Shiriki K. Kumanyika, PhD, MPH
Solving our Obesity Epidemic
We are living in an environment of obesity, says Shiriki Kumanyika, PhD, MPH, an epidemiologist at the University of Pennsylvania and one of the leading experts featured in the new documentary on obesity. The four-part film by the Institute of Medicine (IOM) and HBO has placed the Weight of the Nation in the spotlight.
The facts are alarming: Two-thirds of US adults and one-third of children are now overweight or obese. The percentage of children aged 6-11 who were obese increased from 7 percent in 1980 to almost 20 percent in 2008. The consequences are serious: Obesity increases the risk of seven types of cancer, diabetes, and heart disease. It contributes to five of the ten leading causes of death in the United States.
A member of the 2007 AICR/WCRF expert report and the writing panel of the 2009 policy report, Dr. Kumanyika was also a panel member of the IOM policy report. (See Setting Strategies for Prevention below.) She is also the founder of the African American Collaborative Obesity Research Network.
CRU spoke with Dr. Kumanyika about how it’s now time to revamp the way in which we live.
"I firmly believe that we can fix this problem, in part because we have no choice. The current situation is untenable."
Q: This is a powerful documentary. Why do you think it’s important people watch it?
A: This series is a one-of-a-kind opportunity to obtain a scientifically sound and detailed explanation of what obesity means from a health perspective and to become sensitized to the personal struggles of people who are living with obesity (without the hype and even ridicule that often accompanies media portrayals of people with weight problems).
Q: Do you think kids should watch this?
A: Parents may want to consider whether their children should see some of the more graphic depictions of the health consequences of obesity, but much of the content will be informative to children and youth who are old enough to understand it, particularly if parents actively engage in discussions with their children to help them to understand what is being portrayed. The films offer an outstanding opportunity for people, including within families, to begin conversations about what obesity means, why overweight and obesity affect so many people in our society and what can be done about it.
Q: The documentary states that 20% of cancer cases in women and 14% in men are caused by obesity. What are some other serious health problems of obesity?
A: High blood pressure, heart disease, osteoarthritis, and liver disease are some of the other obesity-related conditions. Type 2 diabetes is the chronic disease most closely linked to obesity. The potential to prevent diabetes and its consequences (which may include heart disease, kidney disease, blindness, and amputations) by preventing obesity is a strong takeaway from the HBO films.
Q: In the film you visit an inner city store where we can see how high calorie, high-sugar foods are so cheap and accessible. What are some actions that parents and communities can take to make purchasing healthier foods easier?
A: Parents and community members can work with neighborhood store owners to improve the food options that are available, but they cannot do this alone. Retailers may be willing but face the risk that changing options will not be profitable if their youth or adult customers do not choose the new options with sufficient frequency. Feasibility is also an issue if stores do not have refrigeration or other resources needed.
Parents will need to form coalitions and connect with other organizations. Experts in retailing as well as public health professionals should be included in these efforts, to help with understanding key issues from the retailer’s perspective and to assist with the “social marketing” of healthier choices. Partnerships with non-profit organizations, health departments, and local universities can be very helpful for obtaining this expertise.
You can visit the Healthy Corner Stores Network for resources and ideas.
Q: You chaired an IOM Committee on Childhood Obesity Prevention, can you speak to why the issue of childhood obesity is so important to get a handle on now?
A: The crisis associated with the increases in prevalence of childhood obesity has been recognized for more than a decade, but we, in public health and in the society as a whole, have not been able to get ahead of the curve on this issue. Concerns relate to the health consequences and social problems that affect children with overweight or obesity and to the fact that being obese during childhood carries a substantial risk that the obesity will be lifelong. There are immediate consequences as well as longer-term effects, associated with the early onset of risks for type 2 diabetes, heart disease, and cancer. These risks accumulate over the life course.
The challenge is to actually turn things around so that the average child and adult will maintain a weight that is well within the healthy range.
Q: The IOM report highlights key strategies to combat obesity. Are there specific recommendations or strategies that you hope people can act on now?
A: The IOM report explains that all sectors of society have a stake in turning the obesity epidemic around and that leadership must come from within families and communities as well as from policy makers, businesses, and health professionals
The report calls for a comprehensive approach that changes the dynamics of several, interrelated environments that are key systems influencing obesity at the population level – physical activity environments, food environments, schools, workplaces and health care settings and the overarching information and messaging environments related to eating and physical activity. Changing the dynamics for communities of color and low-income communities is particularly critical, because the food marketing, physical activity, and messaging environments in these communities are even more obesity promoting than in communities in general and obesity and its consequences affect proportionately more people within these communities.
A: As I say in the documentary, “The weight of the nation is out of control, but we can fix that.” I firmly believe that we can fix this problem, in part because we have no choice. The current situation is untenable. The resources and attention being applied to the problem have increased markedly, perhaps to a tipping point. Taken together, the HBO series, the IOM report, the efforts of the partner organizations and in communities throughout the country can create what will be, in retrospect, a social movement that will have enough focus and energy to turn the obesity idemic around. We should all commit to being a part of this effort.
You can watch all the episodes of Weight of the Nation and find more resources online.