Weighing in on Obesity

GW-based alliance develops strategies to combat America’s obesity epidemic.

May 8, 2010

Christine Ferguson at table

By Jamie L. Freedman

America’s population is dangerously overweight. Over the past two decades, obesity has increased dramatically throughout the country—leading to chronic disease, skyrocketing health care costs, and lower productivity in the workplace.

GW is developing ground-breaking approaches to reverse the obesity epidemic. The Strategies to Overcome and Prevent (STOP) Obesity Alliance, based at the GW School of Public Health and Health Services, unites health care consumers and providers, government, labor, business, health insurers, and others in the quest for innovative, practical solutions to combat obesity.

“Over 60 percent of people in the United States are overweight or obese, and if current trends continue, close to 50 percent of the population will be obese within the next 10 years,” says Christine Ferguson, research professor and director of the alliance. “Weight-related chronic disease, such as diabetes and heart disease, is the country’s second highest cause of preventable death behind smoking. America is in a race against obesity, and if we don’t win it, our health care system will be overwhelmed.”

Launched in 2007, the STOP Obesity Alliance develops policy recommendations aimed at changing society’s perceptions of, and approaches to, preventing and treating obesity. “The alliance brings together a very disparate group of members, such as the Centers for Disease Control and Prevention, the National Business Group on Health, the Service Employees International Union, America’s Health Insurance Plans, and the American Diabetes Association,” Ms. Ferguson says. “It is a powerful step forward for us all to be at the table together tackling obesity.”

After spending much of the first year developing consensus on some foundational policies, the group issued a series of recommendations focusing on four key areas: redefining success, encouraging innovation and best practices in obesity treatment, addressing and reducing stigma as a barrier to obesity treatment, and broadening the research agenda to examine the many factors contributing to obesity.

“There is agreement across the board that society’s tremendous stigma about obesity is one of the biggest hurdles we have to jump,” says Ms. Ferguson. “People feel that if you are overweight, it is your own fault, which has led to a reluctance to address it. There’s also a real sense of futility about treatment because the definition of success—normal BMI—is unattainable for many. The alliance, therefore, recommends redefining success as five to 10 percent weight loss sustained over time leading to significant health improvement.”

The policy recommendation, based on studies performed by the National Heart, Lung, and Blood Institute at NIH, cites a growing body of evidence that a five to 10 percent reduction in weight helps decrease the incidence of Type-2 diabetes, improves lipid blood levels, and lowers blood pressure. “By focusing the obesity dialogue on healthy outcomes and away from unrealistic weight-loss goals and cosmetic issues, hopefully some of the stigma may start to melt away,” Ms. Ferguson says. “This is absolutely one of the single most important public health and health service problems in the country, and we are trying to build a real head of steam around it as a chronic disease that needs to be treated.”

The alliance hosted a September event with the two most recent Surgeons General of the United States, Richard Carmona and David Satcher, who urged policymakers to include obesity prevention and treatment in health reform. The group also conducted a national survey that found that employers are concerned about obesity-related health costs and are willing to do more to support employees in preventing and reducing obesity.

The issue is close to Ms. Ferguson’s heart because she has personally fought the obesity battle for decades. Prior to joining GW in 2006, she served as commissioner of public health in Massachusetts under Governor Mitt Romney. “I was more than 100 pounds overweight when I was appointed and struggled with the conflict and shame of being a public health commissioner while being unsuccessful at many attempts to lose weight,” she recalls. She opted to have lap band surgery, losing 125 pounds, but realized that even with an effective tool, sustaining weight loss is a lifelong battle.

“I credit the people of Massachusetts that my weight was never raised as an issue,” she says, “and the experience showed me how important it is to have people in government who have walked the walk on obesity. It is such a significant national problem. We have a responsibility to be involved. We have an absolutely stellar staff in the Department of Health Policy, and we are glad to be an important part of the discussion and debate in this critical field.”