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Roundtable
Explores Approaches to Obesity Epidemic from Many Perspectives
In 1980, 33.2 percent of adults in the United States were smokers. By 2000, that rate had dropped to 22.3 percent.
Similarly, in 1981, 76 percent of the U.S. adult population reported it did not use seat belts. By 1998, that rate had dropped to 31.1 percent.
In both cases, the turnaround in individual behavior has been credited to public health efforts that ranged from media and advertising, to physician involvement, to community programs and beyond.
Now, another group of stakeholders is taking a look at these successes to see what lessons can be applied to fight the epidemic of obesity.
In August, Kaiser Permanente's Institute for Health Policy and the Care Management Institute (CMI), in conjunction with the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention, sponsored a national roundtable to address the prevention and treatment of overweight and obesity. The roundtable included leaders from some of the nation's leading health, medical, community and policy agencies including the U.S. Department of Health and Human Services, the Consumer Federation of America, the YMCA of the USA, the American Cancer Society, and the International Food Information Council.
"This is an issue that's important to our
society and to our organization," said William Caplan,
MD, director, Clinical Development, CMI. "Based
on body mass index (BMI) measurements collected in the Northwest
Region, we know that 35 percent of the Region's members
are overweight, and 6 percent - one out of 15 - are obese.
This bears significant consequences for the health of our
members, and there's no sign of the trend decelerating."
The roundtable inspired a great deal of discussion, but there was agreement that there are no easy answers or quick fixes to the issue.
"We came away with a good platform and framework for policy development based on a strong knowledge base," said Bob Crane, senior vice president and director, Institute for Health Policy.
The group identified several areas in which action is needed most immediately. Among them were:
- Communication: Participants
agreed that the current messages to the public about healthy
eating and active living are confusing and ineffective.
There is a need for coherent, sustained, sensitive messages
for prevention and treatment.
- Develop a Guiding Framework:
A "chronic care" model similar to that used to treat diabetes
may be useful for the treatment of obesity, but not for
prevention. A model for prevention must center around
the individual and the community in which they live.
- Build Community Support:
The involvement of community agencies was seen as the
key to promoting healthy eating and active living. Currently,
the organizations involved in day-to-day support of the
community are disconnected from the medical and scientific
knowledge in the health care industry. Under-represented
groups also need to be brought into the process.
- Coordinate Research and Knowledge
Transfer: Some organizations are currently pursuing
an obesity and overweight research agenda, but there is
a need to summarize the evidence and identify which research
areas aren't being addressed.
- Develop Public Policy Solutions:
The public sector could influence behavior by establishing
incentives to promote healthy food, requiring nutrition
and physical education in schools, and funding public
advertising programs.
"Each of these areas is going to require the cooperation and expertise of many different groups," said Dr. Caplan. "Our next steps are to develop a coalition or partnerships among organizations so that we can step to action."
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