Genetics, fast food, larger restaurant portions, stressed and sedentary lifestyles: The theories behind America’s weight gain are as widespread as many of the derrieres. Medicare and Medicaid, the Internal Revenue Service and the Centers for Disease Control and Prevention have classified obesity as a disease. Is it a disease – or a lack of personal responsibility?The latest report – “Obesity among Adults in the United States” – from the CDC’s National Center for Health Statistics showed that 72 million – more than one third of all U.S. adults – are obese.The good news is that the increase in the prevalence of obesity has tapered off.According to the report, “Among men, there was an increase in obesity prevalence between 1999 and 2006. However, there was no significant change in obesity prevalence between 2003-2004 and 2005-2006 for either men or women.”Cynthia Ogden, CDC epidemiologist, researcher and the lead author for the latest report, said the increase in the prevalence of obesity in men could be related to communication between doctors and patients. “We looked at what percent of obese adults were ever told by their health care provider that they were obese,” Ogden said. “Obese women were told more often than obese men.”Obesity is defined as a body mass index of 30 or greater – calculated by using a person’s weight and height.A complex issueIn a 2006 interview for a special health care publication for the Colorado Springs Business Journal, Dr. Laura Kettel-Kahn, CDC deputy chief for chronic disease and nutrition, said this about obesity: “We need to address this as a societal problem.Obesity is a disease. It isn’t about someone being a glutton. It’s an eating disorder. It is similar to alcoholism – there are physiological components, and it’s not a simple disease.”Ogden agreed that the obesity issue is complex and adding to it is an environment that promotes obesity, she said. Fast food joints on every corner and restaurants that serve large portions contribute to fat America, Ogden said.The environment affects the choices people make, said Deb Galuska, associate director of science with the CDC’s Nutrition, Physical Activity and Obesity Division.”People make choices about what they eat and how physically active they are,” Galuska said. “And they make those choices within environments that make it easier or harder for them to eat good food or be physically active.” For example, if green space is limited in a particular neighborhood, choices for physical activity also are limited,” she said. But the bottom line: it’s all about physical activity and calorie intake.Obesity has been defined as a disease because of how it impacts a person’s health condition, Galuska said. “Excess body fat … has detrimental associations,” she said. Heart disease, cancer, arthritis and high blood pressure are among the many health conditions directly related to obesity.Psychological conditions like low self esteem and depression also must be considered in the fight to reduce obesity, Galuska said. The question she asks is “which came first?”Government controlsPeople have different perspectives (about obesity),” Galuska said. The CDC’s role is about research and education. “It’s both science and program,” she said. The science helps identify strategies to mitigate the problem, and the CDC works with its state partners – health departments – to implement the programs. “We want opportunities to guide people to healthier lifestyles,” Galuska said.Education is important when it comes to the battle of the bulge, but anything that suggests government controls is “passing the buck,” said David Corder, certified personal trainer and owner of Perfect Fit Wellness Center in Falcon, Colo.Did New York City and San Francisco pass the buck and bypass individual choice?In December 2006, New York City board of health officials banned the use of trans fats from restaurant fare. This last December, San Francisco’s mayor, Gavin Newsome, announced a proposal that would place a citywide surcharge on all drinks containing high-fructose corn syrup, such as sugary sodas.Corder may not agree with government intervention, but he is a firm believer that we are what we eat.”Nutrition is the biggest, single issue and it all comes down to personal responsibility.”The No. 1 thing we’re dealing with in life is a lack of personal responsibility, not only about food … it’s across the board. It’s not taking responsibility for your own actions. People have the opinion that everyone has to do something for them. Everybody is looking for the quick fix.”Disease or personal responsibility?Although Corder agreed that genetic, physical and psychological factors play a role in obesity-related problems, “obesity is not a disease,” he said. “Once we title it, we take away the person’s responsibility.”However, Dr. Kent Herbert, family physician and owner of Falcon Family Medicine, said the advantage to labeling obesity as a disease is the availability of federal funds for prevention, diagnosis and treatment. “It also becomes a covered condition on most health insurance plans,” he said.”A disease by definition is (also found on the online Free Dictionary by Farlex) ‘a pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect or environmental stress, and characterized by an identifiable group of signs or symptoms,'” Herbert said. “This fairly applies to obesity, as there are genetic and environmental causes, and results in definite signs and symptoms. As with other diseases, such as high blood pressure, obesity is caused by both genetic and behavioral factors, but the end result is a negative physical effect on the body.”I think many people are resistant to classifying obesity as a disease because it makes it appear as though it is beyond a person’s control and will lead to more use of medicines and more surgeries and less efforts at diet and exercise.” But Herbert said there are many conditions recognized as diseases – like hypoglycemia – that are primarily treated through diet and exercise.Still, Corder, who also holds a specialization in weight loss, said the simple truth is that Americans are eating too much and too much of the wrong kind of foods. “The TV dinners of the 1950s started changing the type of food we eat,” Corder said. “That’s when everything shifted – it became about convenience.” The “structure of foods” became about taste and how fast they were available, he added.Corder said his clients claim that they’re too busy to exercise or cook. “They say it’s easier to drive through a fast-food restaurant,” he said. “But you have to plan. If you don’t plan, you fail. You pack your lunch; you pack snacks for the car and work … proper snacks.”Companies like Kashi are putting healthy snacks on grocery shelves, he said, but some say eating healthy is unhealthy for their bank account.Eating and living healthy is about making wise choices, and it doesn’t cost any more in the long run, Corder said. “If your body is getting the proper nutrition, you will eat half as much food,” he said. It’s all about educating people. Corder said he offers programs from $10 up. “There is plenty of free information out there, too,” he said. “If you give a man a fish, you feed him for a day; if you teach him how to fish, you feed him for life.”Costs and corporate responsibilityConsidering the overall costs of obesity, eating healthy could save Americans in the long run. The CDC reported that in 2000, the total cost of obesity in the United States was $117 billion – $61 was directly related to medical care.Those costs eventually hit the pockets of every American. Scott McGohan is a partner with McGohan Brabender, an independent employee benefits firm based in Dayton, Ohio. In a December special health care publication of the Dayton Business Journal, McGohan addressed employer incentives as a way to motivate overweight and obese Americans.Companies are already shifting costs to employees, he said. However, under a high-performance health plan, where premiums are based on risk assessments, employees could save money if they’re willing to adopt healthy lifestyles and practice preventive maintenance.”Perhaps it’s time for employers to say they’ll fund a greater percentage of the health care premium if the employee is engaged in good health practices and a lifestyle that is healthy,” McGohan said.The good newsAdopting a healthy lifestyle before the body is challenged by changes, such as age and hormonal fluctuations, may help keep Americans fit through their golden years.Age doesn’t equal fat, Corder said. Although hormonal changes affect the body, it’s a lack of activity that tips the scales for older Americans, he said. “Our bodies are designed to hold more fat as we age,” Corder said. “We will gain a bit – 3 to 5 percent – but that isn’t a lot. It’s the sedentary lifestyle. You can change your shape at 100 years old.”The good news is that the body never loses its ability to grow muscles and burn fat, he said.”You can have a good body at any age.”
