Nation’s obesity problem demands sweeping changes, panel says

They sifted through about 800 programs to prevent and fight obesity--to find the ones most likely to counter the nation’s growing girth. In the end, a panel of independent experts asserted that only by implementing many of those initiatives at once can the nation make real progress.

Reversing the nation’s “obesogenic,” or fat-promoting, culture will require sweeping changes across all aspects of daily life, “modifying factors that shape individual choices and incidental behaviors,” the Institute of Medicine concluded in a report issued Tuesday. Changing circumstances in one sphere of an individual’s life to counter the problem without instituting changes in all spheres of life will set the nation up for failure--and for a future of rising healthcare bills, shorter lifespans and sicker, unhappier people--the report said.

The panel recommended that schools position themselves as gateways to obesity prevention, ensuring that children get at least an hour of physical activity daily, barring access to foods and beverages high in calories, and offering all students healthful, nutritious foods and instruction in the fundamentals of healthful eating and living.

Workplaces and health insurers should “increase the support structure” for obesity prevention, diagnosis and treatment and for encouraging healthful behaviors such as regular exercise, healthful eating and breast-feeding for new mothers.

Congress should support the Obama administration’s proposed funding increase for the school lunch program and join with federal officials in setting aside “substantial funding” for a “sustained and robust social marketing program on physical activity and nutrition,” the report said.

And food beverage, restaurant and media industries should take “broad, common and urgent voluntary action to make substantial improvements in their marketing aimed directly at children and adolescents, 2-17.” That recommendation drew protest from food activists, who consider voluntary measures ineffective, as well as from quarters such as the American Beverage Assn., which argued that efforts to encourage limits on advertising of sugar-sweetend beverages overemphasize the role that such drinks have played in obesity’s growth.

“The food industry is still behaving very badly, producing and marketing unhealthy foods to children in unpardonable amounts” said Kelly Brownell, director of Yale University’s Rudd Center for Food Policy and Obesity. “Their pledges to change have amounted to very little. They’ve shown again and again that they cannot police themselves.”

The report comes a day after the Centers for Disease Control and Prevention issued a forecast of obesity in 2030 showing a slow but steady increase in the proportion of obese Americans (those having a body-mass index of 30 or above), from a current level of 34% to 42%, and a 130% rise in the proportion of Americans who are “severely obese,” defined as having a BMI of 40 or above.

It came on the second day of a conference of 1,200 experts in Washington to discuss the nation’s epidemic of obesity. The most visible element of the conference is a four-part HBO documentary titled “The Weight of the Nation,” which is to be aired--and available free of charge online--on Monday and Tuesday next week.

The documentary is seen as a call to action in a national war against obesity. This week, however, the architects of that conflict hope to agree on a battle plan, and the Institute of Medicine’s report is likely to become a blueprint for action.

The report called on “individuals and groups in every sector and at every level” to identify changes that can be made under their control that improve access to and choices about healthful foods and encourage daily physical activity.