​sized people are now con­sid­ered to be obese because of this. These days, prob­ably every woman over size 10 (which only has a size 32″ bust by the way!!) is con­sid­ered to be enormous!!

  11. I like where this short syn­opsis is pointing. Per­sonal respon­si­bility in regards to obe­sity is def­i­nitely impor­tant, but it’s far past time for the prover­bial ‘us’ to realize that there is so much more at play than just per­sonal choices.

    As you stated, the food industry is respon­sible for some of the envi­ron­ment that plays into our obe­sity, but there are also the var­ious agri­cul­ture and dairy asso­ci­a­tions, and our own gov­ern­mental poli­cies regarding food and nutrition.

    When our own gov­ern­ment tells us to start eating more grains under the guise of health, when really that deci­sion was made in the midst of polit­ical and wartime stres­sors, rather than sci­en­tific studies and the nutri­tional value pro­vided, there’s a problem. This last state­ment is largely unsub­stan­ti­ated (i.e. as far as real proof or evi­dence goes), but it does have recent sup­port to back it up in numerous books and news arti­cles that show how lob­by­ists and agri­cul­ture, et al., indus­tries affect national food policy. I will leave that bit of research up to the reader of this comment.

    Fur­ther, I think there needs to be much more emphasis on *sugar*. It’s time we reg­u­late it and treat it like to toxin that it is. Our bodies were never meant to digest and process as much sugar as we put in it; in fact, our bodies, for most of our evo­lu­tion, did not take in much sugar other than fruc­tose, and that would gen­er­ally only be during har­vest times, when fruit was available.

    The evi­dence against sugars is gaining steam quite quickly, and bodies of evi­dence are now showing just how bad of an effect sugars have on our body — the liver, your fat cells, insulin pro­duc­tion, energy levels, etc. More research and more aware­ness needs to happen in this regard, I under­stand, but I think it’s bor­dering on foolish to dis­re­gard just how much sugars affect you. And not just sucrose (stan­dard gran­u­lated kitchen sugar), but fruc­tose, glu­cose, and all those arti­fi­cial sweet­eners as well — they’re all sugar calo­ries that trick your body into thinking there’s food to digest, when there’s not.

    A calorie is a calorie is a calorie — that’s the mantra. But more and more, it’s being dis­cov­ered that this is not true. The type of calorie mat­ters, and sugar from dif­ferent sources do affect you and your metab­o­lism differently.

    I apol­o­gize if links are not allowed, how­ever, here are a couple of per­ti­nent arti­cles sup­porting the aims of your article, and some of my points as well:

    - http://​www​.thedai​ly​beast​.com/​n​e​w​s​w​e​e​k​/​2​0​1​2​/​0​5​/​0​6​/​w​h​y​-​t​h​e​-​c​a​m​p​a​i​g​n​-​t​o​-​s​t​o​p​-​a​m​e​r​i​c​a​-​s​-​o​b​e​s​i​t​y​-​c​r​i​s​i​s​-​k​e​e​p​s​-​f​a​i​l​i​n​g​.​h​tml

    - http://​www​.reuters​.com/​a​r​t​i​c​l​e​/​2​0​1​2​/​0​5​/​0​8​/​u​s​-​u​s​a​-​h​e​a​l​t​h​-​o​b​e​s​i​t​y​-​i​d​U​S​B​R​E​8​4​7​0​L​C​2​0​1​2​0​508

    - http://www.cbsnews.com/8301-504763_162-57369857–10391704/sugar-should-be-regulated-like-alcohol-tobacco-commentary-says/

  12. The cur­rent gov­ern­ment rec­om­men­da­tion for daily car­bo­hy­drate intake is 300g. 1200 calo­ries from carbs. There is obvi­ously a fun­da­mental mis­un­der­standing of glycogen stores among those who are pub­lishing these guidelines.

    Think of it as a cup. When the cup is filled, it will start to spill over as you add more to it. When glycogen stores are filled, this spill over (for an extremely ele­men­tary analogy), becomes fat.

    The gov­ern­ment should pub­lish new guide­lines that only sug­gest eating foods that you can kill or grow. But I don’t think the agri­cul­tural industry would like that.

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