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Top doc: Fit nation isn’t a matter of dress size

Thu Feb 25, 2010 7:37 AM EST
health, only-on-msnbc-com, fitness, kids, healthy, parents, eat, fit, benjamin, american-academy, regina-benjamin
msnbc.com News — Joan Raymond, msnbc.com - Only on msnbc.com

ALEXANDRIA, VA - JANUARY 28: U.S. Surgeon General Regina Benjamin (L), delivers remarks about government and community efforts to fight childhood obesity during an event with first lady Michelle Obama (C) and Health and Human Services Secretary Kathleen Sebelius while visiting the YMCA January 28, 2010 in Alexandria, Virginia. Benjamin released a paper on the public health challenge posed by the rise in obesity, particularly among children, and the importance of involving parents, health care providers, schools, and local communities in finding comprehensive solutions. (Photo by Chip Somodevilla/Getty Images)

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— Surgeon General Regina Benjamin has her work cut out for her. As the nation’s newest top doc, Benjamin is taking on an epidemic: obesity. The good news is that she’s not alone. Everyone from the Obamas, the Clintons and organizations like the American Medical Association, the American Academy of Pediatrics and a cadre of other big names have joined the fight. With one in three U.S. children and 67 percent of adults considered overweight or obese, it may indeed take a village to combat the problem. But Benjamin, who has weathered some harsh criticism about her own weight, wants to make one point very clear: success can’t be measured by clothing size alone. She talks to msnbc.com about her vision for a fit nation.

Dr. Regina Benjamin: I’m not sure that no one is listening. Weight loss programs and gym memberships are a cottage industry. There was an article last month, I believe in JAMA [Journal of the American Medical Association] that showed that the obesity rate seems to be slowing. It obviously hasn’t completely stopped, so we still have a lot of work to do. Some people are listening, but not enough.

If you talk to the average person, what’s clear is we need to give them tools to make it easier. We need to get people to make good health part of their lives. I’m showing my age, but I remember going out dancing, doing the hustle and sweating off my makeup. That was fun. People need to exercise and eat well because they enjoy it and they want to be fit. It could be taking a walk in a park. But we need nice parks. We need people to buy better foods. But a lot of communities don’t have access to fresh produce. Right now, it’s very difficult to find a meal that’s healthy and competes with a “dollar meal” like a burger and fries. We need to ask the communities and food manufacturers to offer more healthy choices not as alternatives, but as first choices.

I believe in personal responsibility, but as a government, a community and a society, we can help people. [For some people] food is love. In the African-American culture everything is about food, but not everyone is overweight. In my family, we had desserts on Sundays, not every day. It was part of our big Sunday dinner, and the rest of the week we never had as big a meal. Part of the conversation about health and fitness is about portion sizes and what we’re eating.

I don’t know if they’re bad judges. What’s different now is that [heavy] kids used to stand out. Now [your] child can be the same size as the neighbor’s kid. They aren’t standing out anymore. Physicians and clinicians have to have the conversation with parents about body mass index (BMI). A percentage of body fat [reading] is better, but that’s tougher to do right now. When we let parents know where their kids are [in terms of BMI], it brings them to alertness. Even when parents have their own issues and problems [related to weight], they don’t want their kids to have those problems, especially in the context of the child’s health.

Parents need to set examples. Kids usually want to eat what their parents eat. It’s like when a kid gets a shot, a parent would promise an ice cream when they got home. Well, we would put a sticker on their arms. Don’t reward with comfort food. Americans don’t deny kids anything. Kids ask for something and they get it. Sometimes you have to say no.

As a society, we’ve put a requirement on test scores. But we need to look at the overall development of a child. Test scores go up when weight goes down, or gets closer to normal. We need to put recess back and have more outside play and exercise in the school at least four days a week, as I outlined my vision paper. (Read the Surgeon General’s Vision for a Healthy and Fit Nation 2010.)

One prescription doesn’t always fit everyone. Oftentimes, it’s better for people within that culture to set the pace, such as parents and local leaders. As Surgeon General we have the Indian Health Service and are working very closely with many clinicians. About 70 percent of American Indians and native Alaskans (are overweight). We are trying to get local people, people who are respected in the community, to shepherd this. That’s one of the [elements] of the First Lady’s “Let’s Move” campaign.

I’m very secure in my own self esteem, but yes, it was hurtful. There were some mean comments. But what about those kids who will be looking at me as a role model? They may be very discouraged by some of those comments. I exercise regularly, at least four days a week. If I didn’t I probably would be a big blimp. And I try to eat pretty healthy, as much as I can. I know the things that I’m doing. I tend to stay on the elliptical as long as other people. I’m not out of breath. You can be healthy and fit at different sizes. The real message is that you don’t want to limit yourself by your dress size. You need to be comfortable with yourself and have a good body image. Don’t have some dress manufacturer tell you what size to be. Be a size that makes you fit.

Cut down on soft drinks or cut them out completely. Go from fried foods to baked foods. Have a dinner date with your family, and then take a walk. Do something that will get you out as a family being active together. And watch less TV. Studies show that it’s not so much the sitting on the couch watching TV, but rather the [food] TV ads that tend to make people want to eat.

I’ve been though the malls, and I see the Wii and things like Wii that have hopscotch or dancing. They look like a lot of fun and they get you to move. Putting technology in the hands of consumers makes them better able to manage health.  We’re collaborating with Microsoft HealthVault (msnbc.com is a joint venture of Microsoft and NBC) to provide new features and expand access to My Family Health Portrait. It’s a free Internet resource. You can record your family health history and then integrate that information into a personal HealthVault account. Information can be shared with doctors, family members, pharmacists, whomever you want. It’s important to know family history. One of the things I learned is that thyroid problems run in my family.

Are you hopeful that we can become a fit nation?

Of course, it’s not impossible. But all of America needs to be involved, not just government. This is something everybody should be embracing. We have too much at risk not to.

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TC-1652361

We tend to judge a book by its cover but what's more important is having someone who can get the message across.

Most people talk about losing weight but fail to distinguish lean (muscle) and fat weight. What really counts is body composition. ie. muscle to body fat ratio.

Unfortunately most people are misinformed about exercise and nutrition. Hence, the yo-yo diets and unsuccessful weight loss. When it comes to healthy living, most of the time requires lifestyle changes.

    Reply#1 - Thu Feb 25, 2010 3:20 PM EST
    LightOwl8

    Yes! This article makes some important points. Appearance and clothing size are not the only/best indicators of health. It's got to start inside - make sure the systems are all working, make a better choice today than you made yesterday.

    I tried to make similar points to someone once, and got only blank stares in return.

    Surgeon General Regina Benjamin, I hope your "vision for a fit nation" reaches lots of people!

      Reply#2 - Fri Feb 26, 2010 4:38 PM EST
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