America’s Obesity Crisis: Treatment vs Prevention

AADE General Session
Friday, August 13, 2004
8:00 AM - 9:30 AM

America is in a tug of war with obesity. Certain factors are promoting obesity: economics, biology, and the environment. Grass-roots movements are trying to inhibit the factors that cause obesity. Some powerful influencers-the government, public policy, and the food industry-are helping and hurting the cause of obesity at the same time.

Efforts abound to overcome obesity. Treatment, including diets, lifestyle changes, and medications, have modest effects on curbing the trend. Surgery is effective but is, of course, reserved for morbidly obese individuals. The ultimate answer to the obesity plight may be in public policy, because America-and most of the world-has become a toxic environment in which bad dietary choices assault us at every turn. High-fat, low-nutrition foods have many advantages to healthy foods-they are convenient, inexpensive, and heavily promoted by large corporate advertising budgets. Most people prefer the taste of unhealthy foods to fresh, nutritious foods.

Our environment is filled with many signs that unhealthy foods dominate our lifestyle. Vending machines are ubiquitous. Gas stations and drug stores have become "convenience stores" and must sell fast food to be successful. Portion sizes have increased, and "supersize" has become a verb. This has happened because the food industry exerts heavy pressure on the federal government-and even entities such as the World Health Organization-to avoid revealing the true state of American eating habits. The public has access to a great deal of information about nutrition, but most of it is generated by the food industry.

Perhaps the worst aspect of the toxic environment is the effect on children. Each child is targeted by 10,000 television advertisements every year, and schools have allowed the food industry to infiltrate their vending machines and lunch programs. One illustrative irony is the McDonald's restaurant in the lobby of Children's Hospital of Philadelphia. The targeting of children through advertisements can be likened to the tobacco industry's strategy several decades ago. It may be that once the public sees the common elements between fast food and tobacco promotion, steps will finally be taken to improve our toxic environment.