Washington, DC; December 6, 1994 -- With mounting evidence that the United States is experiencing an unprecedented epidemic of obesity among both adults and children, Dr. C. Everett Koop -- the former U.S. Surgeon General -- today launched Shape Up America!, his new "great crusade" to place healthy weight and physical activity high on the national agenda.
At a White House ceremony on the importance of physical activity and healthy weight hosted by First Lady Hillary Rodham Clinton, Dr. Koop released a new report -- Weighing In For America's Health: Elevating Healthy Weight and Physical Fitness as a National Priority -- that will serve as the foundation for the activities and advocacy efforts of Shape Up America! Issued as a nationwide call to action, this report declares obesity as a public health crisis that must be addressed "to prevent unnecessary death, disability and disease."
"As the nation considers reforms to the health care system, no workable agenda can ignore the pressing issue of combating obesity in America," Dr. Koop said. "An intensified focus on achieving and maintaining a healthy weight is essential to reducing the risks that threaten the lives and future health of many Americans. Elevating the issue of healthy weight must become a new imperative to which we devote the intelligence and resources of our communities and our nation."
The new report, designed to provide a status report on the state of obesity in America, describes overweight as one of the most pervasive public health threats in this country, confirming and supporting the findings of another report -- Weighing the Options -- issued by the Institute of Medicine of the National Academy of Sciences on December 5. It is now estimated that approximately 58 million adults -- 32 million women and 26 million men -- are obese or overweight, which is over a third (33.4 percent) of the U.S. adult population. Further, childhood obesity rates have increased substantially since 1980 with 21 percent of all 12 to 19 year olds -- one in five teens -- now significantly overweight. And compared to the population at large, Hispanics and African Americans have obesity rates that are 10 to 20 percent higher than whites while Native Americans and Hawaiians have a 10 to 40 percent greater prevalence of unhealthy weight.
But what is especially disturbing, according to Dr. Koop, is that U.S. obesity rates, already among the highest in the world, are continuing to go up -- from 25 percent of American adults in 1980 to 34 percent today. And since being overweight is directly linked to a number of disabling and life threatening diseases -- diabetes, hypertension, heart disease, some forms of cancer, gallbladder disease, osteoarthritis, and gout -- it is likely that the disease rates related to obesity will also continue to rise.
"After smoking, which causes an estimated 500,000 deaths annually, obesity-related conditions are the second leading cause of death in the U.S., resulting in about 300,000 lives lost each year." Dr. Koop explained.
Calling unhealthy weight "a multibillion dollar drain on the U.S. economy," the report summarizes the calculations of medical researchers who put the cost of obesity at more than $100 billion annually. This includes $45.8 billion in direct costs, such as hospital care and physician services -- or 6.8 percent of all health care costs; $33 billion on weight reduction products and services; $18.9 billion in the indirect costs of lost output; and $4.06 billion in work days lost to illness attributable to obesity. In addition, researchers calculated that the work days lost to weight-related health problems amounts to 52.6 million per year.
Medical researchers also estimate that 88 to 97 percent of all cases of Type 2 (non-insulin dependent) diabetes, 57 to 70 percent of coronary heart disease cases, 11 percent of breast cancers, and 10 percent of colon cancers that are diagnosed in overweight people are attributable to obesity. Further, about a third of all cases of hypertension are thought to be due to obesity, while 70 percent of gallstone cases are attributable to being overweight. What is more, unhealthy weight is associated with osteoarthritis and gout, along with a number of other disabling conditions.
"These findings clearly show that next to smoking, the combined problems of unhealthy weight and inactivity have the most devastating consequences for the health of Americans today," Dr. Koop said.
To begin to change these statistics, Dr. Koop is calling for a "national mobilization" based on redefining the overweight problem for the American public. Explaining that the public has yet to embrace healthy weight as a priority concern, the former Surgeon General advocates creating awareness that overweight and inactivity are two of the most serious health threats facing the U.S. today. Specifically, Dr. Koop is calling for a massive public education campaign that puts weight control into a different context for Americans so they are motivated to make change. This will require promoting the concept of achievable and maintainable weight and making the public aware that any loss of body fat is a measure of success and is beneficial for those who have too much.
"Instead of just focusing on the reasons for a healthy weight, the public health community must give people the belief that they can succeed. This means emphasizing an achievable body weight and making Americans aware of the immediate health benefits of even a small weight loss. It also means linking daily physical activity to weight management, encouraging relatively small increases in activity levels that can be readily adopted and maintained," Dr. Koop said.
Shape Up America! is designed to be a catalyst for promoting this new understanding about healthy weight and physical activity among Americans. Involving a broad based coalition of industry, medical/health, nutrition, physical fitness and related organizations and experts, Shape Up America! will focus on the health benefits of weight control as opposed to physical appearance alone, stressing those simple changes in dietary choices and exercise habits that are readily achievable. The campaign is directed by the C. Everett Koop Foundation, which will function as the clearinghouse for all program activities.
The new report issued by the C. Everett Koop Foundation also provides a five-point national action plan to elevate healthy weight as a national priority. Specifically, the report calls for new public education efforts, workplace and insurance incentives for weight loss efforts, increased funding for school and community-based physical fitness and nutrition programs, physician intervention in obesity prevention and weight management, and significant increases in federal funding for obesity research.
"Creating a public policy agenda that elevates healthy weight and physical activity as priority concerns must occur as a first step in combating the obesity epidemic in America. The changes advocated through the Shape Up America! initiative will serve as a catalyst for action that will make a difference in the lives of many Americans," Dr. Koop concluded.
The C. Everett Koop Foundation also publishes a health letter that not only gives helpful information for those seeking a healthier weight and increased activity level, but will provide updates on Shape Up America! activities. For more information, write: C. Everett Koop Foundation Health Letter, P.O. Box 1200, Southport, CT 06490.