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Features Health & Wellness Resolution of epidemic requires community action

Dr. Barton PaschalTobacco use is the number one cause of preventable death in America. Despite its lethality it is not America’s costliest health problem. That distinction goes to an epidemic that began less than 30 years ago and accounts for 20 percent of total U.S. healthcare spending. Presently this scourge affects one-third of adults. By 2030 it could affect as many as 42 percent of adults. Of the ten most common causes of death, four are influenced by this health problem.

That malady is known as the obesity epidemic.

The number of U.S. citizens who are affected by obesity is staggering – 78 million adults and nearly 13 million children.

A particularly alarming consequence of the obesity epidemic is its effect on children. Eighty percent of obese children remain obese as adults. Health problems that obese children carry into adulthood include diseases of the liver, heart, lung and joints as well as type 2 diabetes. Although type 2 diabetes formerly was referred to as “adult-onset diabetes,” this designation has become a misnomer with the recent surge in the number of children with type 2 diabetes.

This surge is directly attributable to the obesity epidemic.

Parents are obliged to protect their children from environmental hazards including those that lead to obesity.

Today’s obesogenic environment makes that task more difficult. Healthy foods are harder to come by. In addition, the general public lacks an appreciation for what constitutes a healthy diet.

Advocates for reform point out that food companies have profited from the obesity epidemic just as tobacco companies have profited from cigarette smoking. Does this situation represent a conflict of interest? Should schools reprise home economics classes in order to facilitate the preparation of healthy foods at home? Do kids have the opportunity to ride bikes or walk to school in a safe environment? Does culpability for the obesity epidemic lie with the food industry, fast food, sugar-containing beverages or the agricultural production system? Or in the words of the creator of Pogo, have we “met the enemy ... and he is us” including individuals, parents, school officials, health care professionals and community leaders?

The control of obesity will require policy changes, coordinated action and individual effort. Schools, workplaces, health care professionals, scientists, food marketers and government all have a role to play. As resources for fighting the obesity epidemic become available, families and individuals must shoulder responsibility for utilizing them.

In the wake of the U.S. Surgeon General’s report on tobacco in 1964, the greatest reduction in cigarette consumption occurred when advocates for smoking cessation shifted emphasis from changing individual behavior to organizing community-based action. There are similarities between public health programs that were designed to curb tobacco use and those that have been proposed to reduce the incidence of obesity. Unfortunately the battle against the obesity epidemic is shaping up to be just as difficult and prolonged as was the battle against tobacco use. For information on how to participate in community efforts to control obesity, visit,, and

Dr. Barton Paschal is certified by the American Board of Internal Medicine in the subspecialty of medical oncology. Dr. Paschal is a member of the staff of Haywood Cancer Center at 600 Hospital Drive, Suite 10 in Clyde and Macon Cancer Center at 190 Riverview Street in Franklin. He can be reached at (828)456-5214 or (828)369-4257.

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