Obesity is not only an epidemic in this country, it is a global explosion. Researchers say “globesity” is out of control, and the health care community has ideas to help stem the tide of expanding waistlines.

A panel of experts shared ideas at the American Dietetic Association Food and Nutrition Conference and Exhibition on how to put a dent in the obesity problem.

Panel members Jim Hill, PhD, John Foreyt, PhD, and W. Phillip James, MD, DSc, all agreed that the environment needs to change if we are to have an impact on the serious consequences of obesity and turn strategies into solutions. There is no simple solution to this very complex problem; taking small steps to tackle the problem is a great beginning.

What is Obesity?

Causes and Consequences

The trend of increasing numbers of adults with excess weight continues. According tothe 1999-2000 National Health and Nutrition Examination Survey (NHANES), more than 64 percent of U.S. adults are either overweight or obese.

The U.S. is not alone. Australia, the U.K., Germany, Croatia, Greece, Finland, and many other countries have a high prevalence of overweight adults, according to the International Obesity Task Force web site.

“The cause of the obesity epidemic around the globe is multifaceted and complex,” says James. “Developed countries have spent large sums of money to provide mechanical, electronic, and physical aids to remove the need to do any physical activity so people burn fewer calories each day.”

According to James, “this is further compounded by intense marketing and availability of inexpensive food that is high in calories, fat, and sugar.”

Well-known health consequences of obesity include type 2 diabetes, cardiovascular disease, sleep apnea, liver abnormalities, and negative psychological consequences.

These conditions are not limited to adults and are being seen in the growing number of overweight and obese children.

Excess weight has been associated with an increased risk of some cancer.

In men and women, being obese or overweight has been linked with an increased risk for kidney cancer. In women, breast, ovarian, cervical and uterine cancer risk all increase with excess body weight.

According to NAASO, The Obesity Society, obese women have a 1.5-fold greater risk for endometrial cancer and a twofold greater risk for postmenopausalbreast cancer.

WebMD Tool: Calculate Your BMI

One Small Step at a Time

“We need to focus our attention on health, well-being, and the improvement of the quality of life that small changes can achieve,” says Foreyt. Don’t think of a diet-and-exercise overhaul; think small steps to halt weight gain and then move on to weight loss.

“If we could simply stop gaining weight, it would be a substantial first step toward reducing globesity” says Hill, one of the founders of America on the Move, which popularized the pedometer.

His advice: make small changes that add up to at least 100-200 fewer calories daily. Eat one less cookie, leave a few bites of the fast-food burger, and walk 2,000 more steps each day to help weight maintenance.

Pedometers keep track of how far a person walks or runs. They also keep track of the number of steps a person takes. That -- plus advice to take 10,000 steps a day -- seems to help motivation for people who don't like to exercise.

Changing behavior is admittedly one of the most difficult tasks health care professionals face, panel members told the audience of registered dietitians. “Taking small steps seem to be the most reliant way for doctors and dietitians to help get people to change the way they eat and exercise,” says Foreyt.

Everyone is looking for the magic bullet but it does not exist, he says. “It starts and ends with personal responsibility.”

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Changing the Landscape

Beyond small changes, we need to change the environment in which we live. “We have to create social change in our communities where eating healthy and physical activity are promoted and supported by everyone from health care, schools, local and state government, parks,” says Hill.

People have to want social change; it cannot be forced upon them. “If they don’t see the value of sidewalks to promote more walking, they won’t support it with their tax dollars and it won’t become a reality.” Healthy foods are being manufactured, as evidenced in the exposition at the meeting, but if consumers don’t support the healthier options with their dollars, these healthier options won’t be around for long.

Make it easy, convenient and start early to help kids develop healthy eating habits and the enjoyment of physical activity. “The secret sauce is making it fun so it does not feel restrictive or like punishment,” says Foreyt. “There will never be a magic bullet for successful weight loss so we need to alter behaviors slowly, gradually and encourage personal responsibility from an early age.”

James encouraged food manufacturers and government to subsidize healthy foods and clearly label them so consumers will be more likely to purchase healthier foods. “Using the simple red/yellow/green stop-light approach is one that all consumers understand and would help when making decisions about what foods to purchase.”

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Things Take Time

Raising awareness is a great place to start to educate people about the perils of obesity and what they can do to improve their health, the panel members say. Beyond raising awareness, Foreyt is an avid believer in the power of keeping records to track food, activity, and weight.

Dietitians at the meeting were challenged to look for ways to play key roles in changing the landscape of globesity and inspiring people to make sustainable changes that will not only reduce the incidence of obesity but improve the health of the world.

By Kathleen Zelman, MPH, RD, reviewed by Brunilda Nazario, MD

SOURCES: American Dietetic Association Food and Nutrition Conference, St. Louis, Oct. 22-25, 2005. Jim Hill, PhD, professor, University of Colorado Health Sciences; co-founder, America on the Move. John Foreyt, PhD, professor, Baylor College of Medicine, Houston. W. Phillip James, MD, DSc, chairman, International Obesity Taskforce; senior vice president, International Association for the Study of Obesity, London. International Obesity Taskforce web site, March 16, 2005. NASSO, the Obesity Society.