The nation's anti-obesity policies lack coordination and are failing to curb the rising obesity rates (search), claims a report issued Wednesday by a nonprofit public health group.

The report accuses the federal government of not having an organized effort to attack rising overweight and obesity rates, which now affects more than 60 percent of Americans. It also blames states for failing to follow up on nutrition and activity programs that are intended to fight the $139 billion-per-year epidemic.

"Simply asking and chastising people to eat less and exercise more is not the way to solve this problem," says Shelley Hearne, executive director of Trust for America's Health, which issued the report.

The group praises Arkansas for becoming the first state to require body mass index (search) (BMI) measurements for all students as part of an effort to accurately gauge obesity rates. BMI is a measure of weight in relation to height and is an indicator of body fat.

But the report says that 40 percent of states do not collect any reliable data on obesity rates in children and that few enforce widespread physical activities in schools. Only four states: California, Hawaii, Texas and West Virginia, have nutritional standards for snack bar and vending machine foods widely sold in schools, according to the report.

Forty-one states have adult obesity rates topping 20 percent, though federal health goals aim to drop the obesity rate to 15 percent by 2010. Alabama remains the heaviest state with 28.4 percent of adults obese, while Colorado is the lightest with 16 percent. Diabetes, (search) a major complication of obesity, affects more than 6 percent of adults in 40 states, the report says.

The group recommends that federal authorities step up their scrutiny of states and compel them to report childhood obesity trends and provide better information on whether health programs are working.

Federal and some state health officials have responded to the rising obesity rates. Some states have moved to limit kids' access to unhealthy foods in schools, while others recently formed commissions on obesity, nutrition, and physical activity.

The federal government has begun funding ad campaigns urging Americans to eat right and exercise, and Medicare announced in July that it would for the first time consider designating obesity an illness, possibly paying for some treatments.

Congress has also begun considering moves to tighten nutritional and exercise standards in schools.

Georges Benjamin, MD, executive director of the American Public Health Association (search), calls the efforts "fragmented" and says that governments are not focusing on obesity prevention.

"We're dealing with things on the back end instead of dealing with things on the front end," he says.

CDC Should Take Over

The report calls for a new national study to accurately determine obesity rates and causes of childhood obesity, noting that the last nationwide youth health survey was conducted two decades ago.

Hearne says that the nation's response should be consolidated inside an obesity "command and control center" at the CDC and that the agency take control of national nutrition recommendations known popularly as the Food Guide Pyramid.

The pyramid is issued by the U.S. Department of Agriculture, which Hearne says is responsible for promoting food manufacturers and grocery producers. "The USDA does have a perceived conflict of interest here," she says.

CDC should also form a rapid response team that quickly dispatch to communities to help them find locally tailored causes and cures for rising obesity rates, the report recommends.

A U.S. Department of Health and Human Services spokesperson could not be reached for comment by press time.

By  Todd Zwillich, reviewed by  Michael W. Smith, MD

SOURCES: "F as in Fat: How Obesity Policies are Failing America," Trust for America's Health, Oct. 20, 2004. Shelley Hearne, executive director, Trust for America's Health. Georges Benjamin, MD, executive director, American Public Health Association.