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January 23, 2010

Extreme measures may be needed to get U.S. in shape

Last month, faculty at Lincoln University in Pennsylvania amended a requirement that obese students take a fitness course to graduate, after the controversial policy was criticized as unfair, stigmatizing and possibly even unconstitutional.

Previously, students who were deemed obese (as assessed through Body Mass Index and waist measurements) were required to take a one-credit course called "Fitness for Life." Under the revised policy, students with health risks will be advised to take the class, but they can opt out of it.

The requirement may have seemed extreme, but with nearly one-third of American adults weighing in as obese, and the U.S. Preventive Services Task Force only just recommending that school-age children and teens be screened and treated for obesity, extreme measures may be in order.

It's too bad the Lincoln faculty caved to pressure, because the college's policy might have been a groundbreaking "tough love" step in a new direction. By impressing upon students that obesity could severely limit their quality (and quantity) of life " and forcing them to take steps to do something about it "" the college might have dramatically changed, or even saved, lives.

College is the perfect time to influence behavior. Students are away from any potentially unhealthy home environments and have access to free or low-cost resources such as fitness centers, nutrition counseling and a variety of healthy food options.

Of course, addressing obesity before students even get to college would be ideal, and, there's good news on that front. Five years after concluding that pediatric obesity programs did not offer significant benefits, an influential advisory panel has reversed its position. In new guidelines issued Monday, the U.S. Preventive Services Task Force said studies show these programs do work and recommended that doctors screen children for obesity and refer them to treatment.

Many pediatricians were already doing these screenings and talking with parents about lifestyle changes, but treatment options have been costly and limited. Now, with solid evidence about what works, health care organizations and nonprofit groups can collaborate on new programs, and with insurance companies likely to be forced to cover the cost, more families may be able to participate.

Colleges, schools, health care organizations and employers that offer incentives and resources to promote wellness are part of the solution. But what we really need is a cultural revolution. We'll solve the obesity epidemic "" and so much more "" if we can build a culture that values health more than beauty; balance more than excess; and patience and perseverance more than convenience and the quick fix.

Perhaps the most hopeful news was a Harvard Medical School study three years ago that found obesity is "contagious" in the sense that it spreads through social networks. In a study of more than 12,000 people assessed repeatedly from 1971 to 2003 as part of the Framingham Heart Study, researchers found that a person's chances of becoming obese increased by 57 percent if he or she had a friend who became obese.

The good news, the study authors concluded, is that the reverse may also be true "" healthy behaviors can spread. It's no secret that kids are more likely to choose healthy foods if their parents do, and adults are more likely to stick with their fitness routines if they have a friend or group to exercise with. Each of us can positively influence our own circle of friends, family, colleagues and acquaintances.

So, instead of commiserating over the doughnut you shouldn't have had, the New Year's resolution you've already broken or the pants you think make you look fat, focus on sharing what you're doing right. Rave about your favorite Wii Fit game or the great workout you had at the gym. Bring a fruit or vegetable salad to the next office party or family picnic. Challenge co-workers to run or walk with you in a charity 5K.

You never know what positive changes you might set in motion. For example, I know a man who started a food journal in November, after a fellow iPhone-toting acquaintance casually mentioned the gadget's "Lose It!" app, and has since lost 20 pounds.

With medical spending on obesity costing more than $140 billion a year, we can't afford to sit on the couch and wait for the problem to be solved.

We all have a stake in this epidemic, and we all can play a positive part in finding the cure.

Lisa Miller is a freelance writer who lives in Oneonta. She can be reached at