O is for obese

Take a look around you. If you’re out in public, or perhaps even at home with your family, there’s a good chance you’ll see someone battling obesity. Nearly one in four Californians is considered unhealthily overweight, and that number continues to rise.

By 2030, according to a newly released study, the obesity rate in California will double, to 46.6 percent, if current trends continue. Health-care costs related to obesity would increase by 15.7 percent—another staggering figure for a state already racked by financial woes and struggling to meet existing needs.

The study, from the Robert Wood Johnson Foundation and the Trust for America’s Health, has a telling title: “F as in Fat: How Obesity Threatens America’s Future.” It projects a national obesity rate of 44 percent by 2030, including rates over 60 percent in 13 states.

Behind those numbers loom associated health risks. “The number of new cases of Type 2 diabetes, coronary heart disease and stroke, hypertension and arthritis could increase 10 times between 2010 and 2020,” the report says, “and then double again by 2030.”

Moreover: “Obesity-related health-care costs could increase by more than 10 percent in 43 states and by more than 20 percent in nine states.”

California is just one state facing a public-health epidemic if the trend continues.

“Sadly, it doesn’t surprise me,” said Dr. Christine Sloop, a physician and registered dietician. Sloop, an obstetrician/gynecologist, recently moved from Ohio, and while preparing to open a clinic in Chico she’s been working as a dietician at Feather River Hospital in Paradise.

“The obesity problem is a multifaceted problem,” she continued in a phone interview. “Food for most of us is too available, too easy, in too large of portions and not healthy. There’s the technology issue—technology has made it so we don’t need to exercise much. And then we have all these time pressures: We work more, we have less leisure time, we have many roles that we try to juggle, and we don’t have time to take care of ourselves. And then we don’t sleep as much as we should.

“All of these things are combining to contributing to an obesogenic society. The conditions all are pushing us toward obesity.”

There is a glimmer of hope. The report concludes that “if we could lower obesity trends by reducing the average adult BMI (body mass index) by only 5 percent in each state, we could spare millions of Americans from serious health problems and save billions of dollars in health spending.” Figures for California include $82 billion in savings and 800,000 fewer cases of diabetes.

“Losing 10 percent of your body weight has the same [positive] effect as starting a blood-pressure medication,” Sloop said. Remaining seriously overweight puts extra stress on joints like knees and ankles, along with increasing risks of heart disease, diabetes and high blood pressure.

Faced with such daunting prospects, people would seem to have ample motivation to lose weight. Obviously it’s not that simple.

Sloop compares the obesity crisis to the prevalence of smokers before the 1970s, when the surgeon general pointed out the dangers of tobacco. Obese people may have an even tougher path than those who quit smoking.

“Smoking is yes-I’m-doing-it or no-I’m-not, whereas we all have to continue to eat,” she said. “So, in many ways, eating healthier is harder.”

Recent research has found additional reasons for obesity. First, Sloop pointed out, is the link between sweetness and the drive to eat.

“The sweet taste on our tongue, on our sweet taste buds, goes straight to increasing the dopamine in our brain, and the addiction potential is the same as with cocaine,” she said. We want to have that sweet taste on our tongue, but “we’re going to have to have less sugar in our food if we’re going to eat less food.”

Another study found that women who gain “too much weight in pregnancy”—50 to 100 pounds—are more likely to have children who become obese later in life. Other research determined that the weight a child develops during puberty tends to become the “set point” for adulthood physique.

“A girl who’s pudgy at 12 or 13 is going to battle with weight for the rest of her life,” Sloop said. “So, some of this research is really depressing—we as Americans have been handed a real unfortunate thing that we didn’t know, and now we have to deal with it, because this obesity epidemic is killing us.”

What can be done? Both Sloop and the “F as in Fat” study have suggestions.

The report’s five authors and seven contributors recommend improving nutrition in school-provided meals, re-emphasizing physical education in schools and increasing government funding for obesity prevention using evidence-based medicine.

That’s a macro perspective, which would also include Sloop’s desire for food companies to make their products less sweet, and for cities to facilitate exercise through projects such as hiking and bike trails.

Then there’s the micro perspective—what individuals can do.

“Grocery-shop only when you’re not hungry, so you’ll buy only food that’s healthy,” Sloop said. “Try to eat more at home and less out. Try to adjust your schedule so you have more time that you can eat at home and have time to exercise.”

Physical activity can actually decrease appetite by altering hormones, she said. In addition, research has found that people who sleep less than six hours a night also are more likely to eat more—not just because they’re up more, but again because of hormones.

“It’s about identifying what for each individual person is the trigger and focus on making a change in one area at a time,” Sloop said. “Studies have shown that if you make incremental steps, you stick with them.

“If you have some person who’s 60 pounds overweight and eats steak every night and has never, ever eaten a vegetable, and you tell that person, ‘You’re going to run on a treadmill an hour a day and you’re going to be vegan,’ that’s just not going to work for a large percentage of people.”