Public Enemy No. 1

toddFall 2012

By Elizabeth Caldwell

The triggers for obesity are everywhere.

A fast food chain implores customers to grab a “fourth meal.” Another touts any size soft drink for a dollar. Escalators replace stairs. Even the television remote provides one more opportunity to be sedentary.

The results of an inactive and overindulgent lifestyle make for some scary statistics. More than a third of Arkansans are overweight; almost another third are obese. One in 10 has been diagnosed with type 2 diabetes, and Arkansas is No. 2 in the nation for stroke.

For Arkansas children, the numbers are just as staggering, with 21 percent of school-aged children obese and an additional 17 percent overweight. Obese children are more likely to have high blood pressure, high cholesterol, increased risk of type 2 diabetes and sleep apnea, according to the federal Centers for Disease Control and Prevention.

“Obesity can have a profoundly damaging effect on cardiovascular health,” said David L. Rutlen, M.D., professor and director of the Division of Cardiovascular Medicine in the UAMS College of Medicine. “Some studies suggest more than 75 percent of hypertension can be contributed to obesity.”

“Obesity is a risk factor for developing most of the common cancers seen in the United States,” said Laura Hutchins, M.D., director of the Division of Hematology/Oncology in the College of Medicine. “Furthermore, reducing weight has a major effect in reducing the risk of breast cancer metastases in patients already diagnosed – as much as chemotherapy for some risk groups.”

Obesity is a public and population health problem that is the result of several environmental factors, said Joe Thompson, M.D., M.P.H., Arkansas surgeon general and director of the Arkansas Center for Health Improvement.

“Our bodies are incredibly well-adapted for an environment we no longer live in,” Thompson said. “When we had to hunt our own food or grow our own food on the frontiers of America, we worked hard and burned a lot of calories. Today, we’re a lot less physically active at the same time that we’re inundated with a lot more calories.”

Individual responsibility to make healthy choices plays a part, he said, but that by itself doesn’t explain the obesity epidemic. “It really is about environmental change so that a healthy choice becomes an easier choice.”

In Arkansas, the high rate of obesity is directly related to poverty, Thompson said. Everyone is susceptible to obesity, but “it’s the poverty issue that drives the availability of the food supply.”

For example, in Little Rock, he said, “you’ve got your best fresh fruits and vegetables in the Heights, and nonfat milk and high-quality-nutrient products, and you can’t find them on Asher. So if we have someone with an obesity problem who wants to eat better, we’ve got to have an environment that’s available for them to procure that food at a price they can afford.”

Another tie to poverty: “You have a poor family that can’t afford to keep the oven on for an hour, but two minutes of frying can make the lower-quality meat edible,” he said.

If the obesity epidemic isn’t addressed more fully, Arkansas is not going to be able to afford the health care that people are going to need, he said. And for Arkansans to enjoy better health, they have to address the root cause of the problem.

“When you look upstream from all the things that kill people, obesity is sitting right there as the root cause,” Thompson said.