Coming to Terms with the Obesity Crisis (Adults)
About this Challenge:
In 40 years, the U.S. population has gone from 40% overweight to 68% overweight. Half of American adults are dangerously obese, leading to many chronic conditions and deadly (and expensive) diseases.
Scientists and doctors generally agree the obesity epidemic is behavioral in nature (not the result of a pathogen).The key drivers are our choices of food and activity, but multiple additional factors also play a role — from family dynamics to cultural roots, stress, economics, lifestyle and many more. Unlike smoking or drinking, eating is not optional. How can Americans move to healthier lifestyles — or, if we can’t change these trends, how can the healthcare system cope with the results?
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Prior to his appointment as Commissioner, Auerbach had been the Executive Director of the Boston Public Health Commission for 9 years. He had previously worked at the State Health Department for a decade, first as the Chief of Staff and later as an Assistant Commissioner overseeing the HIV/AIDS Bureau.
I approach the challenge of adult obesity from the perspective of a state public health official as well as a member of the Association of State and Territorial Health Officials (ASTHO). As such, I am I interested in gathering data that sheds light on the problem (e.g.who is most affected and why), in convening the many interested governmental and nongovernmental groups, in piloting new programs based on the best evidence of efficacy, and in considering the policies that will be effective across all levels of public health, within and outside of the health sector.
Daniel Callahan is a Research Scholar and President Emeritus of The Hastings Center. His work over the years has focused on ethical and policy issues of medicine and biology. A philosopher by training (Ph.D., Harvard), he has in recent years focused on health care reform, particularly on issues of rationing and self-determination. He is the author and editor of 44 books and 600 articles.
I bring to the problem of obesity a long-standing interest in those large scale problems that require changing the values, practices, and behavior of large groups or even nations, that have come to be thought hazardous to health. Inevitably, such problems involve scientific and policy disagreements, ideological and political clashes, and divided public opinion. Obesity is influenced by the way we live our lives, often deeply embedded in our culture, and that is why it is a hard problem to deal with.
Christine Ferguson, J.D., a leading obesity researcher has been recognized as one of the most influential health policymakers. She serves as a director on the board of Blue Cross Blue Shield of RI and on two Institute of Medicine boards: Children, you and families; and health sciences policy standing committee on family planning. Previously, she served as Commissioner of Public health in Massachusetts, and from 1995 to 2001, she ran the Rhode Island Department of Human Services.
Dr. Kahan is a physician trained in both clinical medicine and public health. He is board-certified in Preventive Medicine, and his clinical practice specializes in weight management and obesity medicine. He serves as Director of the National Center for Weight and Wellness.
In addition to his clinical practice, Dr. Kahan works as a public health physician specializing in obesity. He has been involved in numerous national and local initiatives pertaining to obesity, nutrition, and chronic disease prevention, and he has worked with Federal, state, and local governments, the National Institutes of Health, and several health advocacy groups.
Joe Nadglowski is President & CEO of the Obesity Action Coalition (OAC), a non-profit organization formed in 2005 dedicated to elevating and empowering those affected by obesity through education, advocacy and support. A frequent speaker and author, Mr. Nadglowski has nearly 20 years of experience working in patient advocacy, public policy and education. He is a graduate of the University of Florida. In addition, Joe is the Executive Director of the American Society for Metabolic and Bariatric Surgery (ASMBS) Foundation, through a partnership between the OAC and the ASMBS Foundation. Through this partnership, the OAC and ASMBS Foundation aim to increase awareness and education on obesity and its treatments by bringing National attention to the cause through the annual Walk from Obesity.
Every day we are bombarded by statistics about obesity, from prevalence to healthcare costs. My hope is that my participation will allow a discussion of not only the statistical and societal impact of obesity, but also the personal impact on quality of health and life. From both my own and family experience, as well as my interaction with the Obesity Action Coalition’s tens of thousands of members who are personally affected by obesity, I hope to raise awareness of the difficulties of living with obesity, the challenge of treating obesity, access to appropriate evidence-based care, weight bias and more.
Dr. Rebecca Puhl is Director of Research at the Rudd Center for Food Policy and Obesity at Yale University. She is a Senior Research Scientist and is responsible for identifying and coordinating research and policy efforts aimed at reducing weight bias and improving the quality of life of children and adults affected by obesity.
Dr. Maya Rockeymoore is the President and CEO of Global Policy Solutions, a Washington, DC-based strategic social change firm that helps make policy work for people, communities and the environment, and serves as the executive director of Leadership for Healthy Communities, a national program of the Robert Wood Johnson Foundation (RWJF). She is also the founder of GlobalPolicy.tv, a web-based public affairs platform that explores important issues related to public policy, politics, and popular culture.
Maya’s expertise includes health, social insurance, income security, education, women’s issues and youth civic participation. She is the board chair of the National Committee to Preserve Social Security and Medicare and serves on the board of the National Association of Counties. Maya is also a member of the National Academy of Social Insurance.
