"F as in Fat" study says U.S. obesity policies are a big fat failure so far.
In the past year, adult obesity rates increased in almost half the states (23 to be exact) and declined…well, in none. That's one of the depressing conclusions documented in “F as in Fat: How Obesity Policies Are Failing in America 2009,” a report released recently by the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).
The report takes to task the so-far-ineffectual policies and programs that have tried to address the nation's ballooning girth. The bottom line: whatever we're doing, it's not working.
Among adults, the obesity rate has been swelling, not contracting, as 16 states saw increases for the second year in a row, and 11 of them for a third year in a row. Overall, 31 states now have obesity rates over 25% and all but one are over 20%.
In 1991, no state was over 20%. In 1980, the average for the whole country was 15%, a distant memory for every state this year. In 2009, Colorado had the lowest obesity rate, at 18.9%. It is the only state under 20%.
For the fifth year in a row, Mississippi led the nation in 2009, this time with an adult obesity rate of 32.5%, followed by Alabama, West Virginia and Tennessee, all with rates of 30%.
Perhaps of even greater concern than adult rates is the similarly growing rate of childhood obesity, where Mississippi also was the leader, with 44.4% of the state's 10-to-17-year-olds classified as either overweight or obese (Minnesota and Utah had the lowest rates, each with 23.1%). In both the adult and childhood categories, eight of the top 10 states were in the South.
As with adult rates, childhood obesity rates have supersized, with the number tripling since 1980.
The current economic crisis could exacerbate the obesity epidemic since food prices — particularly for more nutritious foods — are expected to rise, making it more difficult for families to eat healthy foods. Meanwhile, safety net programs and services are becoming increasingly overextended as the number of unemployed, uninsured and underinsured continue to grow. Also, due to the strain of hard economic times, psychological factors that lead to overeating and obesity — depression, anxiety, stress — are increasing.
The boomers are booming in the wrong way. A recent analysis commissioned by TFAH found that the Baby Boomer Generation has a higher rate of obesity than previous generations. As Baby Boomers age, obesity-related costs to Medicare and Medicaid are likely to grow significantly because of the sheer size of the generation, both in numbers and in girth. And, as Baby Boomers become eligible for Medicare, the percentage of obese adults age 65 and older could increase significantly. Estimates of the increase in percentage of obese adults range from 5.2% in New York to 16.3% in Alabama.
Policies addressing childhood obesity are growing. The study pointed out three areas affecting child nutrition programs where states are taking the initiative:
19 states now have nutritional standards for school breakfasts, lunches and snacks that are stricter than the current standards of the USDA, up from only four states five years ago.
27 states now have nutritional standards for competitive foods sold in a la carte lines, vending machines, school stores and school bake sales. Five years ago, only six states had such standards.
20 states have passed requirements for body mass index (BMI) screenings of children and adolescents, or have passed legislation requiring other forms of weight-related assessments in schools. Only four states had passed screening requirements five years ago.
The report makes some recommendations for addressing obesity within a comprehensive reform of the healthcare system. Among its recommendations…
ensuring every adult and child has access to coverage for preventive medical services, including nutrition and obesity counseling and screening for obesity-related diseases like Type 2 diabetes
increasing the number of programs available in communities, schools and childcare settings that help make nutritious foods more affordable and accessible and provide safe and healthy places for people to engage in physical activity
reducing Medicare expenditures by promoting proven programs that improve nutrition and increase physical activity among adults 55 to 64.
The report also calls for a National Strategy to Combat Obesity that would define roles and responsibilities for federal, state and local governments and promote collaboration among businesses, communities, schools and families. It would seek to advance policies that…
provide healthy foods and beverages to students at schools
increase the availability of affordable healthy foods in all communities
increase the frequency, intensity and duration of physical activity at school
improve access to safe and healthy places to live, work, learn and play
limit screen time
encourage employers to provide workplace wellness programs
How to Get the Report
The “F as in Fat” report contains ranking of state obesity rates and a review of federal and state government policies aimed at reducing or preventing obesity. A copy of the report is available in PDF form at healthyamericans.org/reports/obesity2009.