MY HEALTH AT FIRST

Losing weight and getting fit preoccupied Americans in 2009:

• Nearly one out of two American women, including high school girls, were on a diet.

• Over 40 billion was spent on branded diet plans.

• Children as young as 9 to 11 years old were sometimes or very often dieting.

Yet an epidemic of obesity continues to affect more people than ever before:

• Less than a third of adults enjoyed normal weight.

• Children were two to three times more likely to be overweight today than they were 30 years ago.

Can we begin to reverse these worrisome trends in 2010?
We can if we update our old views with new ways to look at fitness in the coming year.
Old View: It's hopeless! Efforts to lose weight are inevitably doomed to fail. Even if a person manages to lose weight, he or she will eventually regain the weight and add back even more.
New View: You can do it! Strategies for making healthier choices involving diet, physical conditioning and improved self-care are available to you and can be learned. Championing this view is Kelly Brownell, Ph. D., who heads the LEARN Program for Weight Management at Yale University. And thanks to widespread access to the Internet, peer counseling in online communities is expanding. Internet support may include food and exercise diaries, weekly counseling, online weight-loss lessons and motivational phone calls.
Old View: Thin is in! Most individuals, especially women, seek to lose weight because they have internalized the media's ultrathin ideal.
New View: Healthy is in! Health is replacing vanity as the primary reason for pursuing fitness and weight loss. In 2009, researchers reported that four healthy habits could reduce or eliminate 80 percent of major medical problems: eating a healthy diet, not smoking, exercising regularly and maintaining a normal body weight. This insight, combined with rising medical costs, is triggering a focus on fitness.
Old View: If you are fat, you are a bad person. Obesity is a personal problem caused by a lack of willpower.
New View: Obesity is a disease that is treatable. The cost of providing medical care per person has skyrocketed from $356 in 1970 to $8,160 in 2009. Moreover, in 2009, the cost of treating obesity-related medical problems reached $147 billion. Given these costs, obesity has become a public health concern requiring a multifaceted community-based approach. In response, community leaders in Albert Lea, Minnesota, implemented a comprehensive lifestyle program to improve the health and longevity of the city's residents. To increase employee productivity and reduce health insurance costs and absenteeism, corporate wellness programs are proliferating.
Old View: Low-fat diets are required to lose weight. Eating fat makes a person fat. To lose weight, a dieter needs to stick with low- or no-fat foods.
New View: Total calories actually determine weight. The total calories consumed by a person, whether from carbs, fats or proteins, determines weight. Since the goal is a balanced diet, the Mediterranean diet, which includes healthy fats, is recommended by the Mayo Clinic and the American Heart Association as a nutritionally sound and healthy eating plan. Nuts, which until recently were on dieters' "do not eat" lists, are making a comeback because of their health benefits, especially almonds, walnuts, cashews, pecans and macadamia nuts. Momentum is growing for mandating information on the caloric content of fast foods and food products.

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Old View: Medical intervention is needed. Weight-loss drugs or bariatric surgery can solve the problem of surplus pounds for many people, and advances in medicine can address obesity-related problems such as cardiovascular disease, diabetes, stroke and cancer.
New View: A healthy lifestyle is the best way. Prevention, rather than treatment of obesity-related medical problems, will move to the forefront because of the rising cost of medical insurance and healthcare. While the number of bariatric surgeries will continue to skyrocket, family physicians will increasingly write exercise prescriptions in lieu of drug prescriptions.
Old View: Ignore overweight children. Children who are overweight will outgrow their chubbiness, so kids' surplus pounds can be ignored.
New View: Help overweight children now! Dr. Robert Murray, chair of the American Academy of Pediatrics Council on School Health, is alarmed that nearly half of kids and teens are overweight or obese and, as a consequence, children's life expectancies are lower than their parents'. Treating childhood obesity is a serious medical problem that if ignored will place the child at risk for heart disease, diabetes and other serious medical conditions.
Old View: Don't ask, don't tell. Asking employees to modify their unhealthful behavior is an invasion of privacy and violates employees' right to choose their own lifestyle.
New View: Offer help, incentives and access to experts. In 2008, medical insurance premiums reached a record $15,609 for a family of four. Employers are proactively seeking to reduce costs (medical insurance, workers' compensation claims and absenteeism) by restructuring benefit programs. In increasing numbers, employees are being offered incentives to quit smoking or lose weight. They face penalties if they refuse to change habits that drive up the cost of healthcare.
Old View: Hard-core exercise one hour daily. Going to a gym daily for a 60-minute workout on a treadmill and resistance equipment is the best way to exercise.
New View: Diversity, fun and enjoyment. Thanks to popular television programs, dancing for fitness is back, particularly Zumba, a one-hour workout that fuses Latin rhythms with calorie-burning dance movements. Exergaming, such as Wii and Dance Dance Revolution, continues to grow in popularity with young and old alike. Michelle Obama has made the Hula-Hoop popular once again. The use of technologically sophisticated feedback gadgets, from pedometers to heart monitors, will expand. To attract members to the gym during tough economic times, more fitness centers will offer cardio cinema so members can watch a movie while exercising.
Will we continue to get fatter until 2018 when, according to research by Kenneth Thorpe, PhD, of Emory University, 40 percent of us will be obese (and another 33 percent overweight)?
If we are to succeed in reversing the obesity trends and mounting medical care costs, we'll have to find new approaches. And the more readily we learn from the past and update our understanding of the complex nature and causes of obesity, the more quickly we can successfully move into a healthy future.