1. State of Health in America…
Grace H. A. Thomas, MD, FACOG

2. Obesity One word says it all !
By definition – is an excessively high amount of body fat in relation to lean body mass
Body Mass Index (BMI) is a common
measure expressing the relationship
of weight to height

3. Prevalence of Obesity Worldwide:
WHO estimates more than 1 billion people are
overweight – BMI 25-29
300 million of those people meet the criteria for
obesity – BMI of 30 or greater

4. Prevalence of Obesity
There are over 72 million obese adults in the U.S.
Childhood obesity affects approximately 12.5 million
children and teens in the U.S.
In every state, more than 15% of the adults are
obese
In 9 states (including Alabama) more than 30%
of adults are obese
No state has an obesity rate of less than 15%
which was the national goal for 2010

5. Contributing Factors to National Epidemic
Higher medical costs
One study estimated approximately 9%
of all medical costs in 2008 were obesity
related and amounted to $147 billion,
compared with $78.5 billion 10 years
before

6. Contributing Factors to National Epidemic
Lower quality of life
Contributes to many health problems
that are the leading causes of death
in the U.S.

7. Factors in National Epidemic
Heart disease
Stroke
Diabetes mellitus
Some types of cancer
Sleep apnea / breathing problems
Limited physical activity

8. Women and Obesity
Non-Hispanic black women and Hispanic women have the highest rates of obesity
41.9% and 30.7%, respectively
1. Obesity affects fertility throughout a woman’s
reproductive life – Obese women are 3 times more
likely as women of normal weight to be infertile
2. Obesity during pregnancy is related to overall
higher health care expenditures and contributes to
many pregnancy complications including Pregnancy
Induced Hypertension; preeclampsia, gestational
diabetes mellitus, cesarean section and neonatal
death

9. Women and Obesity mothers including Neural Tube Defects,
3. Rates of fetal anomalies are increased in obese
mothers including Neural Tube Defects,
Spina bifida, cardiovascular anomalies, cleft lip
and palate
4. Strong link to gynecological cancers, particularly
endometrial/uterine cancer and cervical
cancer; and well established link between obesity
and postmenopausal breast cancer

10. Why is this epidemic happening?
Weight gain occurs when people eat too
much food and get less physical activity
Societal and community changes have
accompanied the rise in obesity

11. The American Diet Some Americans have less access to stores
providing healthy, affordable food such as fruits
and vegetables, especially in rural, minority and
low-income neighborhoods
Restaurants, snack shops, and vending machines
provide foods that are higher in calories than
home cooked foods

12. The American Diet adults drink at least one sugary drink per day
There is too much sugar in our diet – 6 out of 10
adults drink at least one sugary drink per day
It is often easier and cheaper to get less healthy
foods and beverages
Foods high in sugar, fat and salt are highly
advertised and marketed

13. The American Diet soft drinks – 77 gallons per person each year
Alabama is among our nation’s top consumer of
soft drinks – 77 gallons per person each year
Residents also consume $649 per person in
fast food annually
Reference: 10 States With The Deadliest Eating Habits
by Charles B. Stockdale

14. What happened to physical activity?
**Many communities are built in ways that make it
difficult or unsafe to be physically active:
Access to parks and recreation centers may be difficult or
lacking, and public transportation may not be available
Safe routes for walking and biking to school, work or play
may not exist
Too few students get quality, daily physical education in
school

15. Diabetes Belt mapped higher than average occurrences of diabetes
The term “Diabetes Belt” was coined when researchers
mapped higher than average occurrences of diabetes
mellitus in an area encircling much of the Southeast
Almost all of Alabama’s 67 counties are included
11% or more of a county’s residents have to be diagnosed with
diabetes mellitus to be included in the “Diabetes Belt”

16. Diabetes Belt **In 2010, the Centers for Disease Control (CDC)
reported that 11.6 % of Montgomery County’s
residents have diabetes mellitus; the national
median is 8.1%
Only 2 Alabama counties were omitted from the
“Diabetes Belt” – Baldwin and Shelby

17. Diabetes Belt 4 Distinguishing Factors
1) The population of the Diabetes Belt counties contained
substantially more African Americans compared to the
rest of the country – 23.8 % for diabetes belt, vs 8.6 %
nationally
2) The prevalence of obesity was greater in the diabetes belt
than in the rest of the nation
3) A sedentary lifestyle was greater in the diabetes belt
4) The proportion of people with a college education was smaller

18. What can be done…. Our first lady recently launched the “Let’s
Move!” program, which seeks to eliminate
childhood obesity within the generation
It’s main points of action are; providing healthy
foods in schools, increasing physical activity
and improving access to healthy, affordable
foods

19. States can… Expand programs that bring local fruits and
vegetables to schools, businesses and
communities
Support hospital programs that encourage
breastfeeding
Adopt policies that promote bicycling and
public transportation
Provide supermarkets and farmers markets
with incentives to establish their businesses
in low income areas and to offer healthy foods

20. Everyone can… Eat more fruits and vegetables and fewer foods
high in fat and sugar
Drink more water instead of sugary drinks
Limit TV watching in kids to less than 2 hours a day
Support breast feeding
Promote policies and programs at school, at work
and in the community that make healthy choice the
easy choice
Get moving! – 10 minutes brisk walk, 3 times a day,
5 days a week

21. Alabama Department of Public Health
State Obesity Task force – has developed a
strategic plan for the prevention and
control of overweight and obesity in
Alabama
BITE – Community Grant – 5 Alabama
communities received funds to stimulate
community-based physical activity and
nutrition programs to reduce risk of
overweight and obesity
Scale Back Alabama – Statewide campaign held at
the beginning of each year to encourage Alabamians to
get healthier by losing weight and exercising

22. In Conclusion… Obesity is a complex issue that requires
action on many levels
A cultural shift in the way we think about food: convenience culture vs eating for good health