A former adjunct professor in the Women in Politics Institute at American University, Maya has also served as the vice president of Research and Programs at the Congressional Black Caucus Foundation (CBCF), senior resident scholar at the National Urban League, chief of staff to Congressman Charles Rangel (D-NY), professional staff on the House Ways and Means Committee, and as a CBCF legislative fellow in the office of Congressman Melvin Watt (D-NC).
Too many of us in communities of color have family members who suffer from obesity-related diseases such as diabetes or heart disease. Working on Capitol Hill and within national policy organizations has demonstrated the power public policy has in creating meaningful, measurable and lasting improvements to the quality of life for people and communities. As the executive director of Leadership for Healthy Communities, I work with state and local policy makers to support their efforts to reduce childhood obesity through public policies that promote active living, healthy eating and access to healthy foods.
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21 Comments
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Javier Herrera: The reason, Sean, that highly processed food is cheaper, is very simple, the government is subsidizing the corn, wheat and soybeans to the tune of more than $12billion/yr to big agribusiness. So its a whole lot cheaper to get the burgers and fries instead of the broccoli, brussel sprouts, beans and beats! :-)
Unless we change our governmental leaders and remove the influence of the big agribusiness lobbyists, AND focus those $12billion to local organic farmers who produce around our cities locally, decreasing the cost of shipping and eating locally grown harvest, in season. We will continue on the road to ruin, practicing McMedicine, and seeing the continued demise of health in our country. Oh and yes the good news is that China, our biggest competitor, is also headed full speed into the unhealthy abyss, with the increased availability of YUM corp(KFC, Pizza Hut, Taco Bell) and of course McD's. We need more education at the local level to demand change, educating of children about healthy foods and habits is our only way out of this mess!
Whew sorry... just had to get that off my chest... -
Steve Pehnec: I'm reading a number of books lately, such as "Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health" by Gary Taubes, "Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease" by Robert Lustig, and a great blog by Peter Attia, MD, "The Eating Academy".
The general ideas being posited all aim at upsetting decades-long "food myths" that have been promoted by the FDA, AMA, ADA and others that seem to do more harm than good, especially where the fat and cholesterol content of foods are concerned. While these ideas seem to me to be correct (and even obviously so), I continue to see numerous articles that still promote the old paradigm of "fat bad, carbs good" (and no where more strongly than in the marketing of processed foods where it seems to be especially entrenched ).
So to my question/comment: Is the new (emerging?) definition of good nutrition the correct one, and if so, why doesn't it seem to be gaining greater traction? (Or is it?)-
Lewis Yuan: I feel like it is gaining traction, particularly amongst niche communities (e.g. - CrossFit community) but overall the nation is still inundated with the old paradigm of "minimize fat in diet, load on carbs"... I think with more studies like the one that was published last summer by Dr. Ludwig (http://jama.jamanetwork.com/article.aspx?articleid=1199154) we will hopefully see some progress on reversing nearly 4 decades of bad science.
Here is a layman's summary of the aforementioned article by USA Today:
http://usatoday30.usatoday.com/news/health/story/2012-06-27/calories-low-carb-weight-loss/55843134/1
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Sonali Shah: In our fast pace moving world (including job, raising kids and their activities, using technology 24x7) most do not take care of themselves, feed the body right, sleep enough, nor make home-made meals like our grandmas did. We are always on the go. These days Obesity and Type II Diabetes is more due to ifestyle and less due to genetics. I am worried about the next generation of children. We need to teach them how to cook, enjoy good food, and live a balanced life!
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inigo sainz: Successful treatment models should integrate social, behavioral, cultural and culinary factors and be realistic and compassionate. I always talk to my patients about food and recipes, I never separate food from culture or pleasure. I have learned not to judge and prioritize education over treatment. Instead of a diet I teach my patients to understand their disease and learn how to manage it to live healthier and happier lives.
Dr. Inigo Sainz, MD
Family doctor. Master in nutrition (NYU). IOC diploma sports nutrition
Health Promotion Unit Coordinator
Quiron Araba Sport Clinic - Vitoria, Spain. -
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Sean Spicer: I love how the guy is now using the Marketing science behind junk food to market baby carrots.
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Gregory Coleman: One of the most important things we need to realize is that there is no single cause of the obesity crisis. Additionally, there is no single solution. We all have unique challenges that require different tools. That's why our company has taken the lead in forming a coalition of leading, early stage tech companies. It's called Founders In Technology Combating Obesity or FITco for short (www.fitconow.org). Our mission is to combat the U.S. obesity epidemic with actionable information and free or low cost technology solutions that address the most common challenges, to include food information, fitness tracking, performance monitoring, and behavior modification or motivation.
