The battle to lose


Since the late 1970s, overweight and obesity rates in adults, teens, and children have soared, raising concerns about the impact on diabetes, heart disease, and cancer rates. This month's cover story is our effort to treat with humor a most serious problem.

The epidemic is most poignant in youngsters, but adults have to deal with it too. Losing weight--and keeping it off--isn't easy. Our culture conspires against dieters at every turn.

Tempting high-calorie foods at restaurants beckon us to overeat. Laborsaving devices-from telephones to automobiles--aren't going to disappear. And snack vending machines, ads extolling all-you-can-eat buffets, and home and work imperatives keep us off the bike path.

Then there are the factors we can't control, like our genes, our in utero environment, and perhaps contaminants in our air, water, and food that distort hormonal balances.

If we don't make the effort to lose (or avoid gaining) weight, it won't happen. But it also won't happen if we ignore the environment that undermines our efforts.

So, where to start?

* Restaurant meals. Those 1,000-calorie entrees, shakes, appetizers, and desserts are fattening us up. It is essential that we push for state and federal laws requiring calories on menus and menu boards at chain restaurants.

The first such law, in New York City, is not only spurring consumers to choose lower-calorie foods. It is prompting restaurants to lighten up their menus. With California and Boston passing laws and other jurisdictions considering them--and with KFC, Pizza Hut, and Taco Bell voluntarily listing calories on menus soon--I hope that 2009 is the year that Congress orders calories on menus nationwide.

* PE. Gym classes in schools are a natural, as are community bike paths, tennis courts, and swimming pools. What better way to pay for them than slapping small taxes (say, a nickel a drink) on belly-building soda pop?

* Schools. Getting junk foods out of schools and ads for junk foods off TV and other media aimed at kids is a no-brainer.

* Campaigns. The government should fund mass-media campaigns to encourage people to fill up on vegetables, fruits, and other healthy foods and to cut back on soft drinks, french fries, and other fattening foods.

* Breastfeeding. "Breastfed infants ... tend to gain less unnecessary weight and to be leaner. This may result in being less overweight later in life," says the government, which could mount campaigns to encourage moms to breastfeed for at least six months, maybe even offering bonuses to those who do.

I could go on, but those measures top my wish list. The challenge is to get beyond politicians' handwringing over "the terrible obesity problem" and to invest in the solutions.

Michael F. Jacobson, Ph.D.

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