Indiana residents are among the most overweight and obese in the nation. Combating obesity in children was the subject of a seminar sponsored by the Clay County Step Ahead Council late last month at the Riddell Bank. Dr. William J. Wishner, special consultant to the Indiana State Department of Health, says Indiana has a brighter side, however. The state's sagging industry has possibilities for improvement directly related to its obesity.
"We're the leader in building coffins," Wishner said. "The trend is to build extra wide coffins due to our increasing size. We'll need extra wide hearses and extra wide graves." Dr. Wishner, an adult endocrinologist at Eli Lilly, is currently on executive loan to the State of Indiana to address the specific problem of childhood obesity.
It's estimated that about 15 percent of Indiana's children and adolescence are overweight or obese and the problem is increasing.
Cheaper food fed obesity
Wishner believes environment is most responsible not genetics. Risk factors include parental obesity, sedentary behavior, excessive caloric intake, low socioeconomic status, low birth weight, and formula feeding.
"Our government set the stage for our obesity with changes they put in place in the 40s and 50s after the war," Wishner said. "Food got cheaper. As food cost went down, the food environment changed."
The cost of food went down as the technological boom erupted with television and personal computers. People ate more and their activity decreased. Wishner said the increased weight rate is directly related to the amount of TV viewing time. He believes we've been committing sedentary suicide for the past 30 years
Adults need to encourage activity
"When a child is born he lays on his back," Wishner said explaining the natural activity of children and how inactivity begins. "Then the baby learns to turn over, sit up, crawl, stand and walk. Then we say, 'Sit down' and we sit him in front of a TV."
Wishner said the primary foods of babies 4-6 months old are carrots, sweet potatoes and squash. By the time the children are 15-18 months old the primary food is french fries.
Medical consequences of obesity are high
The child must bear the burden of obesity. Medical consequences are high. There is an epidemic of type 2 diabetes developing in children. Chances of heart disease and circulatory problems increase with obesity even with the very young.
There are sociological issues that overweight and obese children must deal with. There may be social discrimination which affects the child's self-image and self-esteem as he grows.
However, Wishner says we're becoming more tolerant of obese children. Not necessarily out of compassion but because it's becoming the norm. Even medical professionals have become more accepting.
Wishner cited a case of a young child diagnosed with failure to thrive. After doctors were unable to determine the source of the child's problem, it was suggested that the youngster's measurements be plotted against the normal growth curve. It was discovered that the child was normal, just not like the other, obese, kids.
Indiana needs to be a leader in changing food, exercise environment
"Today's children represent the next generation of adults, of childbearers, of teachers," Wishner said. He offered suggestions to deal with the problem. Indiana needs to be a leader in changing its food and exercise environment but it has to be with purpose using the right people.
"Everyone wants to do something," Wishner said." "But they don't know where to fit in or what to do. The Indiana State Department of Health has a plan.
ISDH has a plan
They'll first create and promote awareness of the problem. Information must be shared. It's essential that everybody in the state have access to all the tools available. There will be a clearing house of information created on the website.
Enabling legislation must be promoted by helping to create a legislative tone. Having a Bill requiring vending machines removed from schools would never pass, Wishner said. It would offend the schools by reducing their revenue. It would anger the companies for the same reason. It would also make the consumer, the children, mad because you're telling them they make bad choices.
The best way to combat the vending machine problem in schools is to ask the vendors to put better choices in the machines.
Exercise needs to be put back into schools. But realistically, due to cost, it can't be extensive or immediate. Activity classes and walk to school programs can make a difference.
But primary intervention has to start with the families. They have the most at stake. The families need a source of authority, somewhere to get workable advice. They need answers on what to do and how to do it.
Children need to reduce TV time and increase physical activity. Food choices can be improved and parental modeling is very important. Kids don't buy food for the house. Parents do that. Children should be encouraged to reduce soft drink consumption, decrease portion size and increase fruit and vegetable consumption.
Most importantly, volunteers helping with the transition have to be stakeholders. These are people who have a vested interest in the change and who will be around for the long haul.
Goals should be small initially
Goals should be small initially rather than tackling the overall project which may seem overwhelming. Workers should consider the unique, micro-community. They should not reinvent the wheel and must be persistent and patient.
Wishner had an overhead picture of a family. The mother, father, two children and even the dog were all obese. The caption said "man's fat is man's fate." The State Health Department, with the help of Dr. Wishner, hopes to reduce the fat of the land in Indiana.