Coordinated Efforts Needed to Reduce Obesity in the United States

Abstract

Marilyn W. Edmunds PhD, NP Obesity is endemic in our country. It is insidious and destructive in the lives of those affected. Obesity, regardless of its cause, is associated with decreased quality of life, lower salaries, development of serious chronic medical conditions such as heart disease and diabetes, escalating medical care costs, and premature death. One of the Healthy People 2010 objectives is to reduce to 15% the proportion of adults who are obese. In 2007, no state met this target. In fact, data from the Centers for Disease Control and Prevention’s (CDC) 2007 Behavioral Risk Factor Surveillance System (BRFSS) survey indicated that 25.6% of respondents were obese. This is an increase of 1.7% in obesity from the 2005 survey. So, despite very specific goals, the prevalence of obesity among adults remained above 15% in all states and was above 30% in Alabama, Mississippi, and Tennessee. Colorado was the only state with a level below 20% (18.7%). Who are the obese? In the 2007 BRFSS survey, of the overall obese respondents, 26.4% were men and 24.8% were women. Obesity prevalence ranged from 19.1% for men and women 18to 29-years old to 31.7% and 30.2%, respectively, for men and women 50to 59-years old. Considering obesity by race/ethnicity and sex, obesity prevalence was highest for non-Hispanic black women (39.0%), followed by non-Hispanic black men (32.1%). Education also is related to obesity. For both men and women, obesity prevalence was lowest among college graduates. Men who had some college or only high school diplomas had the highest levels of obesity. For women, obesity was the highest among those with less than a high school diploma. The report suggests that these disparities might reflect differences in knowledge and behavior related to diet and physical activity or might reflect differences in environmental supports for these behaviors, such as access to places for physical activity (eg, local parks or recreation facilities) or access to healthier food options (eg, selection at local groceries). To reverse these statistics and reach the Healthy People 2010 target, nurse practitioners (NPs,) working in concert with others, should focus on actions that promote healthy eating and physical activity. Fifteen activities were identified as national priorities for immediate action in the Surgeon General’s 2001 Call to Action to Prevent and Decrease Overweight and Obesity. Many of these actions require NPs to provide education to patients about healthy food choices and getting more exercise. The report also calls for collaboration across multiple sectors (ie, education, government, and business) and levels (ie, individual, family, community, state, and national) to address the problem of obesity. We urge you to be familiar with the 15 initiatives that the Surgeon General described and to become involved in community cooperative efforts to implement them. Additional information regarding these obesity reduction programs can be found at: http://www.cdc.gov/nccdphp/dnpa/obesity/state_programs/funded_states/index.htm and http://www.cdc.gov/healthyyouth/partners/funded/cshp.htm; and http://www.cdc.gov/steps.