Wrestling With A Weight Problem

By Leef Smith

Washington Post Staff Writer

Thursday, August 21, 2003; Page VA16

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Virginia isn't just for lovers anymore. According to the latest obesity stats, it's for Krispy Kremes, too.

As a national epidemic of fat continues to grow, Virginians risk being crushed under the weight of their own expanding waistlines, according to health experts who say 57 percent of the state's adults are overweight or obese.

Among children, the number overweight is about 17 percent, according to a sample in 2000 of fourth-grade students at 15 schools statewide. Next month, that number will increase -- "alarmingly so," health officials said -- when an updated sample of the same schools is released.

Last year, 700 people classified by doctors as morbidly obese underwent weight-loss surgery at Inova Fair Oaks Hospital, more than any other hospital in the Washington region.

Officials say they anticipate a 15 percent increase in demand this year.

With obesity now ranking as the second-leading cause of preventable death in the country, experts warn that the problem goes far beyond the cosmetic to one that has a serious impact on the long-term health of Virginia residents. Battling the bulge, analysts agree, has never been more important.

Initiatives intended to curb bad lifestyle choices and check skyrocketing health care costs abound. Nationally, policymakers are pursuing a host of legislative solutions, from restrictions on the sale of soda and candy in schools to a proposal from a New York state assemblyman to tax not only fatty foods but also the trappings of the sedentary lifestyle: movie tickets and video game rentals.

In Virginia, the state Department of Health has funded projects to lower obesity and heart disease in 18 health districts, including Fairfax, by encouraging adults to boost their physical activity. Hospitals are adding programs to fight flab, and schools are revamping cafeteria menus and updating curricula to make kids focus more on their fitness than their skills kicking a ball.

"I'm not at all surprised by the statistics, which unfortunately have been a long time in coming," said Mary Marks, coordinator of health and physical education programs for the Fairfax County school system. As a society, she said, "We've not been paying attention for a lot of years, and we're seeing the effects. . . . We have to get a handle on it or this generation of kids won't make it into seniorhood."

This fall, the county will spend a $500,000 federal grant on new, high-tech fitness assessment equipment at each of the county's 27 high schools.

The equipment -- heart-rate watches, pedometers and a fitness assessment system that will measure flexibility, body composition and cardiovascular health -- will allow teenagers to become more familiar with their own fitness level and help them set goals.

Two years ago the schools began altering the physical education curriculum, shifting the focus from sports to a concentration on fitness. This school year, changes will go into effect for elementary students, followed next year by kindergartners.

Marks said obesity "is a problem that has to be fought on all fronts. Parents look at their kids and they seem healthy. Yeah, they look a little overweight, but parents say, 'They'll grow out of it.' Well, you know what? They're not going to grow out of it. The damage has been done. . . . A child who has weight problems as a child will probably have them their entire life."

Part of the problem, experts say, is poor adult role models. A telephone survey conducted last year in conjunction with the federal Centers for Disease Control and Prevention showed that 26.3 percent of Fairfax residents were obese. Loudoun County weighed in at 20.2 percent, and Arlington County at only 8.7 percent.

The culprit? High-fat food, nutritionists say, whose allure knows no boundary. People of all races and socioeconomic classes succumb to the temptation of snack foods and high-calorie prepared meals and desserts.

The fact is, nutritionists concede, it's often cheaper and quicker to feed a family at McDonald's than to cook a meal yourself.

The problem of fat and obesity is multifaceted. It is a tale of modern times, with many families in which the parent or parents work leaving children at home to prepare their own meals and snack in front of the television.

More than ever, children are sedentary. Even in affluent areas such as Fairfax, parents seldom allow their young children to ride their bikes without supervision. Many children spend much of their time sitting at computers or playing video games, often while gulping supersize sugared sodas.

Many parents today just don't have time to take their kids to the pool or out for a walk. So kids sit around more. And more of them are fatter.

Surveys show 15 percent of children and adolescents nationwide are considered overweight, nearly double the number of overweight children and almost three times as many overweight adolescents as there were in 1980, according to statistics kept by the Centers for Disease Control and Prevention.

The statistics are no surprise to Fairfax nutritionists, who say their obesity programs are growing each year with children and teenagers.

Anna Kanianthra is the nutrition program supervisor for the federally funded Women, Infant and Children (WIC) program administered by the county Health Department. The department was among the first in the country to receive federal money three years ago for an obesity prevention project.

The focus of the program, Kanianthra said, wasn't to put the children on a weight-loss program but to teach parents how to create an environment for their children that fostered better eating habits and more physical activity.

"We did focus groups, and we realized that a lot of the Hispanic moms felt that fat was okay, a sign of health," Kanianthra said. "We'd ask them why then don't they take their kids for walks, and they'd say they were afraid" for their security.

The problems, Kanianthra said, often come down to the economies of time and money.

If you're enrolled in WIC, "you're not making much money," Kanianthra said. "You can feed two children in a McDonald's for under $5. But if you go to the grocery store and buy food and prepare it, time becomes a factor. They don't have the time to do it."

The scenario isn't much different for financially stable families, experts say, where mom and dad make a lot of money but also spend a lot of time at the office to maintain an affluent lifestyle.

"They feel so guilty that they spend so little time with their children that if they want to go to McDonald's to have fun, they want the time to be quality and the child is enjoying it," said Susan Baum, nutrition coordinator with Inova Outpatient Nutrition Services. "Often that means overeating."

Inova's doctor-referred program caters to obese patients of all ages, providing for children the services of a registered dietitian, a mental health counselor and aerobics. A program specifically for teenagers was started last year because of the demand.

A study published in April in the Journal of the American Medical Association found that the quality of life for severely obese children and adolescents is roughly equivalent to that of pediatric cancer patients undergoing chemotherapy.

Being overweight "affects all aspects of their life," Baum said. "It's like a snowball rolling the wrong direction. You feel badly about yourself, you stay in more, you become sedentary, you eat for comfort and the joy, and you put on even more weight."