A new report predicts that by 2030, nearly half of all Californians will be obese. The predictions are even more grim for the vast majority of other states — in Mississippi 67 percent are expected to be obese. We discuss the obesity epidemic, its causes and what can be done about it.

Richard Hamburg, deputy director of Trust for America's Health, an advocacy organization aimed at preventing disease and protecting the health and safety of communities
Pat Crawford, director of the Center for Weight and Health, nutrition specialist and adjunct professor in School of Public Health at UC Berkeley
Kristine Madsen, pediatrician at UCSF and assistant professor at UC Berkeley's School of Public Health
Larry Cohen, founder and executive director of the Prevention Institute, based in Oakland

  • Arnie

    Let’s think positively. We could use liposuction fat to make fuel for cars and for heating. Organized on a mass scale under Obamacare, by my estimations we’d surely beat Saudi Arabia, whose oil supply is dwindling, while never asking American fatsos to eschew McDonalds. In fact, Obama could offer free liposuction in return for fast food coupons. His wife could show her support by donating her own ample blubber. The first family would have a whale of a time with the scheme.

    Fight terrorism. Make fuel from fatties.


  • Beth Grant DeRoos

    Am curious why all the SDA (Seventh Day Adventists), and long term vegetarians/vegans (secular friends) we know are not overweight.  It cannot be because we are wealthy, since we aren’t. 

    We eat few if any processed foods/sodas, and a lot more fruits, vegetables and whole grains, and get more physical exercise.  So how do we force the majority of people with access to healthy foods that are NOT expensive change poor food choices?   

    Mrs Obama has been serious about stressing wise choices, as have folks like Dr. Andrew Weil,Dr John McDougall, and Dr. Dean Ornish. But those who need the help to change don’t seem to be getting the help.

  • IlseVonHerzog

    I wish the morning talk shows, like the Today Show, would address exercise and diet on a daily basis.  They have a huge audience and can make an influence.  I don’t have a TV, but when I see these shows I’m dismayed at how much of the content is mindless fluff.  They could start the week with a shopping list of affordable foods and easy to cook meals.  And, on a daily basis commit 10 minutes to exercise and education about exercise.  There are SO many things they could do to help people.

  • Mark, Santa Rosa CA

    I think it is a waste of tax payers money to “inform” over-weight people, that eating less and excercising is beneficial. They know that. They do not want to do anything about it.  So, realistically, charge them more for their insurance. If I were a bad driver, my record predicts the chance of having accidents. The more I claim, the more I SHOULD pay into the pool. If they do not care, why should my premiums support that? They use smoking to charge more, don’t they?

  • Kevin

    The guest seems to be overstating the situation by referring to the “success of CA”. CA is not failing as bad as other states, but obesity rates are very high and getting higher, hardly the definition of success.

  • Isobel

    If inactivity is the issue — if fat people can be just as healthy provided they exercise — then why not be accurate and call it the inactivity epidemic?

  • M.D., Ph.D.

    Recent articles in the Journal of the American Medical Association (JAMA) have demonstrated the substantially higher proportion of overweight and obese children and adults in African American and Hispanic populations. While cultural (poor food choices) and life style (lack of exercise) factors have a substantial effect, it is naive to deny the effect of genetics.

    The obesity epidemic tracks closely with racial/ethnic distributions across our nation and projected increases in obesity mirror which populations are having the greatest number of children (Hispanics>African Americans>>other). These are the facts as I see them.

  • Michael in Berkeley

    Inflammation increases insulin receptor sensitivity, causing cells to think that there is a higher insulin level than there really is, and the cells take up nutrients that they don’t really need. Fat cells are also pro-inflammatory, causing a positive feedback loop.

    With insulin-sensitive cells taking up too much nutrients, other cells can be starving.

    By lowering the chronic inflammation level, proper insulin signalling can be achieved. Then people can lose weight naturally, without any effort.

    See the work by Wolf Droge (do a PubMed search for “Droge w insulin”) for research on aging, inflammation, insulin receptor sensitivity, and middle age weight gain.

  • PaloAltoJeff

    Dr. Robert Lustig’s piece “Sugar: The Bitter Truth” should be required viewing. We also need to change our Ag policy to give subsidies to healthy food and to stop subsidizing corn and soy.

