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Weight of the Nation Conference

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May 7, 2012
Washington, D.C.

When we talk about our country’s obesity epidemic, we’re talking about a relatively recent development. And several factors came together all at once to create the steep rise in obesity that our country has seen over the last three decades.

First, Americans started moving to the suburbs and with that came a car culture.  Walks to school were replaced by a ride on the bus every morning. At the same time, new technology brought more and more of our entertainment right into our homes – from movies to video games to the internet. 

Second, our eating habits changed. Advances in food science allowed food makers to package and sell affordable, but often unhealthy, processed foods. Soda went from being a treat, to something we always had in the fridge.  And at the local sandwich shop, the so-called balanced meal included a bag of chips.

As a result, obesity began to spike in the late-1980s.  In 1985, no state had an obesity rate above 15 percent.  But by 2010, 38 states had obesity rates over 25 percent.

This shocking rise has left millions of Americans at risk for diabetes, heart disease and a host of other health problems obesity is known to cause.

And the impact went far beyond health. Today obesity costs our economy billions of dollars, threatening our economic security. And a recent Army study showed that more than a quarter of our nation’s 17-to-24-year-olds are too overweight to serve in our armed forces, threatening our national security.

But even as all of these factors came together, it really wasn’t until about the year 2000 that we figured out what was happening to our country. At that point we began to see a national recognition of the obesity problem that we face today. And we saw the start of some of the policies and efforts we needed to fight it.

The good news is that in the last decade, we’ve seen the rise in obesity rates begin to stabilize in some areas. A recent study out of Massachusetts even showed a decline in obesity among children under 6 in parts of the state.   That’s progress. But we can’t be satisfied, not when today, nearly one-third of our children are overweight or obese. 

We need to turn the tide on obesity and in the last few years there have been some key factors that give us a real opportunity, not only to stop obesity in its tracks, but to start pushing it backwards.

One of the most important differences has been the First Lady’s Let’s Move campaign.  It’s brought a historic level of attention to the health of our nation’s children.  It’s brought partners together from mayors to Fortune 500 companies to star athletes and performers to help kids eat healthy and get active. And maybe most importantly, it’s changed the conversation about health and fitness. What was once largely focused on appearances and mired in negativity, is now a much more positive conversation about how we can be healthier, live longer and feel better.  That’s a great development.

And while the First Lady has been out energizing the country, the federal government has been getting in on the act too.

In 2010, President Obama signed a law that will improve the quality of food in schools and result in healthier school meals for kids around the country. A partnership between HHS, USDA and Treasury is bringing supermarkets to food deserts to get healthy food into some of our most deprived communities. And new guidelines developed jointly by federal agencies, including HHS, will make healthier food available to hundreds of thousands of federal employees around the country.

At the same time, through CDC, we’ve been helping businesses create workplace wellness programs that can improve the health of their employees and reduce their health spending. And thanks to the Affordable Care Act, preventive services like BMI screenings are now available in many private health plans – making it easier for families to learn about healthy weight.

What’s unique about these efforts is that it’s not just HHS leading the way.  Under the first-of-its-kind National Prevention Strategy, we have agencies and departments throughout government working together with states and communities to improve health.  And this isn’t just a one-time project. It’s a coordinated and sustained effort to make our country a healthier place tomorrow, next month and over the next decade.

We finally have federal, state and local government, the private sector, and community organizations working in sync to achieve the same goals. And for that reason, I’m optimistic.

But all of us in this room know the history of public health.  We’ve seen over and over again, whether it’s TB, HIV/AIDS or tobacco – there’s no such thing as inevitable progress. The second that our focus shifts or resources drop, the threat can return and our health can suffer again.  We take our foot off the gas and we start rolling back down the hill.

That’s true for obesity too.  A study presented here this morning showed that if we don’t keep up our current efforts, we could see the obesity rate climb to 42 percent by 2030.  We can’t let that happen.

So, the question for all of us in this room is: what do we need to do now to build on this progress? 

And there are some immediate actions we can take to keep our momentum going in the right direction.

First, we need to continue what I call an “all-of-the-above” approach. Obesity can be caused by any combination of factors.  For some it’s an addiction like smoking.  For others it’s a lack of fresh fruits or vegetables near their home.  The point is, we need to meet people where they are and use every tool we have.  So when we talk about which policy to push or which proven program to fund, the answer needs to be: all of the above.

Second, we need to look across the whole lifespan. There’s been an understandable focus on kids in child care and school. But we know that a mother’s health during pregnancy and decisions like whether or not to breastfeed can have a huge impact on both the mother and child’s health.  And these impacts last a lifetime.

That’s why we want to make sure that women have the information and access they need to make the best possible decisions for their children.

As part of the IOM women’s health guidelines we adopted last year, new health plans are providing breastfeeding supplies and support and screening for gestational diabetes at no cost. CDC continues to work with hospitals to increase access to breast feeding initiations for mothers who intend to breast feed. And thanks to the Affordable Care Act, the Department of Labor now requires employers to provide break time and an appropriate place for nursing mothers to pump breast milk.

But we need to do more.  It makes sense to keep a focus on children to prevent obesity in the first place, but we also need to reach out to adults who are obese or overweight today.

Because, even if you’ve been overweight for a long time, losing weight can have a huge health benefit right away. Losing just 5 to 7 percent of a person’s total weight lowers blood pressure, improves blood sugar levels and lowers the risk of diabetes.  So we’re helping people access the care they need to lose weight if they want to.  For example, last year Medicare announced it would begin to cover screenings and preventive services for obesity without a co-pay or deductible.   And we’re going to continue to expand our efforts to fight obesity throughout the lifespan.

The third thing we need to do is put an emphasis on research and measurement that lets us compare the success of weight and health interventions.  Many of our efforts to tackle obesity are still in their earliest stages – from menu labeling to front of package information.  Obesity doesn’t just happen for one reason, and there’s not just one way to fix it. So we need to have a special focus on identifying what works and what doesn’t.  And when we find something that works, it’s even more important to spread those proven programs far and wide.

That’s the fourth thing we need to do.  We need to sustain the programs that work. 

Over the last 3 years we’ve funded proven, evidence-based community level interventions through programs like our Community Transformation Grants and Communities Putting Prevention to Work.  This funding allows us to support community organizations that are helping people eat better, get fit or quit smoking.  This is an historic investment.  But as we’ve seen in the ongoing debate over student loans, it’s a natural target for cuts. We’re going to continue fighting these cuts because this Administration refuses to save our kid’s future by sacrificing our kid’s future.

No one would ever propose giving our kids half an immunization.  Or purifying half a city’s water supply.  And we should be just as insistent when it comes to sustaining other life-saving prevention programs too.

If we can do these four things, we’re going to make a lot of progress and improve a lot of lives.

But we can’t do any of it without all of you.  You’re the ones on the ground helping us to beat this epidemic community by community, school by school, and family by family.

What we want to do is support you.  If you’re a researcher, we want to make sure that your findings guide federal, state and local policy. If you’re a local community organization getting results, we want to help your efforts spread across your city or town -- and then, across the country. And if you’re a state health official, with an innovative policy improving people’s health, we want to know how it to make it a federal priority.

As you all know, we can’t just flip a switch to make this problem go away.  We need to get all the partners we can, roll up our sleeves and do the work.

We have a great opportunity today to turn the tide on our nation’s obesity epidemic and we won’t let it slip away.

Thank you.