Kelly Jamieson Thomas
Over the past thirty years, we have witnessed an astronomical increase in worldwide obesity, which has reached epidemic proportions. Worldwide, more than 1.1 billion adults are overweight, of those 312 million are obese, with the remaining on the path to becoming obese. In the US, obesity rates rose from 14.5% to 30.9%, more than doubling, between 1971 and 2000. Currently, in the US, more than 37% of adults, about 78 million, and 17% of youths are obese. If the obesity rate continues to grow at current rates, healthcare costs attributable to obesity, which were $147 billion in 2008, are predicted to increase to $957 billion dollars by 2030, a startling 18% of total US health expenses.
As the leading cause of preventable death, obesity, characterized by a Body Mass Index (BMI) greater than 30, poses an enormous burden in healthcare costs and a significant risk for decreased life expectancy, type 2 diabetes, heart disease, osteoarthritis and some cancers. We need to take responsibility for our long-term health by developing public strategies to combat weight gain. How can we accomplish this goal? By making small and consistent changes that include increasing physical activity and modifying our food choices.
Energy in, Energy Out
One contributing factor to the rise in obesity has been a substantial decrease in daily physical activity. This has led to changes in energy balance tipping the scale in favor of a gradual weight gain of 1.1-2.2 lb per year. In “The Importance of Energy Balance”, the authors explain how the delicate seesaw of energy balance has been disturbed by our decrease in physical activity, resulting in a state where any excess food consumption results in weight gain. To prevent weight gain, and ultimately obesity, energy in (food) must balance energy out (exercise).
Several studies that show that increasing our physical activity, combined with controlling our food choices, is the best way to combat obesity. In a 20-year long study, men with high levels of physical activity gained 5.7 lb less than those with low physical activity and women who exercised more in this study gained 13.4 lb fewer than those who didn’t. BMI, which is used to measure obesity, was also inversely associated with physical activity in 5 different long-term studies. Another study showed that either walking or high-intensity exercise one time per week led to a decrease in body weight of 1.76 lb for men and 1.39 lb for women over a two year period.
Unfortunately, most weight loss programs solely focus on restricting diet, not increasing exercise and curbing food intake. Studies have shown that calorie-restricting diets lead to 33-66% of dieters regaining more weight than they lost on the diet. Long-term, this does not help fight obesity. Weight gain prevention is key. Making small changes in our diet and exercise now, as little as 100 kcal/day, prevents weight gain and obesity over time. In the morning, go for a run or power walk outside. After work or on the weekends, meet with friends for a game of Frisbee. If it’s too cold outside, follow an exercise program on TV.
How to fight obesity: Community-based prevention
The most effective way to prevent obesity is to do so as a community, with partnership programs that provide education on how to exercise and eat properly and community aid in following prevention guidelines. While public strategies focused on obesity prevention have had varying degrees of success, one strategy, EPODE (Ensemble, Prévenons l’Obésité des Enfants), has been developed around a successful prevention program tested in France, the FLVS study, which decreased childhood obesity 9% in 4 years. EPODE, according to a recent article in US Endocrinology, aims to reduce childhood obesity by encouraging and monitoring healthy eating and exercise both at school and at home, as intervention solely targeting schools was unsuccessful. The EPODE model stresses the critical role of awareness, willingness, and involvement of initiatives that combine efforts from NGOs, private partners, and government to fight obesity. As of 2012, 17 countries have implemented EPODE-inspired programs, including VIASANO in Belgium, JOGG in the Netherlands, and OPAL in South Australia. Implementation of such programs requires comprehensive community effort, but the long-term results may significantly alleviate our obesity problem.
Prevention is the Cure
There are no safe and efficient drugs to cure the obesity epidemic, but we can prevent it by making small and consistent changes in our lives, starting at a young age. It is time to take responsibility for our long-term health and prevent obesity by exercising daily and eating healthier. In doing so, we not only prevent obesity, one of the largest public health problems we face as a population, but also lower our risk for type 2 diabetes, heart disease, osteoarthritis, decreased longevity and cancer.