Surgeon General Takes Stern Stance on Obesity


The nation’s epidemic of obesity is almost as menacing to health as smoking, the U.S. surgeon general said Thursday as he called on Americans to eat less and exercise more.

Deaths related to obesity have reached 300,000 a year, said Dr. David Satcher, compared with 400,000 deaths annually from illnesses associated with smoking. Heart attacks, diabetes, strokes and various forms of cancer have all been linked to obesity, Satcher said.

With his national plan of action, Satcher hopes to do for excess poundage what Luther L. Terry did in 1964 with his report on smoking: use the power of the surgeon general’s office to draw attention to a critical, and potentially fatal, public health issue.

In less than a generation, the lack of exercise and a diet filled with fats and sugars have produced an alarming rise in the ranks of those who are dangerously overweight. The vast majority of Americans have a paunch problem, Satcher said: 62% are either overweight or obese, compared with only 48% in 1980.


“We have become increasingly sedentary . . . probably the most sedentary generation in the history of the world,” Satcher said.

All Americans Asked to Lose 10 Pounds

To fight the epidemic, all Americans should lose 10 pounds as a patriotic gesture, said Health and Human Services Secretary Tommy G. Thompson.

“As much as we love to eat, too often we fail to consider the consequences of that love,” Thompson said at a news conference.

In a recent informal survey at UCLA medical center, half the patients visiting doctors’ offices were obese, said Dr. David Heber, professor of medicine and director of the UCLA Center for Human Nutrition. “We are seeing grade school children in Los Angeles with Type 2 diabetes,” a weight-related condition typically seen in adults, he said.

The epidemic among both children and adults is striking particularly hard at immigrants from Mexico and Central America, who are genetically predisposed to developing diabetes, Heber said. They are healthy in an environment where they consume a lot of fruits and vegetables, he said. But in the United States, where the diet is “heavy in hidden fat and sugar and refined carbohydrates,” they develop diabetes.

Satcher’s report faulted school districts nationwide for eliminating physical education programs. Illinois is the only state where all students from kindergarten through high school must take physical education.

Less than a third of all adults meet the government’s suggested exercise standards, which call for 30 minutes of moderate physical activity at least five times a week. Walking 1 3/4 miles in 35 minutes is an example of appropriate exercise, said the report.


Such a daily walk can take off 10 pounds in a year. A daily 12-ounce soda (150 calories) can add 10 pounds of weight in a year.

Body Mass Index the New Obesity Indicator

The latest scientific research and analysis no longer depend on a simple poundage figure as a standard of health and fitness. Instead, the government endorses a measure called the body mass index (BMI).

It works this way: Take a woman who weighs 140 pounds and is 5 feet, 4 inches tall. Multiply her weight by 703, which gives a total of 98,420. Divide this total by her height in inches (64), giving a figure of 1538. Divide it again by her height, for a total of 24. That is her body mass index, and it is considered healthy. Anyone can calculate a personal BMI by using the same calculations: your weight times 703, divided by your height in inches, and then divided by height again.


A figure up to 24 is considered healthy. Any number between 25 and 30 means the person is overweight. A reading over 30 is an indicator for obesity, placing the individual in serious danger of developing heart disease, high blood pressure, diabetes and other ailments.

About 35% of adult Americans have a BMI that classifies them as overweight, compared with 33% in 1980. More troubling, 27% are considered obese based on their BMI, a jump from just 15% in 1980.

A more informal measure of obesity is waist size: 35 inches or more in a woman, or 40 or more in a man, according to Dr. Louis Aronne, clinical associate professor of medicine at Cornell University Medical College in New York.

About 14% of children, triple the figure in 1980, are considered overweight. There are no specific “overweight” and “obese” categories for children because they have different rates of growth and development.


Satcher urged Americans to consume smaller portions at meals, eat less food with high fat and calorie content, eat more fruits, vegetables and whole grain foods, watch less television, send their children outside to play and insist on healthier lunches in schools.