Need to Know: Obesity as a Threat to Our Future

On Friday evenings I often watch a program called Need to Know on public television.  This week’s episode, hosted by Scott Simon, dealt with the problem of obesity, first on the personal level, with the story of 10-year-old Carla, then on the public policy level, when Ross Hammond of the Brookings Institution was interviewed.  Carla, who lives in the South Bronx with her parents, is overweight and has been told that she is at risk for developing diabetes, an illness that runs in her family and has already killed one of her relatives.   

Children like Carla who live in low-income, predominantly minority neighborhoods have a one-out-of-two chance of developing diabetes at some point during their lifetimes, according to Dr. Alan Shapiro of the Children’s Health Fund.  Nationwide, children today have a one in three chance of getting the disease.  Correspondent and producer Sarah Schenck follows Carla as she enrolls in a health and fitness class and then proceeds to pass on what she has learned about diet and exercise to her parents.  In neighborhoods like Carla’s, sometimes called “food deserts,” nutritious food is scarce and expensive, while fast food is plentiful.  Opportunities to exercise outdoors are also limited.  Carla, a highly motivated and unusually articulate young person, seems to be making good progress toward her goals.

In the second part of the show host Scott Simon talked with Ross Hammond, a Senior Fellow at the Brookings Institution who is also on the editorial board of the journal Childhood Obesity.  As Carla’s story had illustrated, Hammond emphasizes that obesity has complex causes, including biology, the brain, and the person’s physical and social environment.  For this reason “it is very difficult to think of a single solution that will work for everyone.”  Instead, it is important to coordinate a variety of approaches to attack this urgent problem.   

According to Hammond, medical care for the overweight and obese can cost as much as 100% more than that for people of normal weight.  It is estimated that care for this group now accounts for 21% of all medical spending.  Obese patients require larger beds and special equipment in emergency rooms.  (I would add that very overweight patients in nursing homes will have the same needs over longer periods of time and that additional staff will probably be required as well:  think what it would take to turn a 400-pound patient over in bed!)  The best role for government, according to Hammond, is “helping to provide a playing field in which people can make appropriate choices and choose for themselves healthy options and have those healthy options be just as available, affordable, and convenient as unhealthy options.”  He calls obesity “a huge threat to our country.”