Top doc: Fitness is more than a dress size - MSNBC

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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.

Msnbc.com: Researchers estimate that by 2015, nearly 75 percent of the U.S. population will be overweight or obese. A great job been done in getting people to quit smoking, but no one seems to be listening when it comes to losing weight.

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.

So how do you reach more people?

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.

Every day there’s a new study saying that genes, the environment or some other factor is to blame for obesity. At what point does personal/parental responsibility come into play?

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.

Are parents poor judges of their children’s weight?

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.

But oftentimes parents feel guilty denying a child food.

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.

There is a lot of evidence showing a relationship between poor school performance and childhood obesity. Yet, test scores are emphasized often at the expense of recess or physical education.

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.)

There are some racial and ethnic disparities with childhood obesity. American Indian/Native Alaskan children have the highest BMIs. And obesity prevalence is higher in Hispanic and black kids than it is in whites or Asians. How do we deal with that issue?

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.

Your weight was made an issue when the President picked you for the post, and you said it was hurtful. So how do we talk to our kids about a sensitive topic like weight?

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.

How can a parent start?

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.

Are there any fitness or health technologies you like?

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.

Joan Raymond is a freelance journalist whose work has appeared in Newsweek, the New York Times, MORE and Woman's Day.

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