Surgeon General warns obesity may be more deadly than cigarettes

WASHINGTON (AP) The nation's obesity epidemic has gotten so bad it soon may overtake tobacco as the leading cause of preventable deaths, the surgeon general said. He called for changes in policies from schools to the fast-food industry to trim Americans' waistlines.

Some 300,000 people a year die from illnesses directly caused or worsened by being overweight. The toll threatens to wipe out progress fighting cancer and heart disease, and could even exceed cigarettes' harm, Surgeon General David Satcher warned.

Some 60 percent of adults are overweight or obese, as are nearly 13 percent of children, rates that have steadily risen over the past decade. The reason isn't a mystery: People eat more calories too often by shunning fruits and vegetables in favor of super-sized junk foods than they work off. But how to solve the problem is vexing, as warning after warning from health officials has gone unheeded.

Satcher said a key is treating obesity not just as a personal responsibility but one shared by the community and industry. He called for a national attack on obesity like the one federal health officials declared on smoking.

Among his recommendations:

  • Schools must provide daily physical education for every grade. P.E. has gradually been disappearing, particularly for older students. Just 6 percent of schools require it for high-school seniors.
  • Schools must provide healthier food options, and better enforce federal rules restricting students' access to junk food in the vending machines present in most middle and high schools. Agriculture Department rules say school lunches should contain no more than 30 percent fat but the national average is 34 percent, and a recent survey found just 20 percent of high-school lunches provide proper vitamin levels.
  • Communities must create safe playgrounds, sidewalks or walking trails, particularly in inner cities. Employers should provide time for workers to get physical activity on the job. After all, healthier workers mean employers' insurance and absenteeism costs will drop.
  • Industry should promote healthier food choices, including "reasonable portion sizes."

    Ironically, the poor have a tendency to be fattest. Among the reasons, Satcher cited fast food crowding out access to healthier foods in inner cities. He urged communities to study fast-food marketing practices, comparing the situation to tobacco companies' targeting of inner-city minority communities in the 1990s. And he encouraged government-funded attempts to increase the availability of affordable fruits and vegetables.

    "Sometimes the most fattening foods are the cheapest," Satcher lamented in an interview.

    The National Restaurant Association rejected as "simplistic" the idea that fast-food joints cause obesity, and the National Soft Drink Association urged more focus on Satcher's exercise recommendations, calling vending machines in schools adequately regulated.

    Consumer advocates praised the report for finally acknowledging that people's environments can either help or hinder weight loss. But, "talk is cheap," said Margo Wootan of the Center for Science in the Public Interest, asking how the government would implement Satcher's recommendations.

    The Agriculture Department has targeted childhood obesity as a major concern and will take some action, though just what hasn't been decided, said Ron Vogel of the special nutrition program. Officials are helping schools to improve lunch nutrition. While the USDA has authority to restrict use of vending machines only if they are in cafeterias, it is considering whether to seek broader authority.

    As for physical education, the Education Department can't force schools to require it, a decision made locally, said spokesman Dan Langan. But this fall, it did provide $5 million in grants to help 18 school districts begin or expand P.E. classes.

    As for overweight Americans, don't get discouraged if a diet doesn't cause as much weight loss as expected, Satcher said. Even losing 10 pounds can reduce someone's risk of getting diabetes or heart disease, as can simply walking 30 minutes a day.

    "Every pound counts," he said.


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