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Obesity: A looming national threat?

By Manav Tanneeru
CNN
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(CNN) -- Four years ago, Arkansas Gov. Mike Huckabee weighed around 300 pounds.

"The only reason I don't have an exact figure is because my scale stopped at 280 pounds," he said. "I had to kind of guess at that point."

The weight, on his 5-foot-11-inch frame, posed dangerous health risks and made daily life difficult and sometimes embarrassing. He recalled a humiliating meeting that made him realize his weight was a problem.

"[The staff] all stood like they typically do and I went to my chair at the head of the table, and as I sat down the chair collapsed," he said. "I dusted myself off and got up and tried to make light of it and said that they just don't make chairs like they used to. But it wasn't the chair that needed rebuilding, it was me."

The epiphany, however, arrived when he was diagnosed with type 2 diabetes in 2003. Huckabee's doctor told him that without a lifestyle change he had about 10 years to live.

"It was a real wake-up call," Huckabee said.

Over the past two years he's lost about 120 pounds, embarked on a crusade against fat and has become something of a national example of the growing threat of obesity -- and a success story for battling it.

Startling statistics

An estimated two of every three American adults, and more than one in six children and adolescents are considered overweight or obese, according to the Centers for Disease Control and Prevention.

The rates have been on the rise since the late 1980s after being relatively constant in the '60s and '70s, said Dr. Cynthia Ogden, an epidemiologist at the Centers for Disease Control and Prevention.

The percentage of adults who are obese -- defined as having a Body Mass Index of 30 or more -- has doubled to 31 percent, or some 60 million people, over the past two decades, Ogden said. (What's your BMI?)

Being overweight increases the risk for diseases such as type 2 diabetes, heart diseases, stroke, sleep apnea, respiratory problems and some cancers. Being obese poses the greatest health risks.

A study released in 2005 by the National Institutes of Health suggests average life expectancy could decline by nearly five years if the rising rates of obesity cannot be curbed.

Some critics are skeptical of the NIH study's methodology and argue that medical progress could increase longevity, but many generally agree that obesity does pose a legitimate threat to American society.

Huckabee said he was especially troubled by the rising rates in kids and adolescents.

"We're now seeing pre-teens, kids who are 8- or 9-years-old, who are being diagnosed with type 2 diabetes," he said. "If we continue with this trend, within another generation you'll be seeing kids dropping dead at their desks at the high school."

In addition to the obvious human toll, "The economic impact of this current health crisis is so overwhelming that I think it's hard to even begin to make it comprehensible to the average person," Huckabee said. "Some 700,000 people a year will die in America because of inactivity, overeating and smoking. Those three lifestyle choices are essentially driving the cost of health care."

Costs attributed to overweight and obesity accounted for 9.1 percent of total U.S. medical expenditures in 1998, according to a study cited by the CDC. The costs may have been as high as $78.5 billion -- $92.6 billion in 2002 dollars.

There are several reasons for the rising rates, experts say. Contemporary life has become more sedentary, with more time spent in front of the computer and TV screens and less time engaging in rigorous activity.

"Kids today don't come home and play in their neighborhoods and run and romp 'til it's dark," Huckabee said. "They come home, they get in behind locked doors so that their parents can know where they are and they turn on the computer or television or a video game and they sit with a bowl of chips in their lap and they eat and they sit."

Americans are also eating out more often and becoming accustomed to larger portions. Changes have also occurred in modern diet, with foods containing more calories and preservatives, and less nutrition, Ogden, the CDC epidemiologist, said. (How eating habits have changed)

Really an epidemic?

J. Eric Oliver, among others, disputes the claims of an obesity epidemic. "Undoubtedly, we are gaining weight, but it's another thing to call this an obesity epidemic," said the University of Chicago political science professor and former health policy scholar at Yale.

Oliver said the basis for measuring obesity, the BMI tables, is flawed. The Body Mass Index is the weight of a person relative to their height.

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Arkansas Gov. Mike Huckabee says reversing the nation's obesity trend is possible in the next decade.

An athlete may be overweight based on the BMI tables, but that weight is due to muscle mass and not necessarily body fat, Oliver argues in his book, "Fat Politics: The Real Story Behind America's Obesity Epidemic."

"The BMI tables are the predominant measure because it is easy to conduct epidemiological studies by calling someone on the phone and asking them how tall they are and how much they weigh," he said. "It is so much easier to measure [that] than things like diet, exercise, family history or another measure.

"We're really sort of defining the problem by what we can measure [rather] than by where the problem exists."

Oliver suggests in his book that the talk of an obesity epidemic is driven in part by the diet and pharmaceutical industries, and a subconscious discrimination in society against fatness.

"I don't think weight is a very good barometer of health. In and of itself, it's a very crude measure," he said. "It sends the message that in order to be healthy, all you have to do is be thin, which isn't true."

Oliver said the real health problem of obesity and some other health threats stems from a society not adjusting to modern life and choice, essentially being able to eat what you want, where you want, whenever you want.

"That's consumer capitalism catching up with where we eat," he said. "Ultimately, the real problem is that we don't seem to be very biologically equipped to deal with the contemporary lifestyle."

A 'culture of health'

For the most part, researchers and experts in the public health sector believe obesity has negative consequences and raises the risk for certain diseases.

"What I continue to say is that there needs to be a culture of health developed in America," Huckabee said. He cited four examples -- litter, seat belt usage, smoking and drunken driving -- in which concerted public campaigns, aided by government, led to cultural shifts.

Some legislation, such as restricting marketing toward kids and curbing certain foods in school cafeterias, already has been suggested. But in the end, Huckabee said, change centers on personal responsibility.

"My own experience gives credibility to the fact that people can change," he said.

He is optimistic that significant steps can be taken over the next 10 years.

"It's not unrealistic to say that within a decade we could see a significant turning," Huckabee said. "Will all of America be healthy and thin? No. But will we have maybe reversed course? Yes, I think it's possible."


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Health officials estimate two out of every three American adults are overweight or obese.

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