Obesity, Health and Weight Loss
Obesity Issues
Obesity has reached epidemic proportions in the United States and shows
no signs of abating. Currently, 31 percent of the population is obese
and another 34 percent is overweight. Based on trend analysis, we predict
the obesity rate will be 39 percent by 2008. Despite obesity being recognized
as one of the top public health threats, there are few public health efforts
directed toward obesity. The lack of public health programs is likely
due to the complexity of the issue, incomplete understanding of it's etiology,
and a lack of success models in addressing obesity. Both the public and
private sectors are aware of the issue and of the need for action and
have programs in development. Despite a call from the Surgeon General
for public-private partnerships to address obesity, few efforts in this
area have been made.
Prevention of Weight Gain
Another barrier to effective programs is the lack of specific goals for
how to address obesity. We have recently argued that our first goal should
be to prevent weight gain in the population. Our analyses suggest that
the average U.S. adult is gaining 1-2 pounds per year. Further, we have
estimated that weight gain in 90 percent of the population could be prevented
by reducing positive energy balance (some combination of eating less and
increasing physical activity) by 100 kcal/day. We have been unsuccessful
in producing and sustaining large lifestyle changes. We may be more successful
in producing and sustaining small changes in energy intake and physical
activity on the order of 100 kcal/day. Such changes could prevent weight
gain in most of the population.
Colorado on the Move
We established a public-private partnership in Colorado to develop a program,
Colorado on the Move (www.coloradoonthemove.org) to test this hypothesis.
The program involves using electronic pedometers to set walking goals
in terms of steps/day. The goal is for participants to increase walking
by 2000 steps/day (about 100 kcal/day). Programs to support pedometer
use have been developed for schools, worksites and communities. We strive
to involve the private section in supporting and sustaining the increases
in walking. We have shown that this goal can be achieved in most participants
over 14 week programs. A national version of this program, American on
the Move, will be launched in May 2003. We hope this will be a major grassroots
effort to address the public health problem of obesity. America on the
Move will involve small increases in physical activity (2000 steps/day)
and small reduction in energy intake (choosing a single behavior each
day to eliminate 100 kcal intake).
Source: James O Hill, PhD Director, Center
for Human Nutrition, University of Colorado Health Sciences Center, Denver,
Colorado, USA. (2003)
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