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The Weight of the Nation Conference

Omni Shoreham Hotel, Washington, DC - May 18, 2009

Remarks as prepared for delivery

Acknowledgements

Thank you for that introduction.

I want to thank everyone who made today possible, especially Dr. Frieden who was such a trailblazer as New York City Public Health Commissioner and who has done such a great job in his first few months as the head of CDC.

I’d also like to recognize Dr. Howard Koh, our new Assistant Secretary for Health, who will be heading the H-H-S Office of Public Health and Science.

With their leadership and the incredible talent we have from top-to-bottom at the CDC and throughout the Department, we’re in excellent position to move forward with our wellness and prevention policies.

I’d also like to acknowledge President Clinton who’s made such an important difference on these issues and others through his Foundation.  And who served his country so well both as President and as Governor of Arkansas (which is only about 50 miles away from being the best state in the country).

Finally, to the CDC and all the other organizations who worked so hard to put on this event and draw attention to this important issue – thank you for your efforts.  This is the first Weight of the Nation conference, but I am sure it won’t be the last.

The two reports

Yesterday, we heard some bad news and some good news.

The bad news was that over two thirds of American adults – and almost one out of every five American children – are obese or overweight.

We heard about how obesity increases your risk of heart disease, certain cancers, and stroke.  About how obesity is the single biggest predictor of diabetes.

And we heard from a new report that says obesity costs our health system as much as $147 billion a year…a number that has almost doubled since the last time the CDC calculated it in 1998.

To put that figure in perspective, the American Cancer Society estimates that all cancers combined cost our health care system $93 billion a year.  So ending obesity would save our health care system fifty percent more dollars than curing cancer.

That’s the bad news.  But here’s the good news.  No, ending obesity won’t be easy.  But the CDC also released a second report yesterday.

That report asked, what can we do about the growing costs of obesity?  And it came back with a heartening answer: it turns out, there’s a lot we can do.

Like the school district in Southern California that got almost half their kids to start eating at the salad bar by serving fresh, local produce instead of greens that looked like they had been under saran wrap for the last month.

Or the city in Northern California, which got twice as many girls to go to dance class as the neighboring community by providing buses to drive them there.

It won’t be easy.  But this report is a big step towards developing a national blueprint for how to get Americans to slim down while trimming a significant chunk of our health care costs at the same time.

And it’s a major part of the broader commitment the Obama administration has made to transforming our health care system from a sickness system to a wellness system…a commitment that will make us not just a healthier, but also a wealthier country.

The special significance of childhood obesity

But before I tell you about some of the exciting plans the administration has in this area, I want to talk for a few moments about childhood obesity.

If you asked anyone in this room what the most important group of Americans to help was, they’d say children.

That’s because we all love our children.  But it’s also because children have an advantage on the rest of us: they’re going to be around a lot longer.

If you give a child a good education, she’s going to be a productive worker and taxpayer for fifty years.  There’s the same payoff for investments in health.  If we can teach our children healthy habits when they’re young, they can benefit from these habits for the rest of their lives.

But right now, they’re learning the wrong habits.  The share of children that are overweight has quadrupled in the last 40 years.  Type 2 diabetes used to be called “adult-onset” diabetes.  Now doctors don’t use the term because so many kids are getting it.  Overweight adolescents have a 70% chance of becoming overweight or obese adults.  According to the Robert Wood Johnson Foundation: “Childhood weight problems can lead to complications such as elevated blood pressure and cholesterol, joint problems, type 2 diabetes, gallbladder disease, asthma, depression and anxiety.”  No wonder some scientists have said that this might be the first generation of Americans in 200 years to have shorter life spans than their parents.

If there was an epidemic of little kids getting cancer, it would be a national crisis.  But because it’s obesity and the damage doesn’t come until later in life, we’ve been slow to act.  I’m counting on people in this room to tell Americans that as our children’s weight is growing, their lives are shrinking.  We can’t ignore this problem any longer.

Why now is different

Right now, you’re might be saying to yourself: if we’ve been concerned about obesity for so many years and we haven’t done much about it, why is anything going to change now?

The truth is that our country had the same problem trying to lose weight as Americans do.  A poll I saw from Time Magazine a few years ago explains it pretty well.

The poll found that about six in ten Americans wanted to lose weight.  So about six in ten Americans are obese or overweight and about six in ten Americans want to lose weight.  Sounds about right.

But here’s the problem.  Only three in ten Americans said they were actually trying to lose weight.  And only one in ten said they had a specific plan to do so.

