As the 16th Surgeon General of the United States (1998 to 2002), David Satcher wanted to be known as the surgeon general who listened to the American people and who responded with effective programs. His personal mission was to ensure effective public health policy for all groups in the United States, and to that end he helped create Healthy People 2010, a national health promotion and disease prevention initiative. He then spearheaded the report, Surgeon General's Call To Action To Prevent and Decrease Overweight and Obesity. This was one of the first attempts by any government to draw attention to the issue of obesity as a public health crisis.
The report stressed that health problems resulting from overweight and obesity could reverse many of the U.S. gains in health and wellness. This was news to most people at the time.
“Overweight and obesity may soon cause as much preventable disease and death as cigarette smoking,” warned Satcher. In the previous year, approximately 300,000 U.S. deaths were associated with obesity and overweight, while cigarette smoking was the cause of approximately 400,000 deaths. The total direct and indirect costs attributed to overweight and obesity was then estimated at $117 billion.
Satcher continued, “People tend to think of overweight and obesity as strictly a personal matter, but there is much that communities can and should do to address these problems.”
The Call to Action report suggested community strategies such as educating new mothers about breastfeeding, requiring physical education for all school grade levels, supplying healthy food options on school campuses, and creating safe and accessible recreational facilities for community residents.
Years have now passed, and while there has been progress in some of these areas, much remains to be implemented. Although health articles published in November 2007 heralded a study titled Obesity Among Adults in the United States—No Statistically Significant Change Since 2003-2004, the accompanying data brief supplied by the Centers for Disease Control and Prevention (CDC) still showed an increase of over two percent in that time period and assessed the obesity level at 34.3 percent of the population. In addition, over the preceding 25 years the distribution had shifted, and “the shift was greatest at the upper percentiles of the distribution. This indicates that the entire adult population is heavier.” Eight months later, another series of studies reinforced the findings that American adults are still growing. A July 2008 report by the CDC showed the level of self-reported adult obesity increased by nearly two percent in a similar time period.
Based on survey results of height and weight in the 2007 Behavioral Risk Factor Surveillance System, an ongoing government-sponsored health survey of 404,300 U.S. adults, the proportion of obese adults increased to a nationwide average of 25.6 percent. These self-reported numbers were significantly lower than the 34.3 percent reported by health professionals less than a year earlier, which may indicate that the American public is larger than they wish to believe. In both studies, the increase was about two percent in a similar time period. Investigators in each study converted the height and weight to body mass index (BMI) measurements, and both studies defined obesity as having a BMI of 30 or greater.
The obesity epidemic is not confined to the United States. According to the London-based International Obesity Task Force, other countries are following suit, with growing obesity problems in the Middle East, Europe and even poverty-stricken developing countries. And other countries are also beginning to take action.
According to current health news reports, a Japanese law that came into effect in 2008 requires waist measurements of Japanese citizens between the ages of 40 and 74 as part of an annual checkup. Britain’s government-sponsored School Food Trust was formed in 2005 “to promote the education and health of children and young people by improving the quality of food supplied and consumed in schools.”
Government and other public measures may be helpful, but without each individual taking personal responsibility for healthy weight, the obesity epidemic will continue to expand. One specific objective of Healthy People 2010 is to reduce the prevalence of obesity in the U.S. to less than 15 percent. While this is a lofty goal for the country as a whole, individuals can help achieve this goal and improve their own health at the same time by taking this as a personal challenge.
Satcher's words remain as true today as they were in 2001: “Taking action to address overweight and obesity will have profound effects on increasing the quality and years of healthy life and on eliminating health disparities in the United States,” he said. This applies to the public sector as well as to individuals. Maintaining a healthy weight results in both immediate and long-term positive effects for each person as well as for the greater community.