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Commentary: We've learned to control smoking. Will we ever control obesity?

Emerson Smith (copy)

Emerson Smith

Many American infants and children are gaining weight and becoming obese adults for life. Can we do anything about it?

The Centers for Disease Control and Prevention reports that from 1999 through 2020, adult obesity increased from 30.5% to 41.9%. By comparison, about 10% of adults were obese in 1955.

Obesity includes multiple diseases. And the more insured obese people there are, the more our hospitals, physicians and surgeons are ready to turn them into patients.

Hospitals and medical professionals have two primary types of obesity treatment: drugs and surgery.

The newest weight-loss drug from Eli Lilly, tirzepatide, is awaiting approval by the U.S. Food and Drug Administration. Bariatric surgery, the most common surgical treatment for obesity, may involve significantly reducing the size of the stomach, ideally reducing hunger.

There are three other ways society uses to promote a healthy weight:

One way is to point fingers and make fun of people who appear to be overweight, blaming them for apparently eating too much of the wrong food, too often.

Another way, more civil and recommended by doctors, is to encourage people to eat fruits and vegetables, and to get more exercise such as walking.

A commercial option includes working with Weight Watchers, now known as WW, Keto Cycle, Noom and others to create healthier lifestyles.

But it's doubtful that any of these will lower obesity over the long term in South Carolina.

A government program in Australia, Eat for Health, seeks to limit the intake of saturated fat, salt, sugar and alcohol because regularly consuming these items leads to obesity, heart disease, stroke, type 2 diabetes and cancer. 

In much of the world, except in America, there is a national focus on limiting consumption of high levels of sugar, salt and saturated fat often found in highly processed foods. The Heart and Stroke Foundation of Canada identifies two types of processed foods. One type includes simple bread, cheese, tofu, canned tuna and beans, all of which are healthy. It characterizes the other type as ultra-processed foods, such as soft drinks, chips, chocolate, candy, ice cream, sweetened breakfast cereals, packaged soups, chicken nuggets, hotdogs and fries, which the foundation says account for at least half of the calories many people consume in a day.

The U.S. Department of Agriculture and the group Eat Real are working to limit sugar and salt in food served at school cafeterias.

An optimistic solution for us would be for manufacturers in the United States to stop making and selling ultra-processed foods. But is that going to happen?

Canada, Hungary and other countries have worked to limit the advertising of what they call junk foods. But the Prevention Institute reports that in 2010, "the food and beverage industry spent over $40 billion lobbying Congress against several regulations including those that would decrease the marketing of unhealthy foods to kids, and potential soda taxes.”

Given that Congress is unlikely to limit the marketing of junk food, we can only hope that the Federal Trade Commission and the FDA will create rules to limit advertising and consumption of highly processed foods.

When I was a child, in the 1950s, the most curious behavior I noticed was cigarette smoking — in the streets, in offices, on airplanes, in restaurants and in my home, where my father smoked unfiltered Camel cigarettes. In 1970, President Nixon signed legislation banning cigarette advertising on TV and radio. The CDC says only 12.5% of adults smoked cigarettes in 2020, down from 56% in 1955.

What behaviors do children notice today in South Carolina?

They notice that their parents — and other adults and children — are regularly and happily eating a lot of quick food and drink promoted by convenience stores, drive-in restaurants and grocery stores.

They notice also that this food looks and tastes yummy. They expect the Easter Bunny will bring them a basket filled with sugar-laden Easter candy. After all, it is a tradition.

Emerson Smith is a Ph.D. sociologist at Metromark Research in Columbia. He is also a clinical research assistant professor of internal medicine at the University of South Carolina School of Medicine.

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