Can Americans Reverse the Obesity Epidemic?
(HealthDay News) -- Americans got themselves into the obesity crisis, and they’re looking for all sorts of ways—including a pill—to get themselves out of it. More than 64 percent of adults in the United States are considered overweight, and almost 25 percent fall into the category of being obese, according to government statistics. Obesity is defined as men with more than 25 percent body fat and women with more than 30 percent body fat.
The reason that most medical experts consider being overweight a dangerous health problem is that a preponderance of evidence indicates it leads to a number of diseases.
Chief among them is diabetes. According to the American Diabetes Association, about 14 million Americans had type 2 (adult onset) diabetes in 1998. In 2005 that number had ballooned to 20.8 million, more than 7 percent of the U.S. population.
But overweight problems extend to almost every disease or condition imaginable, from cancer to heart disease, from arthritis to stroke.
Is there a quick fix, a miracle pill that one can take and lose weight? Scientists have been making some progress, although the government hasn’t approved the “magic pill” yet.
In late February, the maker of the diet drug Acomplia, whose application to market it in the United States had yet to be approved, said it was still pushing to sell the drug in America this year. The pharmaceutical firm Sanofi-Aventis planned to meet with regulators from the U.S. Food and Drug Administration in March 2006 to answer questions the FDA had required before it would approve Acomplia.
Acomplia has shown significant weight loss results in trials in addition to its already proven effectiveness in helping people quit smoking.
But it’s doubtful that Acomplia or any other medication will replace the traditional two-pronged solution to weight loss: diet and exercise. In fact, the Acomplia literature stresses proper diet and regular exercise as part of its weight loss regimen.
One of the biggest barriers to keeping the weight off is Americans’ fascination with the “more is better” syndrome. A Journal of the American Medical Association report emphasized that serving sizes are getting larger and larger. "Between 1977 and 1996, food portion sizes increased both inside and outside the home for all categories except pizza," the report says.
That conclusion comes from two major studies: the National Food Consumption Survey, which gave information on 1977 portion sizes, and the Continuing Survey of Food Intake, which gave data for 1989 and 1996.
The surveys contained information about specific food items -- salty snacks, desserts, soft drinks and French fries -- and eating location -- home, restaurant or fast food outlet.
Fast food establishments such as McDonald's and Burger King might have led the way with their "super size" portions, but the increase was evident everywhere, says Samara Joy Nielsen, a doctoral student in nutritional epidemiology at the University of North Carolina, who did the study with Dr. Barry M. Popkin, a UNC professor of nutrition.
"Fast food establishment servings are larger, and they have increased at home as well," she says. "It is hard to say which came first, but the point is that it is happening in both locations."
The results of the study are presented both in terms of ounces of food and as the amount of energy contained in food, in calories. For example, the energy in salty snacks increased by 93 calories and the size increased from 1 ounce to 1.6 ounces.
Similarly, a hamburger serving increased from 5.7 to 7 ounces, or 97 calories; a serving of French fries increased from 3.1 to 3.6 ounces, or 68 calories; and a serving of Mexican food increased from 6.3 to 8 ounces, or 133 calories.
"Since an added 10 kilocalories a day of unexpended energy is equivalent to an extra pound of weight per year, it is easy to see the potential impact of large increases in portion sizes," the report says. (What scientists call kilocalories, most of us call calories.)
While there has been a lot of emphasis on heart-healthy eating -- avoiding fatty foods and so on -- much less has been said about the sheer quantity of food consumed, Nielsen says.
"We need to be telling people that it's not just what you are eating but also the quantity of food you are eating," she says.
"I call it portion distortion," says Wahida Karmally, Director of Nutrition in The Irving Center for Clinical Research and associate research scientist and lecturer in dentistry at Columbia University..
"Eating habits have created a toxic environment for the American population," Karmally says. "Obesity rates have gone up to epidemic proportions and that has a tremendous impact on health. The effect on hypertension, diabetes and heart disease is quite evident."
People need to be aware of the effect of larger portions on their weight, and to make sure their children know it too, she says. "Parents have a responsibility to show children how to eat," Karmally says. "It shouldn't be the old strategy of 'Clean up your plate.'"
On the Web
You can learn more about obesity, its problems and how to avoid it, from the National Institute of Diabetes and Digestive and Kidney Diseases.
SOURCES: Samara Joy Nielsen, doctoral student and nutritional epidemiology researcher, University of North Carolina, Chapel Hill; Wahida Karmally, MS, RD, CDE, Director of Nutrition, The Irving Center for Clinical Research, associate research scientist and lecturer in dentistry, Columbia University, New York City; Jan. 22, 2003, Journal of the American Medical Association
Publication date: March 1, 2006
Author: Ed Edelson, HealthDay Reporter
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