AMY D’ONOFRIO AND CAROLYN LOCHHEAD, Hearst Newspapers 
August 17, 2009

Obesity is the elephant in the room of health care reform, a public health catastrophe that kills well more than 100,000 Americans a year, costs New York more than $6.1 billion a year in medical services and promises to shorten U.S. life expectancy for the first time since the Civil War.

Whatever Washington does this year to try to lower medical spending almost certainly will be swamped by the nation’s rising weight. Obesity lurks as a cause behind the top chronic illnesses — heart disease, diabetes, stroke and colon, breast and prostate cancers, among many others. Treatment of each individual case routinely cost hundreds of thousands of dollars.

As recently as 1985, less than 10 percent of New York adults were obese; now nearly a quarter are.

Every third child born in 2000 is likely to wind up diabetic. Obesity strikes hardest at the poor and minorities; black women are nearly 40 percent more likely to contract heart disease than white women. Fifty-nine percent of New York adults are overweight or obese.

Obesity is causing “death and illness on a massive scale,” according to a new study by University of Virginia and Urban Institute researchers.

Obesity is all but impossible to treat.

“Rising obesity rates are increasing health care expenditures per person in a way that is going to be very difficult to finance,” said Jay Bhattacharya, a doctor and health economist at Stanford University’s Center for Primary Care and Outcomes Research. “Unless there is some vast improvement in the efficiency of the health care system — and I mean vast — we’re going to be spending a lot more just because a lot more people will have diabetes” and other obesity-related diseases.

Prevention is the only cure. Yet while health care legislation in Congress would raise spending on prevention of chronic disease, it does little to tackle the underlying obesity epidemic directly; in fact, most of the bills are silent on what many contend would be one of the most effective weapons: a tax on soda.

Junk food taxes are part of a growing consensus among public health experts to adapt the successful fight against tobacco to the more complex obesity epidemic.

New York City and four counties — Westchester, Rockland, Ulster and Suffolk — require menus to be labeled with nutrition information in restaurants because of legislative changes. Albany County passed a law Aug. 10 to require menu labeling.

Still, the struggle remains for small gains against a barrage of junk food marketing, sedentary lifestyles, cheap food economics and perverse federal farm and transportation policies.

Many efforts to reduce obesity are focused on the youngest New Yorkers. Sen. Kirsten Gillibrand, D-N.Y., and New York City Council Speaker Christine Quinn announced a joint effort Aug. 12 to improve nutrition in-state and around the country.

Gillibrand plans to introduce the Lowering Urban Nutrition Costs for Healthy Eating at Schools Act to make free and nutritious meals more accessible to students. Also, the city council is organizing urban leaders from across the country to help lobby Congress for improvements to the Child Nutrition Act.

“As Congress debates how to improve health care access and lower health care costs, we must also pursue a strategy to tackle childhood obesity and improve the health of our future generations,” Gillibrand said.

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