U.S. obesity epidemic: A Social Justice Issue

Despite the Surgeon General's call to prevent and decrease obesity, rates of obesity among U.S. adults have risen alarmingly in the past two decades, from 13.5% in 1987 to 33.8% in 2008. If these trends continue, experts predict that U.S. adult obesity prevalence will reach 41% within 5 years and exceed 51% by the year 2030. The health consequences of obesity are dire. Obesity is directly implicated in numerous highly prevalent and costly medical conditions, including heart disease, type 2 diabetes, and various cancers, and increases the risk of premature all-cause death by 50-100%. Experts assert that obesity's toll on health may be equivalent to that of poverty, smoking, or problem drinking, and they predict that within 15 years, adverse trends in obesity will completely overwhelm any benefits that have been attained by reductions in rates of smoking. A principal goal of Healthy People 2010 is to eliminate health disparities in obesity rates; however, many segments of the U.S. population are disproportionately afflicted. Obesity rates among African American/Non-Hispanic and Hispanic adults are 50.6% and 21.1% greater, respectively, than those among Caucasian/Non-Hispanic adults. By 2030, the rate of obesity among African American women is projected to reach nearly 100% (96.9%). Given the rising trend in overall U.S. prevalence, profound health consequences, and widening disparities in rates across population segments, obesity has become a significant U.S. social justice issue. This issue not only resides in the epidemiologic and biologic domains (our first two presentations), but must be considered in terms of public health policy. In our third presentation, we consider ways in which to evaluate the comparative effectiveness, safety, and costs of weight loss treatments across an array of current and emerging options. This is followed by an overview of current access, coverage, and reimbursement policies for weight loss treatments offered by U.S. public and private health care systems. Our final presentation summarizes these presentations and considers obesity as a social justice public health issue in need of specific recommended informed policies and practices.

The session will be comprised of 5 presentations: • U.S. epidemiologic trends in obesity and the impact on public health and economic costs • Mechanisms of obesity-related chronic illness as social injustice • Comparative effectiveness research of weight loss treatments • U.S. access, coverage, and reimbursement of weight loss treatments • Obesity: A Social Justice Issue