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Panel Detail:

Monday, April 28, 2008
11:00 AM - 12:15 PM

An Unhealthy America: Obesity and the Economic Implications of Chronic Disease

Moderator:

Richard H. Carmona, 17th Surgeon General of the United States (2002-2006); President, Canyon Ranch Institute

Members of this panel addressed the prevalence of obesity in the United States, factors that have contributed to its proliferation and actions the private and public sectors can take to help reduce its prevalence in the population. Moderator Richard Carmona, the former surgeon general who is now with Canyon Ranch Institute, framed the discussion by acknowledging that "as surgeon general, few issues that I faced had the pervasive ... effects of obesity."

Obesity has increased significantly in the United States over the past few decades. In 1991, explained Ross DeVol of the Milken Institute, none of the 50 states had average obesity levels greater than 20 percent. By 2006, only three states had an average obesity level less than 20 percent. The highest levels tend to be concentrated in states with the lowest socioeconomic levels, supporting other research that has confirmed the relationship between obesity and socioeconomic status.

Panelists discussed several reasons for the increase in obesity. Tomas Philipson of the University of Chicago explained that increases in agricultural productivity have resulted in a declining price per calorie of food, and that full-time employment requires less physical activity now than in the past; many people are now sedentary in their jobs. Rather than exercising as part of the workday, they now pay to exercise, at health clubs and gyms, or as part of their leisure and family time.

Francine Kaufman of the University of Southern California Keck School of Medicine discussed her research, which is demonstrating links between obesity and diabetes, and the biological and genetic factors that contribute to a person's propensity for obesity. While diet and exercise are the most significant determinants of obesity, genetic characteristics for different U.S. populations also affect the likelihood of becoming obese.

Public policy can have unintended effects on health and obesity, and former Surgeon General Carmona noted that there is a need to consider the consequences of a government health policy before implementing it. Steven Burd of Safeway Inc. offered an example: Many public schools have eliminated physical education as a means to reduce costs and to improve academics. But the result of this policy has been a decrease in academic performance, in addition to the expected general decrease in physical activity among young people. Commenting on the increased prevalence of chronic diseases among children, Carmona said, "We're taking middle-age diseases and ratcheting them down to children."

The government, private sector and individuals can all take actions to reduce obesity. Panelists suggested various government incentives, such as compensating physicians for time spent helping patients prevent obesity rather than only treating its effects.

Representing the private sector, Burd said that "information is important, but insufficient." He outlined several steps Safeway is taking to reduce obesity among its customer base and work force. Specifically, Safeway allows loyal customers to download nutritional information for purchases made over the previous six months and compare it to established standards. Businesses can also encourage their employees to take part in nutritional and exercise programs.

Mark Mastrov of 24 Hour Fitness explained that individuals can combat obesity by introducing more movement into their lives during the day, such as walking, taking the stairs or spending time outdoors. He also discussed the importance of being accountable to others for weight-loss goals. 24 Hour Fitness emphasizes the role of trainers, using workout buddies and group classes to remain committed to exercise regimens.

Panelists agreed that obesity is a significant problem in the United States, and that it will take the cooperation of individuals and organizations to prevent further deleterious effects on individual health and the economy.

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