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Stuart P. Weisberg

JAMA. 2002;288:2176.

In a recent survey of the American public, 78% of respondents reported that their body weights were not a serious health concern.¹ Approximately one third of these respondents were obese, two thirds were overweight, and 15% of their children were overweight. This indifference is not appropriate. Obesity may soon replace smoking as the leading cause of preventable death in the United States. Obesity may be responsible for approximately 300 000 US deaths per year, and, unlike smoking, the prevalence of obesity is rapidly increasing.²

Public health officials now refer to obesity as an epidemic. Unlike infectious diseases, obesity kills and disables by gradually increasing the risk for diseases like diabetes, heart disease, stroke, and cancer. Recent studies estimate that obesity is more strongly associated with chronic medical conditions, and reduced health-related quality of life, than smoking, heavy drinking, or poverty.³

Articles in this issue of MSJAMA emphasize the importance of societal change to address obesity. Tarayn Grizzard examines the undertreatment of obesity by American physicians. Susan Blumenthal, Jennifer Hendi, and Lauren Marsillo argue that a public health approach is required to address the myriad environmental and sociocultural factors contributing to obesity. Lawsuits have recently emerged to uncover and redress alleged food industry misconduct that may be contributing to the obesity problem. Richard Daynard, Lauren Hash, and Anthony Robbins discuss the future of this food litigation.

The prevalence of obesity among children is also rapidly increasing and has been associated with hyperlipidemia, hypertension, and impaired glucose tolerance.² Robert Carter reviews the rationale and the results of school-based obesity interventions. Ellen Fried and Marion Nestle argue that soda consumption makes an important contribution to childhood obesity. They describe marketing practices designed to increase soda consumption among schoolchildren and discuss recent political initiatives to restrict these practices.

The burden imposed by overweight and obesity on the United States is very high. The estimated total cost of overweight and obesity in 2000 is estimated to have been $117 billion, nearly 10% of the US health care expenditure.² By contrast, the United Nations estimates that the yearly costs of HIV/AIDS prevention and care in Africa, Asia, and Latin America will be $9.7 billion by 2005.⁴ Given the exorbitant costs of obesity, more effective interventions are urgently needed to decrease its prevalence. The fact that most Americans are overweight, yet are not concerned about the health importance of their own body weights, suggests that there remains much room for improvement.

REFERENCES
1. Lee T, Oliver JE. Public opinion and the politics of America's obesity epidemic. KSG Faculty Research Working Paper Series. May 2002. 2. Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity. Available at: http://www.surgeongeneral.gov/topics/obesity/. Accessed on October 6, 2002. 3. Sturm RM, Wells KB. Does obesity contribute as much to morbidity as poverty or smoking? Public Health. 2001;115:229-235. FULL TEXT | WEB OF SCIENCE | PUBMED 4. Schwartlander B, Stover J, Walker N, et al. Resource needs for HIV/AIDS. Science. 2001;292:2434-2436. FREE FULL TEXT

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