Challenges and Hope at the CDC Conference on Obesity
July 29, 2009 (Washington, DC) — The Centers for Disease Control and Prevention (CDC) has released a set of communitstrategies to prevent obesity in the United States.
"Obesity, and with it diabetes, are the only major health problems that are getting worse in this country," said Thomas Frieden, MD, director of the CDC. "This is the first time the CDC has provided a comprehensive approach to obesity prevention and control."
The CDC hosted its inaugural "Weight of the Nation" conference here to address the obesity epidemic. The 6:30 am exercise session was the first clue that this conference was serious about its goal of trimming down America. Experts from health insurance agencies, advocacy groups, university public health departments, and other groups with a wellness mission were on hand to share ideas and experiences, all with the goal of finding an answer to the obesity question.
"Childhood obesity has become an obsession of mine," said former president Bill Clinton, who gave the conference's keynote address. Mr. Clinton also received the CDC's 2009 Pioneering Innovation Award for his work with Alliance for a Healthier Generation, a joint initiative between the former president's foundation and the American Heart Association that supports innovations to reduce childhood obesity by 2015.
Soaring Costs
In his speech, Mr. Clinton announced newly released figures indicating that obesity may have cost the United States $147 billion in 2008 — a sharp increase over the estimated $78.5 billion cost in 1998. The study, published in the journal Health Affairs, showed that an obese (body mass index, >30 kg/m2) person spends $1429 more per year on healthcare than the roughly $3400 per year spent by a normal-weight (body mass index, 18.5 – 25 kg/m2) person with similar characteristics.
The bulk of the cost differential was attributed to prescription medication use, according to study author Eric Finkelstein, PhD, from RTI International, Research Triangle Park, North Carolina. Overweight people (body mass index, 25 – 30 kg/m2) were excluded from the analysis because the 1998 study indicated that healthcare for normal-weight and overweight people incur similar costs.
When asked about the cost of health reform, a frequent topic of discussion throughout the conference, Dr. Finkelstein said it was difficult to predict health costs down the road, but "we know the status quo is very costly."
Strategies for Reform
The CDC outlines the new program to curb these numbers in its current Morbidity and Mortality Weekly Report.
The report lists 24 strategies, each with a corresponding measurement that can be used to assess a strategy's implementation. The methods are all evidence-based, according to William Dietz, MD, PhD, the CDC's director of the Division of Nutrition, Physical Activity, and Obesity. He acknowledged, however, that this evidence is not perfect. "We can't wait for the best possible evidence," to combat obesity, Dr. Dietz said, but instead must use the best available evidence.
The strategies aim to promote the availability and affordability of healthy foods and beverages, support healthy food and beverage choices, encourage breastfeeding, push young people to exercise, and create safe environments for physical activity.
One possible strategy that Dr. Frieden and Dr. Dietz have advocated for is a soda tax. According to Dr. Frieden, research has shown that a big part of the obesity problem is sugar-sweetened beverages. "If you have a candy bar before dinner, you are likely to spoil your appetite," he says, but this is not true if you have a presupper soda. Congress has considered incorporating such a tax in health reform.
In a conference panel on health reform, Christine Ferguson, JD, director of the Strategies to Overcome and Prevent Obesity Alliance, recommended that policy makers ask themselves 3 basic questions when considering a policy change: What will be the definition of success, how will this success be achieved, and how will the results be used to refine research efforts. Overall, however, her wishes for reform were less exacting: "I believe that whatever they pass this year in health reform, as long as it puts money on the table, will be great," she said
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