"The Weight of the Nation," a new HBO documentary airing Monday and Tuesday nights, raises the alarm about America's obesity epidemic. HBO is offering the film for free to non-subscribers, and health organizations like Kaiser Permanente are promoting it. We talked to Dr. Lisa Liu, Physician in Charge of Kaiser's Elk Grove offices, about how obesity affects Elk Grove—where about a quarter of fifth-, seventh- and ninth-graders combined are overweight, according to the California Center for Public Health Advocacy—and what can be done about it.
What’s the main point of “The Weight of the Nation?”
This documentary is really a very in-depth look at the obesity epidemic. What we’re really hoping is it’s a call to action so people will have a very frank conversation on what obesity is and more importantly galvanize them so they will act either as individuals or with other people to do what they can to reverse the trend.
What makes someone obese as opposed to just overweight?
It’s a spectrum. For instance, if you’re 5’6” and 150 pounds that’s considered normal. If you’re 160 that would make you overweight and if you’re 190 that would put you into the obese category. The calculation depends on age somewhat and on gender. What we understand is that when you become obese it significantly increases your risk of developing chronic medical conditions like high blood pressure, diabetes those types of things.
How prevalent is obesity today in the U.S. how does Elk Grove stack up?
It’s huge—pardon the pun. In the U.S., two thirds of adults are considered overweight or obese and a third of youth. I think the Elk Grove population really just reflects national trends. We’re pretty comparable.
Elk Grove has a lot of fast food and chain restaurants. What can be done about companies that profit from selling unhealthy, processed food?
That’s a challenging question. The businesses are out there to make a profit. The documentary is going to talk about how advertising affects our choices, but when it comes down to it we are really responsible for the choices we make.
It’s not just about fast food. It’s about knowing what type of community activities are out there, whether they be walks or runs, or how to shop the supermarket. We call it shopping the perimeter. If you ever look at a supermarket, most of your fruits and vegetables tend to be along the perimeter aisle as opposed to middle aisles where processed foods tend to be. For many communities they don’t even have access to healthy foods, so pushing farmers’ market development and making those things available are absolutely key.
I’ve gained about 20 pounds since moving to the Elk Grove area from San Francisco. Is there something about the city’s layout that is conducive to obesity?
The explosion of suburbs where many of us have to get into our cars to drive to different locations has definitely contributed to the potential weight gain.
I think Elk Grove is a very smart community in that they very much focus on their layout. There is an attempt to incorporate greenbelts and parks. They certainly have farmers’ markets, the schools are invested in doing what they can.
Most of us know that our country has an obesity epidemic, but tackling it can seem daunting. For individuals who are see this documentary and want to take action, where can they start?
As a start, they can recognize that even if they may not necessarily have a weight problem, people around them do. And then looking at what you can do to help reverse that trend. A lot of is getting involved not only within your family but your community where you live, participating in events at your church or place of work.
You might not necessarily be able to lobby a fast food chain, but you can educate yourself when you go to those chains, do what you can to get your children involved in activities. Every person has some important role to play.
Obesity is not just an individual problem, it’s a public health problem. When you look at the societal cost of obesity, what we know is that obesity-related medical conditions currently cost $147 billion a year, which is 10 percent of our healthcare budget. When you look at the number of people who do not have obesity-related medical conditions yet and fast forward 10 years that social cost is astronomical and unsustainable.
What else is being done in Elk Grove to combat obesity?
I can tell you what we’re doing. Kaiser funds a number of grants that are available for community organizations to develop programs, whether they be safe places to play or bringing farmers’ markets to the area. We cosponsored the [half-marathon] and will be doing that on an annual basis.
We also work with the health technology academy and nutrition is a big part of it. The physicians we send out really work with those students to develop teaching points so they can work with the communities around them and also the school community to encourage health and nutrition.
We’re a healthcare institution and we do a great job of treating people who have chronic medical conditions. But I think we have to pay even greater attention to people who will become those patients in the future. What I do in my practice is just the tip of the iceberg. To truly be impactful you have to go where people live, reach them where they gather, whether it be in churches or schools. Traditionally, our healthcare system is about fostering individual health and I think as a nation we have to go broader than that.
Parts 1 and 2 of "The Weight of the Nation" air on HBO at 8:00 p.m. Monday night, followed by parts 3 and 4 at 8:00 p.m. Tuesday. Non-subscribers can view the films online as soon as they air.