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Date Posted: 04:43:30 02/24/04 Tue
Author: J.R.Smith, c.f.t. ISSA
Subject: Obesity is a condrum

Tell me your thoughts on the matter...
J.R.

Monday, January 19, 2004


WASHINGTON, Jan 19, 2004 (United Press International via COMTEX) -- With increasing evidence that rising rates of obesity are having a negative on both health and the economy in the United States and around the world, government leaders are looking to take steps to address the problem.

Health experts say the growing rate of obesity is an epidemic affecting more than 60 percent of adults and 13 percent of youth in the United States, a level twice the rate three decades ago. Of particular concern is the escalation among the young.

Obesity is associated with increased risks of heart disease, cancer, diabetes and muscular-skeletal disorders, causing an estimated 300,000 deaths a year. This makes it second only to smoking as the leading cause of preventable death in the nation and a significant driver of ever-rising healthcare spending in the United States.

A study from the RAND Corporation even posits that obesity is a key cause of the more than 50-percent increase in U.S. disability rates over the last two decades, particularly among younger Americans.

While the incentives toward disability created by greater access to disability insurance and the impact medical advances are also probable causes of the increase, the researchers concluded that another likely factor explaining such a large jump was the significant upward trend in obesity rates over the last 20 years.

Darius Lakdawalla, a RAND economist and lead author of the report, told United Press International that while it is not an open-and-shut case, obesity rates on the national scale closely follow the increases in disability in the United States.

"Obesity is about the only thing that you can look at that can account for the disability changes we saw," said Lakdawalla.

In addition, the number of disability cases attributed to musculoskeletal problems -- such as chronic back pain -- as well as diabetes -- both illnesses linked to obesity -- grew more rapidly than those from other problems during the period.

He added that what is needed is research at the individual level, something he and his colleagues are exploring.

Recent studies have also found that the risks for obesity start in children as young as 3, a finding attributed to contemporary sedentary lifestyles.

While the problem is clear, solutions are not. Nevertheless, some lawmakers, public health officials and advocates continue to press policymakers to address the problem.

The issue has even been part of the debate between the Democratic presidential candidates. All those present at a Jan. 6 debate on National Public Radio agreed that obesity was a major healthcare problem that deserved presidential attention.

However, the policy proposals were all over the map with Sen. John Kerry, D-Mass., promising executive leadership on fitness issues, a traditional approach that critics contend would likely have little to no affect on the overall problem.

Sen. Joe Lieberman, D-Conn., advocated for a government investigation into the marketing of junk food to youths, a proposal clearly aimed at public advocates on the issue.

To the delight of the libertarians listening, former Ambassador and Sen. Carol Moseley Braun, D-Ill., argued that education was the answer, not "Big Brother telling people what to eat."

At the international level, the World Health Organization has produced a controversial plan to combat obesity around the world that has been praised by public health officials but derided by some food manufacturers.

The WHO estimates that 1 billion adults are overweight worldwide and at least 300 million are obese.

While the plan is not binding, it is considered a guiding document for public health efforts on the issue worldwide.

Among the proposals is a restriction on targeted advertising of nutritionally questionable foodstuffs toward children and for the imposition of taxes and farm subsidy changes aimed at increasing junk-food prices.

The Bush administration on Thursday came out in opposition to the plans, saying it will demand significant changes to the initiative.

U.S. officials argued that the plan is based on faulty scientific evidence, exceeds the U.N. group's mandate, and ignores a needed emphasis on personal responsibility.

The Bush White House's move has been criticized as a clear effort to placate U.S. food and sugar interests.

The fact that they would lobby for such an effort should not come as a surprise, given the legal pressures the manufacturers and distributors of junk food are increasingly facing.

Ben Kelley, executive director of the Public Health Advocacy Institute, a research affiliate of Northeastern University School of Law in Boston, argued in a Washington Post commentary last August that while a high-calorie, low-nutrition product like soft drinks are not exactly like cigarettes in terms of their potential harms, those that produce and market such products should face similar legal challenges as Big Tobacco.

Kelley said these foods involve, "not just product content but marketing, packaging and labeling, often in combination" through school vending machines and youth-targeted advertising and other campaigns geared toward a younger demographic.

The idea is that these efforts habituate children to excessive consumption. Because of this, litigation is already here with more expected to come.

In some ways, companies are fighting back or at least fighting for the hearts and minds of consumers.

The Center for Consumer Freedom, a group backed by restaurant and food companies, launched a television ad on CNN, Fox News Channel and MSNBC last year that lampooned lawsuits against businesses that sell high-fat food.

The move was made in response to a forum held by Kelley's group examining the obesity problem that promoted litigation against the food industry.

Some companies are doing more than just taking notice of the potential problem and attempting to fight the surge in related bad publicity.

Last year, Kraft Foods announced a global initiative to reduce obesity through corporate practices.

However, it remains unclear what this will exactly mean. After all, no one believes the company will stop marketing foods to youth markets.

The WHO proposals echoes those of U.S. public health advocates who say more proactive steps are needed to address the roots of the problem.

Leif Wellington Haase, a healthcare fellow at the liberal Century Foundation, warned that in pushing for change lawsuit may not be the best approach -- because unlike tobacco, fast food is not an inherently harmful substance being marketed -- but that it such lawsuits were defendable.

"While Americans, rightly or wrongly, generally see the issue as a personal one and fast food manufacturers are ensconced in society, that in no way means you cant hold them (food manufacturers) liable in this situation," Haase told UPI.

According to Lakdawalla, policymakers must realize that the problem is a massive one with no easy solutions.

"The real challenge is how to figure out a way to mitigate the impacts of obesity on health, given that it is going to be impossible to roll weights back, and figure out ways to give people the right incentives," said Lakdawalla.

--

(This is Part One of a two-part series on obesity and public policy. Part Two will examine the social cost historically to government reaction to social and health ills, both real and perceive, with policy conundrums such as obesity.)

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