IOM Urges Collective Action Against Obesity

The Institute of Medicine is urging all Americans to come together to systematically attack the "obesity epidemic." In a report released May 8, a blue-ribbon panel convened by the IOM made five basic recommendations to fast-forward progress on curbing the nation’s growing girth.

Panel vice chair William Purcell called the recommendations "straightforward, direct goals" to not only combat obesity, but to hopefully end the problem. The panel recommended:

• integrating physical activity every day in every way for everybody.

• making healthy foods available everywhere.

• marketing what matters for a healthy life.

• activating employers and health care professionals.

• strengthening schools as "the heart of life."

The recommendations are part of the committee’s report, "Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation."

The 16-member committee, made up of nutrition, obesity, and marketing experts; epidemiologists; and behaviorists, among others, said that all of the recommendations – and strategies to put them into place – hinge upon each other for success.

"We need to do it all, we need to do it now, and it involves all of us," said Mr. Purcell, an attorney and former Nashville mayor, at a plenary session on the report at the meeting.

"Obesity is both an individual and societal concern, and it will take action from all of us – individuals, communities, and the nation as a whole – to achieve a healthier society," said IOM president Harvey V. Fineberg, in a statement.

In putting together its report, the IOM committee reviewed 10 years worth of data and some 800 of previous recommendations. The scope of the problem has become very evident, panel members said.

About one-third of American adults are obese, and 17% of children are obese. Among certain racial and ethnic groups, especially blacks and Latinos, the number is even higher, according to the report. The committee estimated the annual cost of obesity-related illness at $190.2 billion, or nearly 21% of annual health spending.

Panel chair Dan Glickman said that rising costs were as likely as any other factor to push policy makers, health professionals and community leaders into action.

"We are increasing our debt by about $1 trillion a year and the biggest part of that is health care costs. We can’t sustain that," said Mr. Glickman, former Secretary of Agriculture and currently executive director of congressional programs at the Aspen Institute.

Mr. Glickman also said that business has become more engaged in trying to tackle obesity, which was not the case 10-15 years ago.

"We’ve known the problems are severe, but society has to reach a point where it’s ready to tackle them and I think we’re much closer to that than we have been," he said.

The panel’s outlined a series of strategies to address obesity in a variety of environments.

For instance, the panel suggested how schools could find ways to encourage more physical activity and serve healthier meals to students. And, schools should provide food literacy or nutrition education classes, they recommended.

Further, governments should seek ways to reduce consumption of sugar-sweetened beverages especially by children, and possibly even should prohibit serving them to kids. The panel also called for development of standards on how food and drink are marketed to children.

Health care providers should adopt standards of practice for prevention, screening, diagnosis, and treatment of obesity, and should be advocates for greater access to physical activity in their communities, according to the report. Employers should also be advocates for better lifestyles, the panel said.

Special attention was given to how all of these strategies could be applied to low-income Americans and minorities.

For instance, the lowest-cost foods are often the least healthy and most calorie dense; people in low-income communities often rely on those foods because they are inexpensive, according to panel member Shiriki K. Kumanyika, Ph.D., of the University of Pennsylvania, Philadelphia.

The panel also noted that the mix of retail outlets in low-income and certain racial communities drives people toward less healthy eating.

Marketing efforts surrounding some less-healthful food choices seek to make those foods more appealing to minorities; ads for high-calorie foods are much more prevalent in minority communities than in white communities, Dr. Kumanyika added, who added that this is especially true of marketing to black and Latino children.

"We have to be thinking about transforming the environments to get rid of the inequities," she said.

The IOM report is the first to pull together recommendations that target everything from how communities are laid out and built, to how food and beverages are marketed to how schools and work places can encourage healthier living, Jamie F. Chriqui, Ph.D., of the University of Illinois, Chicago.