The obesity epidemic in the Americas: making healthy choices the easiest choices.

In this presentation I will attempt to illustrate the serious impact of the obesity epidemic throughout the Region of the Americas. Particular attention will be paid to the increasing rates of obesity in Latino populations in North America and South America, the underlying factors, and, most importantly, how we can prevent the epidemic from spreading further. Obesity is behind the three major killers in the United States of America: diabetes, cardiovascular diseases, and hypertension. Obesity also accounts for about 300 000 deaths annually (many of them premature deaths), consumes up to US$ 100 billion per year in health care costs, and has quite possibly already surpassed smoking as the country's number one health burden. To top it off, obesity already is taking a major toll on children's health. Diseases that just a few years ago were seen only among adults are now increasingly being diagnosed and treated among youth in the United States (1). Throughout this presentation I refer to obesity using body mass index, or BMI. This index is obtained by dividing a person's weight in kilograms by the square root of his or her height in meters. A BMI value of 25 or higher defines overweight , and BMI values of 30 and above indicate obesity. This is not a 100% perfect measure at the clinical level, but it is good enough when we evaluate large population groups. And, yes, I did say 300 000 deaths and US$ 100 billion in health costs annually in the United States. So why aren't the emergency sirens going off, telling everyone that we've gotten ourselves into huge, serious trouble? You may remember the recent epidemic of SARS, the respiratory infection that started in China. It claimed about 800 lives worldwide , put public health authorities and politicians on alert, made the front pages of newspapers, and was mentioned on television news shows daily until the bug died out. If you compare 300 000 deaths annually with those 800, you might conclude that human beings react to sorrow, pain, and death when it comes to accidents but less so when the conditions kill us slowly. Maybe. That argument is partly true, though. Take the case of tobacco; we don't pass away right after a puff, do we? However, our public health system has been embarked for some time now on a worldwide campaign, wielding all sorts of arms to uproot cigarettes from …