Future Perspectives on Obesity Policy

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Future Perspectives on Obesity Policy
Dr. William Rowley
Southern Governors Association
37th Annual Meeting
Biloxi, Mississippi
August 25, 2007
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Orientation

• Im going to show you a terrible problem
• Ill tell you whats going to happen
• Ill show you how we can solve the problem
• Ill show why conventional wisdom cannot solve
  the problem
• Finally, Im going to ask you to change your minds

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Increasing Prevalence of Obesity
1990
Source CDC Behavioral Risk Factor Surveillance
System
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Increasing Prevalence of Obesity
2015 1,115,068
Pop. 20 y/o 2,183,000
51 Obese
Wang Beydoun, The Obesity Epidemic in the
United States Gender, Age, Socioeconomic,
Racial/Ethnic, and Geographic Characteristics A
Systematic Review and Meta-Regression Analysis.
Epidemiologic Reviews, 5/17/07
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Increasing Prevalence of Diabetes
1995
Source CDC National Diabetes Surveillance System
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Diabetes in 2025
Americans with Diabetes
2000
2007
17 million
26 million
120B
180B
(Mississippi State Budget 4.4B)
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Outlook for our children?
During their lifetimes
1/3 will get diabetes
1/2 will become obese
Earlier disability
When will society wake up?
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The Solution
Change Obesogenic Environment
Change Body
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Health care can solve this!

• Bariatric surgery works

• Lose 40-70 of excess weight

• Resolves 60-80 of co-morbidities
• Expensive significant risks
• 15 million morbidly obese

• Only 2 FDA approved medications
• Modest benefit (7-15 pounds)

• It takes 15 years to get new drug to market

• Little is known about changing behavior

Image www.easternhealingcenter.com/En/images/Weig
htloss2001209.jpg
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All it takes is personal responsibility
If the military culture and incentives cant keep
people thin within our obesogenic environment,
what is the hope for the rest of America?

• 13 are obese
• 3,000 separations per year

fitnessbusinesspro.com/military/Navy2.jpg
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Changing minds to change policies
Start with children
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Changing minds to change policies
Change the way we eat
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Role Model for a Mind Change

• Study of adults who lost at least 30 pounds and
  kept it off for at least 1 year

• Hallmarks of long-term success
• Low calorie diet (

• Fast food limited to 1X/week
• High level of physical activity (60 min/day)
• Weigh themselves at least once a week

A permanent life-style change through uniting
their minds with their bodies
Phelan et al. Are the Eating and Exercise Habits
of Successful Weight Losers Changing? Obesity
2006 14710-716
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Summary

• Obesity and diabetes are becoming terrible
  problems

• But, they are problems that can be solved
• To address these we need to change our minds to
  change our behavior to change our bodies
  individually collectively
• Beware of false solutions that sound good but
  wont work
• Are you ready to change your mind to defeat
  obesity and diabetes?