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Posted: **Aug 13th 2004, 10:39 am**

Obesity Report Card: Many States Failing
Nearly Half of All States Fail in Efforts to Control Obesity Epidemic

By Jennifer Warner

Reviewed By Brunilda Nazario, MD
on Wednesday, August 11, 2004
WebMD Medical News

Aug. 11, 2004 -- Nearly half of all U.S. states are failing in their efforts to control the obesity epidemic facing the nation, according to a new national obesity report card.

Researchers say it's the first report card on state-based efforts to combat obesity, and 23 states received a failing grade for taking no action at all.

No state received an "A" for passing laws to help prevent and treat obesity, such as limiting the types of foods and beverages sold in schools and expanding health insurance to cover obesity treatment.

Arkansas was the only state to receive a "B" for its efforts. Last year, Arkansas became the first state in the nation to mandate annual body mass index measurement (BMI, a measure of weight in relation to height used to measure obesity) for all public schoolchildren.

"Given the enormous attention we allegedly pay to our diets, and the amount of money we invest in controlling our weight, exercising, and the rest, it was really surprising to see how badly the states are doing," says researcher Zoltan Acs, professor of economics and entrepreneurship at the University of Baltimore, in a news release. "Simply put, state governments are not addressing this problem effectively, and it is doing a lot of unnecessary damage."

Researchers say the damage includes an estimated $44 billion a year in direct health-care costs attributable to obesity for problems ranging from diabetes to heart disease to cancer, and that figure is expected to nearly double by 2015.

Most States Fail to Address Obesity

In their study, researchers looked at what states are doing to treat obesity as a threat to public health, as they did with nicotine and secondhand smoke in the 1980s and 1990s.

They graded each state on its efforts to pass obesity control measures, including:

Nutrition standards: Controlling the types of foods and beverages offered during school hours

Vending machine usage: Prohibiting types of foods and beverages sold in school and prohibiting access to vending machines at certain times

Body mass index (BMI) measured in school

Recess and physical education: State-mandated additional recess and physical education time

Obesity programs and education: Programs established as part of curriculum

Obesity research: Other institutions or groups directed by the legislature to study obesity.

Obesity treatment in health insurance: Expanding health insurance to cover obesity treatment where applicable

Obesity commissions: The legislature established commissions designed to study obesity

Points were awarded to the state if such legislation was introduced, but successfully passing a law was necessary to receive an "A" in each category.

The study showed Arkansas, which ranks 15th in the nation in terms of obesity prevalence, leads the country in passing laws to control the obesity epidemic and received a "B." Ten states received a "C," 16 got a "D," and 23 received an "F" for taking no action at all.

Researchers say some of the states with the most serious obesity problems received a failing grade and have taken no steps to address the obesity epidemic.

State Efforts to Control Obesity*:
A
No state received an A.

B
AR(15)

C
CA(18), HI(35), IL(21), IN(5), LA(8), MD(25), MS(1), RI(36), TN(9), TX(6)

D
CO(39), CT(36), FL(32), ID(23), KS(17), KY(4), ME(29), MO(10), MT(33), NM(31), NV(28), NY(26), OR(19), SC(15), VA(23), VT(37)

F
AK(17), AL(7), AZ(34), DE(23), GA(12), IA(14), MA(38), MI(3), MN(27), NC(11), ND(24), NE(22), NH(29), NJ(29), OH(14), OK(19), PA(16), SD(20), UT(32), WA(30), WI(13), WV(2), WY(27)

*Numbers in parentheses show state's rank by obesity prevalence. (Mississippi ranks first with the country's highest obesity rate, followed by West Virginia and Michigan. Colorado has the lowest obesity rate, ranking 39th).

Researchers also graded states on their efforts to control childhood obesity. Connecticut joined Arkansas as the only states to receive a "B," but the majority of states received a "D" or an "F" for their efforts in this category.

State Efforts to Control Childhood Obesity:

A
No state received an A.

