Obesity: Less Talk, More Action

The CDC is wrapping up its first Weight of the Nation Conference in Washington, D.C. today, a meeting designed to discuss the prevalence and prevention of obesity in the United States. In a speech at the conference, Health and Human Services Secretary Kathleen Sebelius pointed out that more than two thirds of Americans are obese or overweight, and that obesity-related health problems now cost the nation $147 billion per year, far more than the $93 billion annual cost of treating all cancers. In her comments, Sebelius cited a Time Magazine poll that found that while most Americans say that they want to lose weight, far fewer Americans have any plan for losing that weight. These Americans know there is a problem, but the solution - and the motivation to make a change - has eluded them.

Obesity has complex sources and it requires a multi-faceted solution: first of all, better education about and access to healthy food and exercise, especially among the ethnic populations that have the highest rates of obesity. Sebelius hinted about an obesity prevention initiative currently in the works that will be funded by the stimulus package. This initiative would probably work on community-wide solutions (such as supporting local exercise programs and improving access to grocery stores and farmer's markets) and nation-wide solutions (such as pressuring the food industry to remove more fats and sweeteners from its products). But I think that these solutions should be combined with direct financial incentives for individuals. Maybe there could be an income tax credit for people who maintain a healthy body mass index (B.M.I.). What if health insurance under whatever new plan arises from the Obama administration were free for people who maintained a healthy B.M.I., and reasonably prorated for all other Americans? If the possibility of weight-related disease and disability won't make people lose weight - as it clearly hasn't - then financial incentives might.