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Researchers say 54 percent of U.S. adults are overweight

By Paul Recer

-- Americans are just too fat, researchers say, with 54 percent of all adults heavier than is healthy. If the trend continues, experts say, within a few generations virtually every U.S. adult will be overweight.

The percentage of overweight Americans has increased by about a third in the last 20 years, and more hefty adults are on the way because more than 25 percent of today's children are overweight or obese, says obesity researcher James O. Hill.

"The trend will continue. There is no indication that it will turn around. Actually, it seems to be getting worse," said Hill, director of the Colorado Clinical Nutrition Research Unit at the University of Colorado. "The predictions are that it is increasing at such a rate that we'll all be overweight at some point."

People stay at the proper weight if they eat only the amount of food needed to fuel their physical activity. Americans now generally eat far more than they need and exercise far less than they should, Hill said.

He blames the environment: Americans have too much food available, social situations encourage overeating, restaurants compete by offering bigger and bigger servings, and technology has made it possible to avoid exercise.

"Becoming obese is a normal response to the American environment," said Hill, lead author of a study appearing today in the journal Science. "If the environment continues to encourage high [ food ] intake and low activity, then we'll all be overweight."

The body, he said, has mechanisms to prompt people to eat when they are undernourished. But there are no such mechanisms "to stop us from eating if there is a lot food around," Hill said.

Being overweight or obese is not just a personal problem but a genuine public health threat, said Hill. Obesity increases the risk of diabetes, cancer, heart disease, and other chronic disorders. Some studies have shown an increase of up to 60 percent in the risk of death from all causes for obese people.

A study by the Institute of Medicine estimates that obesity costs the United States $70 billion annually in direct health-care expenses or in lost productivity.

"We can't become complacent about this epidemic of obesity, which seems to be worsening over time," Dr. JoAnn Manson, a specialist at Boston's Brigham and Women's Hospital, said in Science.

Another researcher, Steven Blair, of the Cooper Institute in Dallas, said Americans were spending $40 billion a year on weight-loss treatments. "This approach is clearly not working," he said.

Science has yet to find a magic pill that cuts weight gain without unhealthy side effects, and in any case, many researchers believe that any such drug will have to be combined with diet and exercise. Scientists are still searching for all the genes that may be linked to weight gain. Genes, some say, may contribute to 40 percent to 70 percent of obesity cases.

Hill believes public policy changes are needed to control what he calls "the fat epidemic." He said it took government action to reduce the health threat from cigarette smoking, and government policies may be appropriate to control obesity.

Among his proposals:
 * Increase the sense of urgency about controlling obesity among both the public and health-care workers. Despite clear evidence that obesity poses a major health threat, Hill said, "it remains low on the list of important public health problems."
 * Require schoolchildren to have at least 30 minutes of vigorous physical activity daily.
 * Encourage physical exercise, perhaps even awarding people with reduced insurance premiums or additional vacation time.
 * Encourage restaurants not to use food portions as a competitive issue. People generally will eat all that they are served. "Our culture's apparent obsession with 'getting the best value' may underlie the increased offering . . . and the attendant risk of obesity," Hill says in Science.
 * Increase the availability of low-fat foods, such as fruits, vegetables and whole grains, and make processed low-fat foods as tasty as high-fat versions.
 * To head off a future fat generation, parents must set an example. "Parents are role models," Hill said. "We sit on the couch, eat our high-fat foods, and then tell our kids to eat right and go out and exercise. That doesn't work."