B
AR, CT

C
CA, HI, IN, MD, MS, MT, RI, TX, WA

D
AK, CO, DE, FL, GA, ID, IL, KY, LA, ME, MA, MN, MO, NH, NY, NC, ND, OK, SC, SD, VT

F
AL, AZ, IA, KS, MI, NE, NV, NJ, NM, OH, OR, PA, TN, UT, VA, WV, WI, WY

Posted: **Aug 13th 2004, 10:49 am**

Yay, Montana got a D in controlling obesity and C in controlling obesity in children. But I think the real question is why do we care how well the state is doing? When did it become the goverment's agenda to manage our weight? If I was overweight, should I hold the gov't accountable for inablility to wear pants that don't have an elastic band? I think not. It never ceases to amaze me how americans can defer blame and shed personal accountablility.

I do think it is a good idea to promote healthy foods in public school lunches but I don't think it's the states responsibility to do so. If your child is fat, perhaps you should try making him/her a healthy lunch, and involving him/her in an activity other than Xbox when they get home from school.

Posted: **Aug 13th 2004, 11:26 am**

Nothingman wrote: It never ceases to amaze me how americans can defer blame and shed personal accountablility.

Exactly. if you're an adult, and you're fat, it's your problem.

Nothingman wrote:If your child is fat, perhaps you should try making him/her a healthy lunch, and involving him/her in an activity other than Xbox when they get home from school.

This is where I disagree. Why should children suffer because their parents aren't intelligent enough to realise facts about healthy diet/exercise etc? I think that there, the state has a responsibility towards its younger, less able to defend themselves, residents to promote a healthy way of life. Even if it doesn't work, it's worth a try.

Posted: **Aug 13th 2004, 1:01 pm**

starbug wrote:Why should children suffer because their parents aren't intelligent enough to realise facts about healthy diet/exercise etc? I think that there, the state has a responsibility towards its younger, less able to defend themselves, residents to promote a healthy way of life.

If the state is to intervene because of the incompetance of the parents, in some sort of nutrition neglect shouldn't the parents be held responsible? I think the responsibility should rest soley on the parents. I do not think that any parent should be able to say my child is overweight because the schools serve unhealthy foods. Should the parents be able to request healthier schools lunches so that they make take advantage of the program? Certainly, but if the school serves nothing but corn dogs and mayonase packets then it is still the parents responsibility to ensure their child is propperly fed, no different then it is their job to ensure their child bathes propperly, or has shoes to wear.

Posted: **Aug 14th 2004, 11:47 pm**

I think what Starbug was saying, was that if there are parents who don't care about health, exercise, or body weight, theirs or their chidrens', rather than their children growing up thinking this is the natural and only way to live, schools can teach children about nutrition, exercise, self-respect, etc. Which, is a good idea. I don't think, however, that it's the government's job to replace people's personal responsibility.

Anybody else find it suspect that they're quoting an economist rather than someone in the medical field? ...

Posted: **Aug 17th 2004, 12:55 am**

Notice that the state with the lowest obesity prevalence scored a 'D' in both obesity control categories...

I know obesity is a major health problem, but I can't help but think of how so little time has passed since starvation and malnutrition were facts of life the world over (and still are in some places). IMHO, I'm glad I have access to inexpensive high-quality foods. Even if they do rot my teeth and clog my arteries, I'll take those problems over the alternative any day!

Posted: **Aug 17th 2004, 4:54 am**

That's what I was saying, Jody

I certainly don't think the parents should absolve themselves of responsibility for their obese children, but I do think that the state has a responsibility to teach children about health. That theory should translate into practice by the giving of healthy school meals.

Of course, recourse to child neglect laws for those kids whose parents are clearly putting them on a drip-feed of lard the moment they arrive home, seems a sensible solution. I think allowing your child to eat copious quantities of junk with the result that they're obese is as much a neglect issue as allowing them to starve to death. It's possible to be obese even if you do have one healthy school meal a day... if you quaff chocolate the minute you get home, in front of the Play Station, you're going to be fat whether or not you ate a salad for lunch.

Posted: **Aug 17th 2004, 10:46 am**

I agree with you there Starbug. I was using your post more as a platform to address the issue of parental neglect than anything. It was nothing personal or aimed to discredit you. I sure could have used a course on how to put together a balanced meal in college. You're sent out on your own with little or no instruction on how to plan or manage your diet. I ate healthy at home, my mom made excellent nutritious lunches. But when it came time for me to do it on my own I was lost, and I don't think I was the minority on this. Some how-to instruction about selecting balanced meals at cafeterias, or quick foods from the grocerey store would have helped a lot.

