Aetna 2002 Annual Report Download - page 31

Obesity: Worldwide Public
Health Crisis
 . , ..
Director of Obesity Institute, MedStar Research Institute
President, American Obesity Association
Washington, D.C.
Obesity, ‘the disease of diseases,’ leads to many chronic conditions.
It’s about time we made it a health priority.
The global epidemic of obesity presents a public health crisis with potentially great economic
consequences. In the last  years, the prevalence of obesity in adults has doubled in the
United States, and childhood obesity has tripled. Similar increases in obesity are being seen
in almost all countries, both developed and developing.
T o understand this crisis, it is critical to understand that obesity is a chronic disease with
multiple causes. Beliefs that obesity is due simply to a lack of discipline or willpower are no
longer credible. In addition to inappropriate diet and reduced activity, other factors play major
roles. The obese have a different biochemistry than lean people. The nutritional status of
mothers during pregnancy, genetic factors and even viruses may play roles in causing obesity.
Obesity has been called “the disease of diseases.” Increasing body fat leads to diabetes,
high blood pressure, heart disease, strokes, cancer and numerous other health problems.
These complications reduce productivity and require expensive treatments. The natural
history of obesity is that disabilities from these complications begin to appear - years after
obesity onset.
Obesity-related diabetes is an instructive example of the economic costs of obesity.
Formerly rare in children, it is now common. Long-term diabetes complications of blindness,
kidney failure and leg amputations produce disability that diminishes or precludes ability
to work. Obesity-related diabetes in adults has a modest impact on society, as disabilities
occur at or near retirement age. Children getting diabetes at ages - will begin to suffer
these disabilities about age . If at age  these individuals drop out of the work force, stop
paying taxes and begin needing disability payments, the extensive costs of public education
and job training will have been largely wasted.
Obese people suffer great discrimination personally, and in employment and higher
education opportunities. Physicians and other health professionals have abrogated their
responsibilities to the obese. Obesity is the only chronic disease for which more patients are
treated in shopping malls (by commercial weight-reduction programs) than in physicians’
offices. Third-party payers do not cover medical treatment of obesity. Funding for obesity
research from the National Institutes of Health is only about . percent of total NIH funding.
Reversing the course of the obesity epidemic will take a concerted effort by health
professionals, insurers, all levels of government and the public. The environment must change
to promote activity and healthy eating habits. Obesity research is a nascent field. Research
funding commensurate with other major public health threats is needed from government
and private industry to find new treatments and prevention methods. The costs of inaction
or failure will be enormous.
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