During our terms as surgeons general of the United States, we were privileged to serve as the people’s doctor. We fulfilled that role in an apolitical manner — our allegiance was and is to the people of this great nation and to the best available science to address the health, safety and security of the nation.
Nearly a decade ago, Dr. David Satcher, 16th surgeon general of the United States, declared that overweight and obesity “have reached epidemic proportions” in the 2001 Surgeon General’s Call to Action to Prevent and Decrease Overweight and Obesity. The evidence base has steadily improved about how to prevent overweight and obesity, as well as how to help people successfully lose weight. Health system reform can and should be based on this evidence of best practices.
Today, by working together in a nonpartisan way we can better inform our political leaders, our communities, our families and ourselves on the critically important need to end the obesity epidemic and how we can accomplish that goal.
We are deeply concerned about the fact that for far too long our nation has turned a blind eye or, worse yet, taken the wrong path in trying to end the epidemic of obesity.
Many of us supersized our meals when we should have downsized them. We often drove our cars to purchase processed food when we could have been getting exercise by taking daily walks or growing our own fresh food.
The nation has begged, educated, scolded and stigmatized people who are obese or overweight — but those countless messages, programs, guidelines and warnings have not ended the epidemic or changed the sedentary lifestyles of the American people.
The burdens caused by the obesity epidemic are unsustainable. Unless we do something now, the cost burden of obesity — currently nearly $150 billion each year — will be an ever-tightening yoke around the neck of future generations of Americans. The emotional burden from stigma bears down on our neighbors and friends every day in the form of an inability to be successful at school, work and in numerous other unseen ways.
In addition to these costs, the actual health burden of obesity is threatening to crush our already tenuous “sick care” system. Obesity accelerates heart disease, type 2 diabetes, some types of cancer, stroke, high blood pressure, breathing issues, sleeping problems and psychological disorders. These are the types of chronic diseases — largely preventable — that cost us 75 cents of every dollar spent on health care today.
Despite the clear harm being done to our nation, current discussions on health system reform are informed more by partisan politics than by evidence and accurate information. Mixing political agendas and public health is counterproductive for the nation and for the individuals who are struggling with weight issues and the associated chronic diseases. Our leaders need to set political aspirations aside and act in the best interest of our nation’s physical, mental, economic and spiritual health.
Health system reform must address the obesity epidemic by incorporating the many practices known to be effective in preventing and reducing the burden obesity places on the nation. We need to promote standardized health and medical treatments that produce effective outcomes. We need to focus on incentives for prevention and reverse the all-too-common progression from being overweight to becoming obese. We need to engage with communities in order to bring what we know from research to what we do in our everyday lives. We also need to make sure researchers continue to find solutions to the many inequities in health related to being overweight or obese.
A lack of clear understanding of this complex health issue, exacerbated by poor health literacy, is a challenge to successfully addressing the obesity epidemic.
For example, we all need to understand that obesity is not a simple matter of personal lifestyle choice. People do not become overweight or obese all on their own. The reality is that their communities may not include safe places to exercise. Their incomes may not allow them to purchase healthy food. Their workplaces may not offer a wellness program. Genetics can also be a reason why some people become overweight or obese more easily than others and struggle unsuccessfully to lose pounds.
A healthy future for America is in peril. Children as young as 10 are now being diagnosed with chronic conditions often related to weight that previously only affected adults, including type 2 diabetes and high blood pressure.
We are at a critical point. At the recent Weight of the Nation Conference in Washington, D.C., our friend and colleague Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, explained that “the average American is now 23 pounds overweight and collectively we are 4.6 billion pounds overweight.”
Dr. Frieden is correct. The data is in and the truth is that we cannot wait any longer. Helping Americans make healthier choices and enjoy a better quality of life can no longer be compromised by political bickering or continued inaction. Instead it must be a national priority.
Dr. David Satcher, director of The Satcher Health Leadership Institute and Center of Excellence on Health Disparities and Poussaint-Satcher-Cosby Chair in Mental Health Morehouse School of Medicine, was U.S. surgeon general from 1998 to 2002. Dr. Richard H. Carmona, president of the Canyon Ranch Institute and distinguished professor at the University of Arizona, was U.S. surgeon general from 2002 to 2006.
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