That’s what we were like as a country.  We wanted to lose weight.  We knew it was important.  But we didn’t have a plan.  Now, thanks to research like the kind we saw yesterday the CDC report, we have a much better idea about what strategies work and how to implement them.  We don’t just have good ideas.  We have ideas that are tested.  And whose success can be measured.

In other words, we finally have a plan.

What we can do

So what’s that plan?  Well you heard a lot about it yesterday in the findings from the Measures Project.

The first thing is that if the government wants people to start eating healthy food, we need to start serving it.  That means offering more nutritious meals not just in public schools but also in child care centers, rec centers, senior centers, and other government buildings.

And we need to serve these healthy meals at a price that people can afford.  Some people say that if kids don’t want to eat healthy, they’re not going to no matter what.  But there are a handful of high school cafeterias around the country that would disagree.  They cut the prices of fruits and carrots and sales started to rise.

No one has done more in this area than President Clinton.  His Foundation struck a deal with three of the biggest soda manufacturers in the world to stop selling high-calorie drinks in schools.  Kids spend half their day in school.  Now, thanks to President Clinton, they’re going to spend half their day not drinking sodas and sugary fruit juices.

The second thing we need to do is give people more healthy options in their own neighborhoods.  Many rural Americans and urban Americans have the same problem: they don’t have any supermarkets that sell fresh produce where they live.  When you can’t buy fresh produce, it’s hard to eat healthy.  One study found that the amount of fruits and vegetables eaten in African-American neighborhoods went up by a third for each supermarket you added.

This isn’t rocket science.  People want to eat healthy diets, but they tend to eat whatever’s convenient and affordable.  If we want to reduce obesity, we need to make eating fruits and vegetables convenient and affordable for all Americans.

There’s a whole lot more we can do.  We need more phys ed classes where kids run around the whole time and fewer where they wait around to use the same piece of equipment.  We need more investments in making cities safe for walking and biking.  We need more investments in public transportation.  (Those of you from DC will know that just walking up the escalator at the Dupont Circle metro is as good as 20 minutes on the stairmaster).

These are investments that can be made at the neighborhood, city, and state levels.  Everyone from parents to schools to local governments to food and beverage companies has a role to play in promoting prevention and wellness.  But I also want to tell you a little about what the Obama administration is doing in these areas.

The administration’s agenda

As some of you may have heard, we’re currently in the middle of a major push for health reform.  President Obama and I are committed to delivering a health care system that provides all Americans with better quality and lower costs.  And fighting obesity is at the heart of both of these goals.

That’s why the President and the First Lady have made investing in prevention and wellness one of their top priorities.

It’s why we’re going to require health insurance plans to cover preventative services like the kind of counseling and care that can help people lose weight or keep the weight off in the first place.

It’s why as part of health reform, we’ll also be investing in programs like the ones highlighted in the CDC report.

These changes will keep people healthy and reduce chronic disease, which is responsible for 70 percent of deaths in the US.  And in the long run, they should save a lot of money too since chronic disease accounts for 75% of our health care costs.

But President Obama and I don’t think this issue can wait. And neither does Congress, which is why they appropriated $1 billion for prevention as part of the American Recovery and Reinvestment Act.

Part of this money will go to immunizations and another part will go to prevent patients from getting infections during surgeries and other medical treatments.  But most of the money is going towards a prevention initiative that was developed by the CDC and the Office of Public Health and Science with input from many of the groups that are here today.  We aren’t ready to officially announce this initiative, but we expect that a significant amount of the money will go to help states and communities attack obesity and other public health challenges.

And if it’s not already clear from my remarks today, I should add that I’m convinced this is not just a challenge for the health community.  That’s why we at HHS will be looking for any chance we can get to partner with other agencies like the Departments of Education and Agriculture to help Americans eat healthier and live healthier lives.

Conclusion

Americans are hearing a lot about health care these days.  Some of it is unpleasant like the partisan attacks that are starting to multiply.  Some of it is difficult and confusing like sorting out the details of different reform packages.

What can get lost in this conversation is the huge, once-in a generation opportunity we have to build a health care system that delivers better results without bankrupting families or the federal government...a health care system that incorporates best practices from across the country…that makes forward-looking investments in prevention and health IT…that eliminates unnecessary procedures and paperwork while expanding access to the best treatments...a system that is designed with one goal: to give Americans the best value and care possible.

Reducing obesity – especially for children – would be one of the biggest steps we could take towards this better health future.  And if everyone in this room throws their weight behind helping Americans lower theirs, I think we make it happen.

Thank you.