The medical costs of treating obesity now approaches $147 billion, according to the Center for Disease Control (CDC). The medical costs of obesity have essentially doubled since 1998, and now account for 9.1% of all medical costs in the US.

Meanwhile, the prevalence of obesity has increased 37% from 1998 to 2006. The average American is 23 pounds overweight and consumes 250 calories more per day now than 20-30 years ago.

The CDC has a small budget for nutrition and obesity programs and is discouraging the consumption of sugar-sweetened drinks. In April’s New England Journal of Medicine, Dr. Frieden, CDC Director, and Kelly Brownell, a professor at Yale, proposed a penny-an-ounce tax on sugar-sweetened beverages, saying that these drinks can be the single biggest cause of obesity.

So,we have the information — but what are we going to do about it?

• We need a concentrated media campaign like the “no smoking” campaign, with an equal concentration and dispersal of information.
• We need to focus on health — not weight! There are many people who will never be thin, but they can still have healthy blood sugar, cholesterol, and blood pressure. This is known as “metabolic fitness”. We need to stop using the word “diet” in every single sentence we speak or write. Diets don’t work. We all know that.
• It’s time to put an end to discrimination against obese people. We need to make fresh fruits and vegetables available at affordable prices in disadvantaged neighborhoods. We need better nutrition education in the schools.

One of the scariest things I heard was that as obesity is increasing, the number of people with anorexia is increasing as well. Is this in reaction to the greater numbers of obese and overweight people?

In this morning’s New York Times appeared the article, “Tossing Out the Diet and Embracing the Fat.”  Whew!! Quite a mouthful.  Easier said than done when someone has been accustomed to dieting and hating the fat for years.

As a therapist who has treated hundreds — if not thousands — of compulsive eaters who are overweight according to our beloved insurance charts and BMI tables, I wish someone could wave that magic wand and have everyone who has lived on and off diets for most of their lives be happy just with themselves as they are.

So many women live sad lives of “when I lose the weight” or “if I’m able to take it off by Christmas,” my  life will be pretty perfect!  So many lives of creative, brilliant women literally on hold with these unattainable dreams.

It could be that we might be in the midst of a bit of a paradigm shift.  Even Oprah “now sites her goal as not being ‘thin, but ‘healthy and strong and fit.”  What a statement!  I’ve always thought that Oprah manages to look pretty snappy even when she’s heavier!  She’s certainly an attractive woman.  What would it take for more and more American women to say, “You know, I think I’ll be like Oprah! I think my goal will be to be fit, strong, and healthy.”

I loved reading about the medical studies that are now reporting that a little extra fat is not a bad thing.  In last month’s Canadian Obesity Journal, researchers confirmed that overweight “appears to be protective against mortality,” while being too thin can be associated with a higher risk of death.  

We’re actually making some progress in size acceptance in addition to Oprah and Kirsty Alley.  The HAES (Health at Every Size) movement has helps women come to terms with their weight and teaches them that they can be vibrant and attractive just as they are!   Glenn Gaesser, professor of exercise physiology at Arizona State University, has written a fabulous book called, Big Fat Lies: the Truth about Your Weight.  The premise of this wonderful book is that some people will never be thin, that some people who are heavy can be much fitter than people who are thin, and that the only measure of fitness and health is not the scale but the tests that tell us we’re metabolically fit.  What is our blood pressure?  Where is our cholesterol?  What is our blood sugar?  Do we exercise?  Are we metabolically fit? These four questions are the only ones that matter!

Yo-yo dieting leads to weight gain.  Yo-yo dieting leads to weight gain.  I can’t repeat that too often.  And we have the $30-billion weight loss industry telling us the opposite!

The last thing I’ll say on this subject from my soapbox is that I’ve absolutely loved Dr. Michelle May’s new book, Eat What You Love Love What You Eat: How to Break Your Eat-Repent-Repeat Cycle.  This book is the perfect remedy for chronic, yo-yo dieting.  With Michelle’s guidance, we can learn to do away with mindless and emotional eating.  We can learn to eat just when we’re hungry.  

How about that?

What Is Normal Eating? A Podcast by Jeanne Rust, PhD