    •  Also relevant: Sugar Blues, William Duffy (1975). Known for long time sugar is poison.  Thanks for info.  Will check it.

  • Dlaurel99

    How much can we achieve on our own and how much do we need the involvement of policy makers at federal, state and local levels?  While not trying to point any fingers, it seems that when Nancy Pelosi worked to make the capital more ‘green’ and put healthier foods in the cafeteria – lawmakers, particularly republicans, mocked her and were quick to throw out all of her efforts the moment they took control.  And, when Michelle Obama started working to encourage healthy foods for kids, folks (such as palin) dismissed her.  So, to cut to the chase – how much do we need our lawmakers and then to the extent we do need them, how do we convince our leaders that these matters are important because it doesn’t seem that awareness and willingness to work on this is there……which is immensely frustrating for me as a mother of three and a tax payer who would rather support preventative efforts than watching tons of money go later on to treatment. 

    • Dlaurel99

      One more point – I was so sad when I watched how Jamie Oliver was both mocked and blocked by local authorities when he tried to come in and improve school lunches.  It was an astonishing eye-opener for how much resistance there is to getting folks healthier.

  • Chemist150

    Of course fat people will do better once they have diabetes.  Given the insulin resistance cause the body to start consuming itself.  The body breaks down the muscle to feed itself but with obese people, there is much more fat available to be broken down first.  However, they’re much more likely to get the disease in the first place. 

  • This fear of violence argument misses the point that kids get so little health education in P.E. class.  Michael Moore’s Bowling for Columbine centered around how America’s gov’t and media is pushing FEAR on us – as though death lurked every other moment, as though terrorists are about to strike us today. Fergawdsakes, to paraphrase Saroyan, “in this life, LIVE!” Attributing obesity to fear of daily life sounds ludicrous.

    I grew up in the 1970s – and we thought no one could eat more crap than we did. Kids, especially, school students eat out more now than ever before, whereas we tended to go home and eat after school. Traditionally, schools sold milk in those little cardboard containers and little else. What is sold in and near schools? Should we require “home ec” classes for all students to teach basic cooking and help-yourself skills? Are these kids parents throwing a few dollars at their kids and saying go buy a burger and fires every day?

  • Ani

    What is being done in an urban planning sense to get people out of their cars, to make walking and biking the easiest choice instead of the hardest choice?

  • Shayna Hirshfield

    I’d love to see a counterfactual study of how Americans’ health would fare if ALL corn inputs were eliminated from our diets – ie eliminate corn subsidies!

  • Ginbahr

    The discussion on obesity is remiss if not speaking about the addictive qualities of the high calorie low nutrient content food that often the only affordable accessible supply for communities. Food has addictive properties- tolerance, craving, withdrawal, in addition to opiate endorphins when we overeat. Obesity prevention must include addressing addiction.

  • Parent

    I heard lot of finger pointing, but no one said I am at fault. Lack of Parental involvement is a major contributor. I say this, because even if you make my kid watch soda ads and hand him a soda can, you are going to get, ‘no thanks, why would I put high fructose corn syrup and color in to my tummy’. It is not that hard nor does it take too long to cook healthy food. ALL parents need to quit complaining and take responsibility

  • Simone de Beauvoir

    Why does not anybody talk about the real issue:  The enormous amount of food kids (and adults) eat all day everyday first because food is omnipresent at all times of day or night in the US and as a consequence  food has gone way beyond its main purpose which was feeding your hunger: Food has become your best friend, your lover, your therapist, your fall back consolation, celebration, purpose. It is hard to control your intake of food under these conditions of superabundance (and of course waste!)

