http://www.cnn.com/2007/HEALTH/diet.fitness/08/27/obesity.study/index.html

Report: National strategy needed to fight fat
Story Highlights
Report: Obesity rates swelled over last year in 31 states; no states saw
decline

First time a state has more than 30 percent obese: Mississippi

Recommendation: National strategy needed to attack obesity

(CNN) -- Americans are already among the fattest people in the world and
they just keep packing on the pounds. A new report finds that obesity rates
have swelled during the last year in 31 states with not one state reporting
that its obesity rate shrank. And, for the first time, more than 30 percent
of residents in one state -- Mississippi -- are classified as obese.

Nationwide, two-thirds of U.S. adults are obese or overweight, according to
the fourth annual report from the Trust for America's Health, titled "F as
in Fat: How Obesity Policies are Failing in America." The report's
co-author says the government needs to treat this trend as an epidemic that
threatens the health of Americans and put in place a national plan in place
to combat obesity.

"The key recommendation in the report is we need a national strategy," said
report co-author Jeffrey Levi.

He noted that the federal government has created a comprehensive plan to be
implemented in the event of an outbreak of pandemic flu.

"We need something like that in obesity that says this is what every agency
of the federal government is doing. [It's] what we can do to directly
affect this problem and motivate individual communities and businesses to
play their role as well," Levi said.

In 32 states, 60 percent of the population is either overweight or obese.
West Virginia ranks highest in the combined statistic, with nearly
two-thirds of its adults obese or overweight.

Mississippi, where almost one in three adults are obese, also ranks highest
in adult hypertension and physical inactivity. It's tied with the District
of Columbia in poverty and ranks second-highest in adult diabetes.

West Virginia came in second in the obesity ranking, followed by Alabama,
Louisiana, South Carolina and Tennessee.

Nationwide, more than 25 percent of adults in 19 states are obese, up from
14 states last year.

"If you go back to 1991, only four states had obesity rates above 15
percent, and none exceeded 20 percent," said Levi.

Physical activity is linked to a reduced risk of dying prematurely. It also
lowers one's risk of developing a host of diseases, including heart
disease, diabetes, high blood pressure and colon cancer.

Obesity also affects the health of the nation's economy. Fat employees
translate into fat medical bills for U.S. businesses trying to compete in
an international marketplace.

A Duke University study that appeared in the Archives of Internal Medicine
found 184 lost workdays per 100 obese full-time employees versus 14 lost
workdays per 100 normal-weight full-time employees.

The average obese worker has up to 21 percent higher health care costs, the
Duke report said.

A Medicare study found that obese patients cost the agency 15 percent more
than normal or overweight patients.

Levi says individuals need the government's help to take control of their
weight.

"People can't exercise personal responsibility in a vacuum," he said. "If
you're telling people to eat healthier food and there are no grocery stores
in the neighborhood; if you're telling them to be more physically active,
and they live in poor, unsafe neighborhoods or in suburban neighborhoods
with no sidewalks, then you've created an environment that doesn't make it
possible for people to exercise that personal responsibility. That's where
government plays a role."

And it's not just government agencies involved in public health that need
to play a role, he said. Zoning boards are involved in building the
sidewalks that encourage people to walk; school boards are involved in
ensuring students get nutritious meals and physical education programs, he
said.

"Everyone has a role to play, starting with though not ending with the
federal government," he said, noting that funding for relevant federal
programs has been flat in recent years.

"The resources are definitely not commensurate with the problem," he said.
"Lots of people share the blame here."

The CDC's point man on obesity, Dr. William Dietz, said he could see no
drawbacks to the appointment of an obesity czar who would coordinate
federal programs.

But, he added, "That's a difficult issue for me to comment on because it's
a recommendation for the administration that I'm part of."

Still, no single strategy will solve the problem, he said, noting that
dozens of societal changes are linked to the nation's expanding waistline
-- the greater availability of food, an increase in television viewing,
cheaper prices for food, and more availability of soft drinks.

But diabetes specialist Dr. Richard K. Bernstein worried that an obesity
czar might lead the nation down the wrong path.

The New York-based author of "Diabetes Solution," contends that the
popularity of low-fat diets is related to the increase in diabetes and
obesity.

"Insulin stores fat," he said. "Eat very little carbohydrate, you're gong
to make very little insulin. Not only will you not store fat, you'll
metabolize it."

A senior analyst for The Center for Consumer Freedom, a food industry trade
group, said government involvement is not needed. "Obesity is a private
issue and we do not need Big Brother wagging his finger at us every time
somebody wants to eat a doughnut," said Justin Wilson. "If someone wants to
be a little heavier because they enjoy eating food that tastes good, that's
a person's personal right."

He cited two simple ways for people to lose weight -- "closing their mouth,
going for a walk. It's the world's easiest diet plan."

The study was carried out by the Trust for America's Health, which Levi
directs. It describes itself as a nonprofit, nonpartisan organization
dedicated to saving lives by protecting the health of every community and
working to make disease prevention a national priority."

The report was supported by the Robert Wood Johnson Foundation.