The AOA has acted to ensure that a major effort to set national health priorities gives appropriate attention to obesity. In September, a draft version of Healthy People 2010, a document that amounts to a national health charter, was issued. Although the more than 650 pages, prepared by the U.S. Department of Health and Human Services, were aimed at increasing the quality and length of life, the draft virtually ignored obesity and its threat to national well-being.

AOA advocates a change in the document to give obesity its due. The organization presented its case at a November meeting of the Healthy People Consortium, an alliance of national membership organizations and government agencies that AOA joined last June, and at regional hearings on the draft document.

The objectives of Healthy People 2010 are to:

Under each objective are 26 chapters, representing specific focus areas. For example, physical activity and nutrition are focus areas and separate chapters under the objective, "Promote Healthy Behaviors." Diabetes, heart disease and arthritis are among the chapters for the objective, "Prevent and Reduce Diseases and Disorders." Obesity, however, was not designated as a focus area and given a chapter of its own. Instead, overweight and obesity are loosely addressed in the nutrition chapter and secondarily in a few other chapters. As a result of these editorial decisions, obesity is unduly minimized in the draft document.

To rectify this oversight and establish clear goals for obesity in Healthy People 2010, AOA presented comments at three regional public hearings, held in Philadelphia (October), Chicago (November) and Sacramento (December), and at the November consortium meeting, held in Washington DC. At the Washington meeting, AOA Executive Director Morgan Downey outlined the importance of obesity treatment and prevention in improving the nation's health. "It is time for the public health community to stop being in denial about obesity," he said. "We propose a broad effort to prevent and intervene in the epidemic of obesity."

He continued: "Our recommendations propose a broad campaign of education about obesity and healthy weight management; we propose that corporate wellness and managed care do better at education, prevention and intervention. We propose that we stop barring overweight persons from access to health insurance because of their weight. We propose major programs for physical activity and education about healthy weight for the nation’s children and adolescents. We need your collective wisdom and experience to stop this epidemic before it becomes the normative condition in the United States. We cannot wait for Healthy People 2020 to address obesity."

Comments Distributed

AOA distributed to meeting participants a working draft of comments, entitled, Obesity: Increasing the Understanding of a Neglected Public Health Hazard. Many consortium members supported AOA’s comments. The AOA working draft was sent to several leading obesity researchers and educators, including AOA’s distinguished advisory council, for review and verification of scientific evidence.

After incorporating the recommendations of the scientific community, AOA’s were reviewed and supported by both governmental and non-governmental, for-profit and non-profit organizations, including leading consumer organizations, professional medical societies and companies with years of experience in providing services or products to persons with obesity. AOA appreciates their contribution and the opportunity to cooperate in carrymg out our mission.

AOA wishes to thank the following: American Association of Retired Persons (AARP), American College of Nutrition, American Society of Bariatric Physicians, Amgen Inc., Health Management Resources, International Federation for the Surgery of Obesity, Jenny Craig, Inc., Knoll Pharmaceutical Co., Lexington-Fayette County (KY) Health Department, Medeva Pharmaceuticals, Novartis Nutrition Corp., State of Maryland, Department of Health and Mental Hygiene, Tanita Corporation, and Weight Watchers International, Inc.

AOA argued that obesity must be a separate chapter in Healthy People 2010 if the disease is to receive adequate attention and resources, because the document will guide state and local health agencies, organizations and health professionals in prioritizing needed improvements in public health. AOA supported its argument by describing the detrimental impact of obesity on quality of life, including stigmatization, disability, and the fact that more than 30 specific deleterious health effects are associated with obesity.

AOA Recommendations

AOA recomrnended that a separate chapter on obesity be placed under the objective, "Prevent and Reduce Diseases and Disorders." It submitted a model chapter that contained 36 goals. They include:

AOA urged that the public be made aware of the health risks of obesity, its complex, multifactorial causes, the use of body mass index (BMI) as a measurement, the importance of achieving and maintaining healthy weight, the benefits of weight loss, the setting of reasonable weight loss goals and the availability of treatment options.

In conjunction with Healthy People 2010, HHS is developing a set of measures, called Leading Health Indicators, that can regularly monitor the public. The indicators would focus national attention on issues of special concern and attract the attention of political, business and opinion leaders.

HHS designated ten criteria for selecting the indicators, which must be readily understandable and applicable to all populations. AOA presented considerable scientific evidence to demonstrate that obesity amply satisfies all the criteria. AOA noted:

AOA’s proposal also contained a comprehensive plan to create healthy weight programs in schools and to teach students (children, adolescents and young adults), teachers, and parents the importance of physical education and sound nutritional practices. In addition, the proposal emphasized obesity education for primary care physicians, routine screening and counseling of obesity in medical settings, access to weight management programs through managed care organizations, and healthy weight programs in communities, social organizations, religious groups and workplaces.

While AOA waits for the final version of Healthy People 2010, work on the document has already proven to be beneficial, because it resulted in our partnering with a diverse array of consumer groups, professional societies, corporations and government health departments.