Experts say Colorado's due for an obesity epidemic

Two out of three Coloradans will be overweight or obese in the next eight years, despite Colorado's perennial ranking as one of the nation's leanest states.

The projection, based on current trends, shows the long reach of a worldwide epidemic considered by many experts to be the most serious health threat facing the population because of its link to so many chronic conditions. Unlike other widespread health hazards, however, this problem is arguably the most complex and insidious that experts have faced.

According to the Colorado Health Foundation, which released a report last week titled "Income, Education and Obesity: A Closer Look at Inequities in Colorado's Obesity Problem, Colorado's obesity rate has doubled since 1995. The poor and uneducated fare the worse, with the gap widening even further between children from low- and upper-income families.

Obesity, defined as having a body mass index of 30 or more, is a driving force behind Type 2 diabetes, osteoarthritis, heart disease and certain cancers. The report said Colorado spends $874 million a year on obesity-related illnesses.

Public health officials say that in many ways, the epidemic tops tobacco, drunken driving and not wearing seat belts in its significance.
On Tuesday, a new study revealed that some obese children have carotid arteries comparable to middle-aged adults. And the Centers for Disease Control and Prevention recently reported that cases of Type 2 diabetes have doubled nationally in 10 years, a trend that mirrors the rise in the waistband.

"I have people in their 20s starting on blood pressure medicine, which was unheard of 10 years ago even," said Lisa Diamond, a nurse practitioner with Colorado Springs Health Partners.

Yet the problem is unique, experts say, in that there's no single enemy like there was with tobacco. And so far, no one solution has proven all that effective.

"It's not just ‘let's get the vending machines out of schools,'" said Dr. Reginald Washington, chief medical officer of the Rocky Mountain Hospital for Children.

Some issues cited by public health officials:

• · The poor often don't have access to grocery stores that carry fresh fruits and vegetables, while fast-food chains are easy to find. Even if the grocery stores were there, the healthy foods are usually too expensive.
• · Food placement in gas stations and grocery stores, such as candy bars at the front counters, caters to impulse.
• · Some neighborhoods aren't considered safe for walking or playing outside.
• · In schools, physical education is often one of the first subjects to go when it is time to revamp curriculums or cut corners.

Race, and cultural attitudes about food and weight, are also significant factors. Many Russians and blacks, for example, prefer to be heavy, said Washington, and some cultures see being overweight as a sign of good health. A physician who tells his or her patient to lose weight, he said, could be insulting them without knowing it.

Diamond said some patients' family members have expressed worry over a parent or grandparent for being too skinny, when in fact they were the ones at an unhealthy weight and grandma was just fine.

Similar puzzlement comes from discussions about how much food they should eat.

"I get blank stares from people when we talk portion sizes in the palm of your hand," Diamond said.

She tries to educate patients about nutrition and exercise, but she concedes the lessons don't go far against an arsenal of excuses that involve family, busy schedules, money and convenience, to name a few.

"I have to have hope, but I tell you it just seems to fall on deaf ears," she said. When one patient gained weight, the reason was this: A family member was binge eating as a final indulgence before gastric bypass surgery and the patient joined in.

So many factors of come into play with obesity that the world, in short, is "toxic," said Terry Huang is director of the Obesity Research Strategic Core at the Eunice Kennedy Shriver National Institute of Child Health and Development, one of the National Institutes of Health. At issue is an abundance of calories and a lack of activity that spiders into daily lives in multiple ways.

That means curbing the epidemic requires changing society. Huang defined success as a "plateau" in obesity rates over the next several years. And that would come from a large-scale, coordinated attack by businesses, governments, public health agencies and community groups.

Although it's a daunting task, it's time to bring it on, said Karen Deleeuw, director of the Colorado Department of Public Health And Environment's Center for Healthy Living and Chronic Disease Prevention.

"Colorado is well-poised to be a national leader in this," she said.

The state's overall ranking as one of the leanest in the nation means it has a head start of sorts, she said.

Public health officials like Deleeuw turn to the anti-tobacco effort for inspiration, where an all-out war on smoking brought it from common in virtually any public place to a highly taxed, unpopular habit prohibited in many places.

Still, a big belly is not Big Tobacco. A person can live without cigarettes, but not without eating, said Washington. And if officials decide to tax Twinkies, he said, they'd better find a way to make healthful foods more affordable. If not, obesity among the poor might change to hunger.


Contact the writer: 636-0198 or brian.newsome@gazette.com