Photo: roujo (Flickr)
This month the Robert Wood Johnson Foundation and Trust for America’s Health released their study F as in Fat: How Obesity Threatens America’s Future.
Although the title may imply that the study criticizes overweight people, it instead offers a comprehensive look at the complexity of the obesity epidemic and explores federal and community programs that have effectively (or ineffectively) contributed to the national struggle to reduce obesity in America.
Obesity In America
More Americans than ever are struggling with obesity – over two thirds are overweight. Not only have national obesity rates risen 19 percent in the last thirty years, since 2008 overweight and obese rates have risen in every state for both adults and children.
People have genetic, physiological, age-related, and psychological risk factors that influence weight gain. However, the study’s data confirms that environmental factors are also influential on a person’s body weight and health. This means that in addition to confronting physical attributes that affect weight gain, people who do not have access to healthy food, live in unsafe neighborhoods, or work in environments that promote a sedentary lifestyle will have a more difficult time managing their weight.
Creating safe places to exercise is important. Sixteen states have already passed Complete Streets laws which require new streets to provide space for pedestrians and bicycles as well as vehicles. Increasing the amount of public transit, green spaces, and zoning codes that promote physical activity also reduces obesity rates.
Sedentary working environments bar people from getting enough exercise during the day and reduce the amount of time individuals have to exercise. Additionally, many work places do not offer healthy eating options int heir facilities, support to breastfeeding mothers, or bike racks and shower facilities for people who want to bike or walk to work.
The ability to afford good food and a place to exercise is a prohibitive factor for many people who are obese to better their health. This is confirmed by the direct correlation between education level and income and obesity. The study found that the more educated and wealthier a person is, the less chance they have of becoming overweight or obese. In fact, six of the ten most obese states are also the top six poorest states in the country.
Loss Of Mobility
The study explored several different groups, their risk of obesity, and how community planning can directly help reduce obesity levels for these groups.
Obesity rates are 60 percent higher in people with disabilities. Universal designs would help people who have difficulty being mobile to be more physically active. Universal designs are public spaces that make it possible for all people to access them, such as cut away curbs and smart buses that tilt to allow and easier entry.
The aging population may also experience a loss of mobility, which will make getting exercise and access to healthy food more difficult. According to the study, universal designs “advocate for new technology that can expand public services for individuals with disabilities, as well as for ‘aging-in-place,’ the idea that living spaces and communities should be designed to allow people to live in the same place as they age and lose mobility.”
Programs that make it affordable and easy to exercise and eat well directly affect obesity rates. For example, a free program through the YMCA has helped recruits for military programs get in shape enough to pass their physical exams before they get to basic training. After receiving a free 6-month membership to the YMCA, “between 85 to 100 percent of recruits in this group passed [the physical fitness test] compared to 30 to 50 percent among those who do not receive the extra help.”
Photo: Elly Blue (Flickr)
Another group that is being watched closely is children. An increasing number of children are overweight and obese, and health officials say that teaching children to eat well and exercise as part of their daily routine will be a crucial step in reducing the obesity crisis. Helping children from an early age learn how to incorporate exercise into their daily lives and how to eat well is one of the most powerful tools the country has to help fight the obesity crisis.
The study found that the most successful programs with kids were fun and participatory with less lecture and more action; reinforced the same healthy ideas every day and had the support of parents who helped reinforce good eating habits and exercise; and established lifelong eating habits at a young age. For this reason, the study praised the Let’s Move! campaign, the Healthy, Hunger-Free Kids Act, and programs that have made school lunches healthier.
What It Means For Our Health
Diseases like diabetes, hypertension, strokes, kidney disease, neurological and psychiatric diseases, liver disease, and arthritis all occur more frequently amongst people with higher body weight. In the last fifteen years diabetes rates have double in ten states and increased by more than 70 percent in seventeen others. Almost every state has seen a rise in hypertension over the last fifteen years.
Researchers believe that being overweight is a factor in earlier onset of puberty in children because puberty is partially triggered by weight gain. Starting puberty early can cause emotional stress for the child as well as a higher risk of illness like diabetes, heart disease, and breast cancer.
Healthy Food And Breastfeeding
A community’s ability to provide affordable fresh and healthy food to its members directly affect’s the area’s obesity rates.
Areas that have a higher rate of fruit and vegetable consumption have a lower rate of obesity. As a result, increasing the amount and availability of a healthy food selection in grocery stores and corner stores could improve the country’s health.
The study also found that children who were breastfed had the lowest rate of obesity. Children have the best chance at having a healthy body weight if they are fed exclusively breast milk for the first six months of their lives, but less than 25 percent of Americans breastfeed their children for this long.
Responsibilities Of The State
The study suggests that federal and state governments should become more involved in the obesity crisis.
School-based programs can reduce obesity levels among children and help keep obesity levels down if the children adopt these health eating and exercise habits. Improving the type of foods available in schools, giving children a chance to drink enough water, and giving incentives for school districts to comply with state health standards are important tools in this challenge.
Some states are experimenting with rewards and punishment systems that address helping citizens and employees to lose weight. The cost of health programs rise with the obesity rates, so states are struggling to make up the difference.
For example, Arizona is discussing a plan to charge Medicaid recipients “who don’t work with a doctor to improve their health” an annual fee, and South Carolina approved a plan to lower premiums for state workers “who try to improve their health in certain ways.” Soda taxes, reformed food stamps, menu labeling, and regulating child-oriented food marketing are just a few other ways states have gotten involved. National grants to programs that create healthier communities are effective.
- F as in Fat: How Obesity Threatens America’s Future (Robert Wood Johnson Foundation and Trust for America’s Health)