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Obesity control the public health challenge

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Title: Obesity control the public health challenge


1
Obesity control the public health challenge
  • Katherine Hempstead
  • Center for Health Statistics
  • New Jersey Department of Health and Senior
    Services
  • June 25, 2007

2
Learning objectives
  • 1. Understand epidemiological data on obesity
    epidemic
  • 2. Review current obesity control policy
    activities
  • 3. Understand challenges facing obesity control
    efforts, role of epidemiologists

3
Overview
  • Background
  • Current policy activities
  • Obesity control vs. tobacco control
  • Outlook/Assessment

4
Age pattern of obesity prevalence, 1998-2006
Source BRFSS
5
If age-specific growth rates persist
Projection 2012
Source BRFSS
6
Prevalence of overweight Children and teens
SourceNHANES
7
Obesity Trends Among U.S. AdultsBRFSS, 2005
(BMI 30, or 30 lbs overweight for 5 4
person)
1519
2024 2529 30
8
Overweight and obesity by race and ethnicity,
adults, 2006
Source BRFSS
9
Overweight by race and ethnicity, 12-19 years,
2003/4
SourceNHANES
10
Burden of obesity
  • Morbidity
  • Disability
  • Life expectancy
  • Cost

11
Public health response
  • Long recognized as health problem
  • Epidemic anticipated since 1970s
  • Focus has been on individual behavior
  • if overweight, decrease energy intake and
    increase energy expenditure Dietary Goals for
    the United States, 1977

12
More recently
  • Obesity is a societal problem
  • The toxic environment
  • Policy focused on altering environment
  • individual change will not work in isolation.
  • Trust for Americas Health, 2006

13
Recent legislative activities
  • Schools
  • Task forces
  • Insurance mandates
  • Taxes/bans on food
  • Menu labeling
  • Improvements to the built environment

14
Enacted obesity legislation
15
Proposed obesity legislation
16
2006 State Report Card
17
Obesity control comparable to tobacco control in
some ways
  • Multiple stakeholders
  • States very important
  • Focus on prevention
  • Focus on environmental reform
  • Emphasis on legislative activity

18
Tobacco control hailed as a great public health
victory
  • Obesity control efforts in much earlier stage of
    development
  • Is obesity control on a trajectory to be
    similarly successful?
  • Unique challenges

19
1. Obesity is a more complex problem
  • Food behavior affected by many factors
  • Physical activity difficult to regulate

20
2. Food supply more difficult to regulate
  • Food supply is decentralized
  • Food industry less monolithic

21
3. More potential for backlash
  • War on obesity or war on obese?
  • Some say too much big brother

22
Summary
  • Challenges
  • Complexity of obesity
  • Decentralization of food supply
  • Potential for backlash
  • What do we need?

23
We need epidemiological evidence
  • Public intervention on the rise
  • But science not driving policy
  • Epidemiologists can contribute with data,
    evaluations, new outcome measures
  • a necessary element of an adequate
    governmental response to the obesity epidemic is
    a robust information-gathering system to monitor
    progress and guide programs and policies. IOM

24
and appropriate expectations
  • Avoid urge to rush into unsupported activities
  • Toxic environment was created over several
    decades
  • Consumers need to develop new lifestyle
    preferences and maintain them
  • Need to de-normalize unhealthy lifestyles
  • Moderate change may confer benefits

25
The problem is pervasive
26
In closing
  • The 'fad diet' approach does not work for
    individuals, and it's not going to work for our
    nation's obesity crisis either.
  • Trust for Americas Health, 2006
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