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Big Problem
Efforts to end obesity in Wisconsin



OBESITY FAST FACTS
2 out of every 3 Number of Wisconsin adults who are either overweight or obese.

26 Percent of the state’s high school students who are at risk for becoming obese or overweight.

$1.5 billion Amount of money Wisconsin’s Department of Health and Human Services spent on obesity-related medical costs annually.

30+ The Body Mass Index (BMI) of an obese adult. BMI is a measure of an adult’s weight in relation to his or her height. An adult standing 5 feet 2 inches tall would have to weigh 165 lbs. to be classified as obese, and just 135 lbs. to be classified as overweight.

73 The last-place overall health ranking of Menominee County in the University of Wisconsin Population Health Institute’s 2007 Wisconsin County Health rankings. Ozaukee claimed the top spot as Wisconsin’s healthiest county.

FACTORS CONTRIBUTING TO OBESITY
While some on the thinner side of the scale may see obesity as a representation of laziness or lack of control, a number of factors beyond simply eating too much or not exercising enough can lead to obesity.

“Obesity is a disease. … It’s not simply a lack of willpower,” says Dr. Jon Gould, a bariatric surgeon and associate professor of surgery at the UW School of Medicine and Public Health. “It’s multi-factoral, it’s partly genetic, it’s partly cultural, it’s partly environmental, it’s partly psychological. It’s not something people have as much control over as perhaps some people think.”

Small, perpetual weight gain
Weight can easily pile up over a long period of time. University of Wisconsin-Madison nutritional sciences professor Dale Schoeller describes this gradual trend toward obesity by highlighting his own experiences. Schoeller says he gained about a half a pound to a pound each year between the ages of 22 and 52, causing his weight to jump from a healthy 155 lbs. to a slightly overweight 180 lbs.

“That’s not a huge change on an annual basis,” Schoeller says. “That’s the way obesity kind of creeps up on everybody.”

Sedentary lifestyles
One major contributor to obesity is sedentary lifestyles. Schoeller emphasizes how most people in higher socioeconomic classes work at desks all day, getting little physical activity. He also says the way cities have been designed encourages people to drive to work instead of using other healthier forms of transportation. Labor-saving devices fill our homes and further feed the growing problem, he says.

Stress
Americans’ busy lifestyles and high stress levels can lead to weight gain, as well. “When a person is tired, be it from either mental stress or carrying excess body weight, you seek rest,” Schoeller says. “We’re programmed not just to burn calories, but to conserve them by resting when we can.”

Economic factors
Unhealthy, processed foods tend to be cheaper than fresh and healthy counterparts. “It’s cheaper to buy a bag of Doritos or go to Taco Bell or to go buy off the 99 cent dollar value menu at McDonald’s and that’s more accessible, too, than it is to get fresh fruits and fresh vegetables,” Gould says.

Self-Esteem
Susan Reinhardt, a bariatric surgery program manager, says the negative stigma and biases people with obesity face may be a stumbling block for those trying to lose weight. “For some, there’s a fear,” Reinhardt says. “They don’t want to go to the gym because they don’t feel comfortable.”

WISCONSIN’S RESEARCH EFFORTS TO CONTROL THE DISEASE
An end to obesity, however, could be found in the brains of mice on the University of Wisconsin-Madison campus.

A research team led by Dr. Dongsheng Cai, an assistant professor of physiology at the UW-Madison School of Medicine and Public Health, has discovered a messaging system in the brain of mice that directly affects food intake and body weight.

The research focuses on immunity pathways and two specific proteins, NF-kappaB and IKKbeta, that are activated by over-nourishment and can disrupt the function of organs that regulate metabolism. Cai and his team found this pathway is present in the hypothalamus at much higher levels than any other organ, and when the pathway is triggered, animals eat more because they lose the ability to sense satiety.

“Animals don’t have the sensitivity to reduce the intake of energy,” Cai said. “They’ve lost the balance … so they keep eating.”

When the researchers removed the IKKbeta protein from the hypothalamus, the mice were less likely to consume excess energy and were therefore less likely to become obese. Although Cai used mice for his study, he asserts it provides a basis for finding a specific protein inhibitor that will work in humans and could possibly control the obesity epidemic.

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