Quotes of the Day

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:

1. Ideas for Schools
We heard about extraordinary nutritional overhauls going on in the schools of Texas, a state with a very high obesity rate, and those changes reflect the effort of one government official: state agricultural commissioner Susan Combs. She has shown what strong government leadership can do.

We heard about the inspiring Edible Schoolyard program that Alice Waters has created at a middle school in Berkeley, CA. Her cross-curricular program of planting and reaping, cooking and serving can change a child's relationship with food in a profound almost spiritual way. It teaches kids to love quality over quantity, and we need to see more like that.

We heard about some valuable federal efforts in schools. Here are two:

From Eric Bost, of the Department of Agriculture, we heard of an initiative before Congress to designate "healthy schools" based on three criteria having to do with phys ed, vending machines and risk avoidance curriculum. The criteria seem a bit squishy — having "some level of physical activity" was the phys ed goal — but he did mention the key step of offering schools financial incentives for schools. This is something we need to do. From Tom Stenzel of the Fresh Fruit and Vegetable Association, we heard about a Department of Agriculture pilot program that gives free fruits and vegetables as snacks to school kids, combined with nutritional lessons. Right now only four states are participating, but there's a push to expand it to eight states and, hopefully, more in the future.

We heard a lot of good ideas about teaching kids about nutrition. But perhaps the most striking and unforgettable lesson we can offer kids is something like the presentation we had from Dr. Mehmet Oz, showing us what organs like the liver look like after years of bad nutrition and obesity. How about a national effort to bring this kind of hands-on lesson into elementary school classrooms? Our student reporters from TIME For Kids confirm that this lesson has the kind of gross-out cool that makes an impression.

One more thought on schools: Given the current direction of education and the pressures to perform on academic tests and teach to tests, there is a clear need for more research exploring the connection between fitness and academic performance. This is an actionable idea for our generous host, the Robert Wood Johnson Foundation, to act on.

Food Industry
We have seen leadership from the Ruby Tuesday chain of restaurants in offering detailed dietary information right on the menu. Now they are reaching out with a new, healthier kids menu. We need more of that. We've seen McDonald's respond to health concerns with new salad offerings and, we just learned, some changes to their kids' menus, such as apple slices for dessert.

We've had interesting suggestions from the floor:

A price break at fast-food restaurants for small portions, and a re-examination of the use of popular cartoon characters to sell junk food. Nickelodeon deserves praise and encouragement for exploring this.

The Workplace
We heard about the CDC's efforts to become a model workplace, improving stairways, for instance, and creating psychological incentives to walk. We did not, however, hear of any financial incentives for companies to make these kind of changes. How about a break on medical insurance costs?

Speaking of the Health Insurance Industry
We heard about a promising new pilot program from Aetna called Healthy Body, Healthy Weight, that breaks new ground in helping overweight patients and reimbursing primary care doctors for time spent on this. We heard suggestions to build financial incentives into our health insurance systems so that companies and individuals reap benefits from changing to a healthier lifestyle, diet and weight. How about a pilot program on that?

Community
We could not fail to be inspired by Majora Carter's efforts to bring green space for exercise to the South Bronx. Or by Lance Morgan's efforts to create an "active living" community for his fellow Winnebago tribe members, so many of whom die young from obesity. We need more ideas like these to bring solutions to minority communities, where obesity rates are sky-high and poverty is an obstacle to healthy eating. We also heard ideas for using more funds from the Transportation Bill for paths for walking and biking.

What will it take to build on these ideas such as these, to extend brilliant local and pilot programs to more people? Alice Waters' one-word answer to this question struck me as the most honest: Money. And that's where the grassroots pressure comes in. The food industry will go where its customers lead them. Government ultimately has to heed the voters. "A million mad moms" — is a phrase that echoes in my ears. There is a role for the media — my colleagues, those at ABC, and elsewhere — to educate moms and dads. Perhaps if we stop playing up the dietary confusion message and emphasize what works in fighting obesity, more folks will get mad, understand what's at stake, and demand the kind of programs and changes we've heard about at this conference. Then we can finally reach and pass the "tipping point" on obesity.

• Claudia Wallis
• A final summation by TIME Editor-at-Large Claudia Wallis