I'd love to hear the thoughts of the community on using technology to address this crisis. -
TEDMED Moderator: "What's Wrong With Fat?" Plenty, including how we think and talk about it, both in the medical community and in society as a whole. That's according to UCLA sociologist Abigail Saguy...whose book of that title launches Jan. 3. Saguy doesn't deny the health problems resulting from overweight. But she claims confirmation bias among scientists and journalists tends to reinforce a whole host of assumptions, including failures to remember that "correlation isn't causation." Meanwhile, she says, studies show overweight women are less likely to seek medical care because they don't want to face criticism or insensitive behavior from health professionals. -- posted 12/20/12
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TEDMED Moderator: "Scientists link obesity to gut bacteria," reads a recent headline in the Financial Times. According to a study published in the peer-reviewed journal of the International Society for Microbial Ecology, the presence of certain bacteria (enterobachter) in our systems promotes weight gain. An obese patient who followed a diet designed to reduce the bacteria lost 29% of total body weight in 29 weeks. But...does overeating tend to encourage our own production of this bacteria in the first place? -- posted 12/19/12
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What are the top 10 contributing factors for the Great Challenge, "Coming to Terms with the Obesity Crisis (Adult)"?Discussion Policy
Discussion Policy
- The TEDMED Community is offered as a free public service to promote discussion on the future of Health and Medicine.
- Any “Submission” made is of the opinion of the community member who posted it and does not, in any way, reflect the views or opinion of TEDMED.
- In making a Submission, you agree that you will not violate any trademark or copyright laws. You agree and acknowledge that TEDMED does not represent any rights to the Submissions.
- As a member of the TEDMED community, we encourage you to share your knowledge, information and opinion. In making a Submission, you agree that such submission is made in a professional manner with the purpose of furthering or expanding discussion on TEDMED.com.
- As a member and participant of TEDMED.com, you also agree to respect the Submissions of your fellow TEDMED community members and allow for equal opportunity and participation.
- In making a Submission you consent to the right of TEDMED to expand or edit any Submission and we may contact you to discuss further.
- TEDMED has the right to remove, in its sole discretion, any Submission made that does not represent or encourage a professional and communal environment.
- TEDMED has the right to indefinitely suspend, in its sole discretion, any account for members registered at TEDMED.com.
6 Comments
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Javier Herrera: The reason, Sean, that highly processed food is cheaper, is very simple, the government is subsidizing the corn, wheat and soybeans to the tune of more than $12billion/yr to big agribusiness. So its a whole lot cheaper to get the burgers and fries instead of the broccoli, brussel sprouts, beans and beats! :-)
Unless we change our governmental leaders and remove the influence of the big agribusiness lobbyists, AND focus those $12billion to local organic farmers who produce around our cities locally, decreasing the cost of shipping and eating locally grown harvest, in season. We will continue on the road to ruin, practicing McMedicine, and seeing the continued demise of health in our country. Oh and yes the good news is that China, our biggest competitor, is also headed full speed into the unhealthy abyss, with the increased availability of YUM corp(KFC, Pizza Hut, Taco Bell) and of course McD's. We need more education at the local level to demand change, educating of children about healthy foods and habits is our only way out of this mess!
Whew sorry... just had to get that off my chest... -
Steve Pehnec: I'm reading a number of books lately, such as "Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health" by Gary Taubes, "Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity, and Disease" by Robert Lustig, and a great blog by Peter Attia, MD, "The Eating Academy".
The general ideas being posited all aim at upsetting decades-long "food myths" that have been promoted by the FDA, AMA, ADA and others that seem to do more harm than good, especially where the fat and cholesterol content of foods are concerned. While these ideas seem to me to be correct (and even obviously so), I continue to see numerous articles that still promote the old paradigm of "fat bad, carbs good" (and no where more strongly than in the marketing of processed foods where it seems to be especially entrenched ).
So to my question/comment: Is the new (emerging?) definition of good nutrition the correct one, and if so, why doesn't it seem to be gaining greater traction? (Or is it?)-
Lewis Yuan: I feel like it is gaining traction, particularly amongst niche communities (e.g. - CrossFit community) but overall the nation is still inundated with the old paradigm of "minimize fat in diet, load on carbs"... I think with more studies like the one that was published last summer by Dr. Ludwig (http://jama.jamanetwork.com/article.aspx?articleid=1199154) we will hopefully see some progress on reversing nearly 4 decades of bad science.
Here is a layman's summary of the aforementioned article by USA Today:
http://usatoday30.usatoday.com/news/health/story/2012-06-27/calories-low-carb-weight-loss/55843134/1
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Sean Spicer: I love how the guy is now using the Marketing science behind junk food to market baby carrots.
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Douglas Robb: Obesity is not a disease...it is a symptom of disease. By focusing on this one symptom, we ignore all of the other nasty stuff that our Lifestyle Disease is causing. This disease has numerous causes...all related to our hectic "modern" lives.
The real question is how do we hold on to the great parts of our society while eliminating all the bad - poor physical health, poor mental health, poor emotional health, etc.... -
Dina Ralt: I have suggested that obesity is the result of a "worry" which promotes the body to save on current energy expenditure and save it as fat tissue for better times in the future.
http://www.biomedcentral.com/1471-2431/6/33
No wonder that Obesity and Under-Nutrition Prevalent in Long-Term Refugees Living in Camps
http://www.sciencedaily.com/releases/2012/10/121002171626.htm
Responses By Team Member:
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Participants:
John M. Auerbach, MBA, Dan Callahan, PhD, Christine Ferguson, JD, Scott Kahan, MD, MPH, Joe Nadglowski, Rebecca Puhl, PhD, Maya Rockeymoore PhD
Meet the Team