Lessons from the Summit

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Dr. David Katz of the Yale School of Public Health delivers his talk, "What Should We Eat?"

The following remarks were part of an informal discussion that helped to sum up TIME's Obesity Summit of 2004. These remarks did NOT appear in TIME magazine and have only been published on TIME.com as part of the Obesity Summit conference materials.

It's been an exciting, illuminating, brain-bursting couple of days. We've heard about projects and efforts around the country that are inspiring and give one hope in the face of this enormous epidemic of obesity. But we've also seen differences of opinion and outlook that at times filled this auditorium with a palpable sense of tension — and frustration.

In summing up what we've learned and what lessons we might take home, I'd like to begin with what we all seem to agree on. That's the easy part. Next, I'd like to highlight the areas of disagreement and tension, and finally, I will offer a summary of what struck me as the best, actionable ideas we've heard during these three, information-packed days.

Five Things We Agreed On:
1: Hands-down, we all agree on the enormity of the problem. Not many of us will forget watching of the march of time from 1991 to 2002 on the CDC's obesity map, watching states turn from light blue (for a low-obesity rate) to red-alert for a rate over 20% (the first one appearing only in 1997!) and now even to bright yellow as obesity rates climbed past 20% in some states. We've heard the long list of chronic diseases associated with obesity and their frightening cost in medical care dollars, in lost productivity, lost lives and unmeasurable suffering.

No. 2 We agree that our efforts should be focused on children. This is both for reasons of principle: the future health of the country is at stake, and for pragmatic reasons: prevention works better than treatment when it comes to obesity and early intervention offers more promise than late intervention.

3: We all agree that Americans need to increase their level of activity. On this there is a broad consensus. We saw food industry groups such as Pepsi and McDonald's supporting activity programs, giving away step counters, etc. We've heard about government efforts: HHS Secretary Tommy Thompson's "Small Steps" idea to promote activity and the very entertaining public service ads his department has created, showing lost love handles near the staircase and lost double-chins in the vegetable aisle. We heard about the CDC's VERB campaign promoting activity for kids and were moved by the sentiments of Lynn Swann, who heads the Presidential Council on Physical Fitness and Sports. Many of our most talented and inspirational speakers dwelled on this topic.

4: I think we agree that the U.S. medical system is overwhelmed by the problem of obesity, as Dr. Tim Johnson's video so plainly showed. A large part of the problem is the fact that health insurance does not cover the treatment of our biggest medical problem — being overweight —until it results in morbidity such as diabetes or hypertension. This is truly terrible, especially for kids. This system pushes us toward late intervention, when success rates are slimmest.

5: We agree that the American consumer needs to be better educated about nutrition. We heard a variety of ways to do this: PSA's, programs in schools, better labeling, the USDA's dietary guidelines and food pyramid.

Now for the things on which there is not agreement:
1: We just don't agree on how to get Americans to eat healthier and eat less. While representatives of both the food industry and our federal government emphasized offering "consumer choice" and adding healthier options to our grocery stores and restaurant menus, many others feel that expanding the offerings on the national buffet is not the answer.

2: What is the role of government? We don't all see eye-to-eye that that one either. Many here were disappointed to hear Secretary Thompson stress personal responsibility over government leadership. They were disappointed that his department's initiatives were mainly small, low-budget steps, such as underfunded PSA programs, rather than big well-funded actions. And we just heard that there's only a pathetic $2.7 million budget behind the department responsible for giving us the U.S. Dietary Guidelines and Food Pyramid program.

3: We don't agree on the role of advertising and whether there should there be more regulation of the kinds of food ads that American children see.

4: We don't agree on whose responsibility it is to deliver messages to the nation on nutrition, and just what those messages should be.

Which leads me to point number 5:

5: Are we really that confused about diet? We don't seem to agree on our own level of confusion! We heard from a bunch of "diet warriors" advocating somewhat different approaches to healthy eating and weight loss. And yet, while some stress the confusion and need for more research, others emphasize that we have basically known what we need to do about diet for about 100 years.

Good ideas/ Actionable ideas
Over these past three days, we've heard an abundance of good ideas. But I want to start with one very big idea that seems to underlie many of the other changes. Bill Dietz of the CDC, Niels Christiansen of Nestle and Dr. Andrew Weil all mentioned this: The challenge is to shift from an economy and eating habits that are quantity-driven to ones that are quality-driven.

Our economy and longstanding government policies are based on providing plentiful, cheap — and often low-quality food. That needs to change.

I can't be comprehensive in naming all the exemplary ideas and programs that have been described here at t his conference, but here are some that are memorable, innovative and worth expanding:

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