Richard H. Carmona

Obesity in America is a growing problem with serious health and public policy ramifications. An AEI conference on June 10 outlined the health problems associated with obesity, addressed the reasons for its growth, and considered policy responses.

AEI fellow James K.Glassman presented alarming statistics illustrating obesity's spread. "Three out of five U.S. adults are overweight, as well as one in seven children and adolescents. Obesity among adults has doubled since 1980, and [the number of overweight adolescents] has tripled. Approximately 300,000 deaths a year are associated with" being obese or overweight.

Calling the evidence of obesity's consequences "overwhelming," Dr. Frank Hu, professor at the Harvard School of Public Health, outlined the specific health problems that often stem from being overweight. "Weight gain during adulthood from age eighteen or from age twenty-one is associated with dramatically increased risk of type-two diabetes, gallstone disease, hypertension, and coronary heart disease."

Yet, University of Virginia professor Glenn Gaesser, author of Big Fat Lies, pointed out that some studies show obesity to be a smaller problem than Hu and others suggest. Providing a contrarian view, Gaesser said that while extreme obesity can be dangerous, the health threat of being overweight or obese has "been exaggerated. This is not to minimize the health implications of obesity, but I do think some scientists, and the media, have overestimated the risks associated with being overweight or obese."

Focusing on the sociological reasons for increased obesity rather than the medical implications, Tomas J. Philipson, professor of public policy at the University of Chicago, cited economic and technological changes. Increased obesity is not new, and, in fact, "height-adjusted weight gain has been picking up for at least one-hundred years." According to Philipson, at the same time as the "real price of calories has . . . been going down," Americans have ceased burning calories by spending their days engaged in strenuous farming activities and now sit sedentary at office desks. "Essentially the technologies that have made us more productive have at the same time made us more sedentary," Philipson said.

Discussing how this trend could be reversed and what role, if any, government should play, Richard A. Epstein, professor of law at the University of Chicago, asserted that government intervention in health crises is necessary and effective in many cases, particularly those dealing with communicable diseases. However, he cautioned that obesity cannot be likened to a contagious disease and that a collective solution to obesity would be impossible; the diversity of the American public and the individualized health problems obesity causes make it a crisis incapable of being solved by government regulation. It is important "to remember that there is no particular advantage that the public health sector has in dealing with the problem of obesity. This is a serious problem for individuals, but like other serious problems, from bankruptcy on the one hand to heartache on the other, there are other ways to do it." Individual responsibility, rather than government regulation, is more likely to lead to a solution, Epstein said.

Also noting the importance of individual responsibility, U.S. surgeon general Richard H. Carmona reminded the audience that obesity "is almost entirely preventable through proper diet and exercise." He offered ways in which the government, healthcare workers, and community leaders could work to prevent the further spread of obesity, including ensuring that all Americans are educated about the importance of physical activity, healthy eating habits, preventive screenings, and making smart choices.

Carmona urged particular vigilance in protecting the health of the increasing number of overweight children and adolescents, "who grew up off the playground and on the PlayStation." He concluded with a statement intended to make all Americans consider the choices they make: "We are at a crossroads in our nation. We are standing at the corner of health and disease. Are we going to sentence ourselves to being a society defined by obesity and disease? Or are we going to choose to be a nation of health and vitality?"