I was walking out of Walmart a few weeks ago and saw a mother talking to another woman with her son standing by her side. To keep him quiet and behaved, she had him open the newly purchased box of pop tarts and start stuffing away. I just wanted to smack her. Her son already has the phsyique of a bowling pin and she had him eating pop tarts before they got to the car.

Posted: **Aug 17th 2004, 11:20 am**

Nothingman wrote:I sure could have used a course on how to put together a balanced meal in college. You're sent out on your own with little or no instruction on how to plan or manage your diet...Some how-to instruction about selecting balanced meals at cafeterias, or quick foods from the grocerey store would have helped a lot.

You and me both. I recall returning home after my first term at Uni and I was quite obviously malnourished. My skin was grey, I'd lost a lot of weight, and the look on my mum's face said it all. I think I survived almost exclusively on toast, coffee and alcohol. Not good. I'm loads better now, but I agree; I didn't really know what I was doing, and it was a combined with resorting to junk so I could go out with my new friends.

Nothingman wrote: Her son already has the phsyique of a bowling pin...

It's not exactly funny that the poor kid was allowed to feed his face with junk, but that description is hilarious!

The situation is getting really bad in terms of child obesity here too. The current government has concentrated on academic subjects, believing (rather shortsightedly in my opinion) that everyone should be fabulous at book-learning, and sod the practicalities of life. after years of this, kids do barely any sport at school (sport doesn't get you into Uni here - there are no sports scholarships or anything, although I won't deny it could help your application to be a wonderful rugby player) and are encouraged to sit in front of the computer using new media to discover everything. Gone are the days where we'd be sent out into the countryside to discover what a rosehip looks like. Gone are the lessons on home economics, sewing, woodwork etc.

thank god my parents were brought up knowing about healthy diets; so many kids aren't and it's so sad when they can't do normal stuff like walk up a hill and look at the view because they're so overweight.

Posted: **Aug 17th 2004, 12:52 pm**

Nothingman wrote:I sure could have used a course on how to put together a balanced meal in college. You're sent out on your own with little or no instruction on how to plan or manage your diet...Some how-to instruction about selecting balanced meals at cafeterias, or quick foods from the grocery store would have helped a lot.

I and a lot of people I knew in college made good use of visiting the school's nutritionist. Our Student Health Center also handed out blue pamphlets (which still sits on my refrigerator) providing a "Food Shopping List (and tips) For Students", they also gave advice (I don't remember if it was through writing or a lecture) about the best choices to make in the dining commons.

starbug wrote:and are encouraged to sit in front of the computer using new media to discover everything. Gone are the days where we'd be sent out into the countryside to discover what a rosehip looks like. Gone are the lessons on home economics, sewing, woodwork etc.

This made me think of this small private university two dear friends of mine attended in Arizona. The school is set up so that you take one class a month -- for one month you go to lectures and discussions/labs everyday for one course. After that month the students have a month break to go out into the world and further pursue/experience/apply what they have just learned, and the school year continues in that way. The learning is intensive but it seems a very intriguing way to learn to me.

((While we're on the subject of universities and eating, can I ask a question of you Starbug? What is a typical university dining hall like in the UK? ... Back story: Three years ago, I think it was, I spent 5 weeks at the University of London studying London authors through the UC system (it was so wonderfully fabulous!) ... we lived in the dorms and experienced a university dining hall that was very different from most in America -- there were all sorts of rules, if you had this item, you could not have that item, and if you had this item and even declined that item, you still certainly could not have that other item, etc. The rules seemed very arbitrary, although I'm sure there was a method to it. Really the part that struck me though was that we were never allowed milk for dinner, only at breakfast, and juice was only served in very small glasses, only in the mornings, and you could only have a glass if you had not already taken a fresh piece of fruit. A college roommate of mine who studied for a year at the university in Glasgow had a similar experience... Probably given the title of this thread, it is needless to say that for the most part, the ones I know anyway, college dining halls in the states are all you can eat ))

(does that pictorial progression make sense?)

Posted: **Aug 17th 2004, 11:22 pm**

Nostradamus wrote:I'm glad I have access to inexpensive high-quality foods. Even if they do rot my teeth and clog my arteries, I'll take those problems over the alternative any day!