  • (1) There is a direct time line correlation between introduction of toxins into population and increase in obesity and other major diseases.
    (2) This issue will not be seriously addressed until (and if) we get health care for all as in EU.  They banned US products realizing the correlation and government could not afford constant increase in disease. (list of banned US products on line.)
    (3) Too many in medical and Rx industry make big bucks from disease.  Ex: I take a pill that cost $38/per here and 38 cents/per in Canada. Same pill. (Obama payback) Head of Contra Costa Health (tax dollars) gets $400,000.  I requested physical exam after 10 years and was told “We don’t do that unless it’s indicated.”
    (4) The solution is to chelate toxins from body.  Not going to happen.  People are now commodities, used to push money to top dividing US into two classes.  Agenda 21.
    (5) Any ‘solution’ that taxes private sector (the wealth creating sector) to public sector (the service sector) accelerates the demise of the US. (Example: Richmond soda tax). Next bubble now being created:  US government.  Bigger than S&L,,RE, etc. See video on Weiss Report. See: Jim Rogers. economist, investor, biker billionaire.
    (6) This is zem-bone, zem-bone systems stuff.  Same as education issues.  Crash to come. Follow the money. Conect the dots.
    Anyone serious about addressing issue:
    caveat: May be too late.


    • Guest

       Read about ACID vs ALKALINE and learn about CARBS. Your article is nonsense.  This is basic science and simple stuff. CARBS are the problem and mixing foods that must be eaten separately. One cannot mix a food that requires ACID to digest with a food that requires an ALKALINE to digest. This causes fermentation. PERIOD. Look up the SCIENCE.
      What are you trying to SELL?

      • Your answer is actually poor science. In our stomach we release HCl to produce a very acidic environment. Here is where foods that require an acidic environment to break down can begin digestion. Proteins break down in to amino acids here in the stomach. When foods leave the stomach through the pyloric valve little by little, the pancreas releases bicarbonate and the environment changes to alkaline. Then enzymes to digest fats (lipase) and carbs (amylase) so that those nutrients can be broken down. These digested foods continue through the lumen of the intestinal tract and are absorbed through the endothelial cells and enter the blood stream. This is biochemistry of digestion. Not sure where you learned your science. Of course this all assumes a healthy digestive tract that is operating optimally. Fermentation occurs when one of these key processes do not work well.

        • Kpinna

          The stomach is the region where protein digestion begins but it continues in the small intestine. The acid in the stomach helps to unfold proteins and activates the protein-digesting enzyme pepsin. However, the pancreas supplies at least 8 or so additional proteases to continue the digestion of protein in the small intestine to amino acids, dipeptides, and tripeptides.
          The pH of the small intestine is not very alkaline, it’s closer to neutral. Last research paper I saw on this gave a pH of about 6 in the duodenum, gradually increasing to 7.4 in the terminal ileum, then dropping to 5.7 in the caecum.

  • Guest

    I am getting tired of hearing this OLD lack of knowledge spiel. Food is broken down by either ACID or ALKALINE. If one eats these two together, then they neutralize and cause ingestion. It’s THAT simple. Look up ACID vs ALKALINE and you will find various websites that teach these principles, which were taught in the 1950s. 

    Most Americans are OBESE because they eat loads of CARBS, such as french fries, potatoes, gravy, rice, etc. Anything WHITE is garbage food. Switch to sweet potatoes and learn about Couscous and Quinoa, which will replace rice, potatoes and gravy, which no one should eat.

    Of course, this eliminates eating out at any of the horrible places that serve burgers with two slices of bread. Primarily, I think Americans are OBESE because they are LAZY.  So die early, since you don’t care about yourself or anyone else.

    Quite blaming anything but the people who eat garbage. This has NOTHING to do with anything BUT CARBS.  Do your research,, PLEASE.

  • Kpinna

    Reading these comments is clear proof that science education is failing. The well-meaning folks who talk about science here don’t have a clue how the body works. Many of you would benefit from taking a physiology or nutrition class before blasting the Internet with opinions about health and nutrition

  • SlySy

    As always, the issue of personal responsibility was completely ignored. It’s advertisement’s fault, the school’s fault, the government’s fault… so which of all these is pointing a gun to your head to make you eat? The final decision of what to put in your mouth is yours, and if you don’t already know that eating too much will make you fat, you need to get out from under your rock more often.

  • David Campbell

    The most interesting and useful comments were from Dr. Madsen as regards the importance of fitness rather than weight. A person can be healthy at any weight; which is not to say that any weight is healthy. Additionally, this obsession with weight rather than health is extremely damaging to the large (and largely unreported) number of youth who struggle daily with Disordered Eating. Healthy eating is important; obsessing about weight, not so much.

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