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Obesity, Health and Weight Loss
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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.

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