I second that emotion.

Posted: **Aug 18th 2004, 5:10 am**

Jody!
Well, from what I recall about my university dining hall (first year only - you're left at the mercy of the private lettings landlords after that) was that the food was absolutely vile. I can't vouch for breakfast as I think I only made it there twice. Lunch wasn't provided, but dinner went thus:

Queue up to be served either a vegetarian or a meat option as the main part of your dinner. Usually this came with some kind of potato-based dish and some vegetables (over-cooked). I think you weren't allowed to have more than one type of vegetable in addition to whatever potato delight was served up that day. One day I wanted carrots and peas, and was told no. Even though I had shunned the main veggie and meat option (usually pork and cauliflower cheese day) so my plate consisted only of potato, they wouldn't give me both other vegetable options. Oh, and if you had a piece of fruit, that was your desert. You couldn't have both the fruit and the chocolate pudding.

I can only imagine it's because the lack of funding meant that they'd carefully worked out per student what they could be expected to consume, and any deviation from that threw their calculations into a wobble.

Oh, and on more than one occasion we saw a rat scurrying along the skirting boards in the dining room

Fish and chips were always served on Friday (I'm told this is a catholic traditions...), but by far the worst dish on offer was the cauliflower cheese. Imagine: you've managed to cook a vast quantity of cauliflower, but you've boiled it almost beyond recognition. It has sopped up so much water that it's virtually impossible to drain the stuff effectively. So you don't bother, and just load it into a tin, make a rudimentary cheese sauce out of (I can only assume) flour and some kind of fake cheese powder, pour on top, stir round, allow to coagulate and curdle, leave until tepid, and serve.

After I'd had food poisoning a couple of times I avoided the meat. I also bought a non-regulation toaster for my room and made toast in the evening. I like to think it's what kept me alive.

Posted: **Aug 18th 2004, 5:24 am**

One of my dorm cafeterias was just awful, and your stories brought it all back vividly. During the first week, most of us learned to avoid the fish at all costs. To this day, I can't see the words "orange roughy" without remembering one of my roommates telling me that it caused explosive diarrhea and that while she was, ahem, letting it all out, she got nauseous and had to puke in the little white house. I know that orange roughy is a perfectly fine fish, but I don't know that I'll ever get past that visual.

That particular cafeteria featured two main dishes and usually two side dishes for each meal. You could only have one of each, although you were allowed to have seconds if you brought your plate back. This policy was really annoying on the nights when they had dishes like chicken nuggets. I grew up eating boxes of Tyson chicken nuggets, so I knew that it would take more than five little breaded nuggets to fill me up but they refused to give us more than five at a time so we ended up making multiple trips to fetch more nuggets.

The cafeteria didn't have a plan where they charged per item - they swiped our cards as we entered the room and that counted as one meal even if you ate nothing. We were not allowed to take any food with us - all food had to be consumed in the cafeteria. The only exception was for sick students. If you were sick, you were allowed to give your ID card to someone else, have your card swiped, and then they would pack up one serving in a styrafoam container to bring back to you. There were some nights when I had to go straight from work to dance practice, so I tried to get a sick tray for myself and they refused to do it. I either had to scarf down a serving of food in five minutes and then fight back nausea during a three hour dance rehearsal or skip dinner altogether (the cafeteria was only open for dinner 5-7pm). Every policy they had was about making money.

I remember how jealous I was when I learned that other schools had all kinds of luxuries like a frozen yogurt machine or small boxes of breakfast cereal available at all meals or even having plain rice at every dinner.

About twice a semester, they would let us have ice cream as a dessert treat. They would haul out this mini ice cream cooler - the kind you see at drugstores - and have eight barrels of ice cream inside. We're talking the big barrels like the ones they have at Baskin Robbins, except they were always less than half full, so when we leaned over to scoop the melted ice cream out, we all ended up with sticky arms. They always had weird flavors too - not the traditional chocolate, strawberry, vanilla, chocolate chip type flavors. Despite all these complaints, every time we saw that ice cream cart, we would all get excited about having ice cream for dessert. We were so desperate and appreciative to have a treat!

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Your State's Obesity Grade

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