By Stephanie Schupska
University of Georgia
That's how Stern opened her 2005 D.W. Brooks Lecture, "Can We Fight Obesity without Fighting the Obese?" She delivered the annual University of Georgia lecture Oct. 3 in Athens.
"It's time for all of us to 'step up to the plate' about obesity," she said after noting she's an Oakland A's fan. "We can't do it alone. We absolutely can't."
The "us" she discussed isn't just consumers or fast food restaurants. She includes the National Institutes of Health, the healthcare system, food industry, Department of Transportation (for promoting inactivity and forgetting sidewalks) and U.S. Food and Drug Administration (for abnormally high standards for obesity drugs).
"Obesity is a chronic disease," she said. "It requires chronic treatment."
Insurance companies cover healthcare costs for people who spent too much time in the sun and develop melanoma, Stern said. They pay for liver disease treatment for those who drank too much and for lung cancer treatment for smokers. But they don't recognize obesity as a disease.
"It's the last area that's seen as OK to discriminate," Stern said. "Blaming the obese doesn't work."
Stern referred to Stedman's Medical Dictionary before pronouncing obesity a disease. To be listed as a disease, a condition must meet two of three criteria: recognized agents, identifiable signs and symptoms and consistent anatomical alterations.
Obesity meets all three.
"The health care system is the house, and obesity is the hole in the roof," Stern said. "If you don't fix the hole, every time it rains, the furniture and rugs are going to get damaged. ... We spend billions each year on heart disease, asthma and other illnesses that have been proven to get better as obesity goes down."
Stern looked at the institutes and centers under the National Institute of Health umbrella. Of the 27, not one focuses solely on obesity. In 2004, she said, the NIH scheduled $2.87 billion for AIDS research. Money funneled toward obesity was $442 million.
But research and health care don't address obesity's "why," Stern said.
The numbers of obese people are growing because people eat too much. In 1970, the average person ate 2,220 calories a day. Now, the average is 2,680.
Portion sizes have increased. When Stern married in 1964, she received the "Joy of Cooking" cookbook. She recently opened the new edition and checked the yellow rice recipe. The ingredients are the same, but now it serves four people. In 1964, the same amount served six.
"We suffer from portion distortion," Stern said.
She uses megamuffins, french fries and soft drinks as examples. The U.S. Department of Agriculture says one serving of muffin is 100 calories. The megamuffin has 800 calories.
"Who cuts it into eight and shares it with seven other people?" Stern asked. "I don't."
One serving of fries is 1 ounce, or 10 fries. The original McDonald's container held 2 ounces. Now, they serve a super with 610 calories, or just over six servings.
"To the consumer, they're all the same size because they consume size," she said.
One serving of a soft drink is 6 ounces and 75 calories. Her son recently bought a 52-ounce, 650-calorie "X-treme Gulp" from a convenience store.
"I told him, 'Daniel, you have to share that drink with five- and-a-half other people,' " she said.
Perceived savings factors in, too. In June 2004, a store advertised a 32-ounce beverage special for 49 cents. The 12- ounce size cost 79 cents.
"I saved 30 cents, but gained 250 calories," she said. "In two weeks, I'll have gained an extra pound for only $4.20."
(Stephanie Schupska is a news editor with the University of Georgia College of Agricultural and Environmental Sciences.)