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  1. Opinion

Column: Fighting obesity and its high costs

Published Mar. 16, 2015

President Barack Obama missed a historic opportunity to raise awareness about the deadliest killer of our children. His 2016 budget proposal for a $215 million precision medicine initiative based on sequencing the human genome is futuristic, but it lacks relevance. Far more Americans will die from obesity and its complications than will be saved by "precision" personalized medications.

Obese adolescents are contracting adult diseases; in my clinical practice I see 15-year-old high schoolers with diabetes, hypertension, fatty liver, infertility and sleep apnea. Can you imagine how broken their bodies will be if they make it to 2030? By then, I will be retiring and the majority of those obese adolescents will have grown into obese adults. Tampa Bay by then will be home to more than 200,000 obese people.

Bariatric-metabolic surgery is safe and effective, but only one of every thousand obese adults who needs it, gets it. Without an effective treatment, the other 99.9 percent will remain at high risk for premature death, poor health and diminished quality of life. Obesity and its related disorders are bankrupting the national health care system; currently, total predicted obesity-related spending in Florida is $35.5 billion. To put this in perspective, Gov. Rick Scott's 2015 budget for the entire state is $77 billion. Medicaid spent $22.2 billion on all health services combined in 2013-14.

The rising cost of obesity will affect every resident, employer and government agency in Tampa Bay. Gallup estimates that obesity adds an incremental annual heath care cost of $1,429 (2009 dollars) per person; assuming that the Tampa Bay population and the percentage of obesity remains the same in 2030, we will grappling with an obesity invoice of $1.2 billion ($1,429/person/year x 4.3 million population of Tampa Bay x 20 percent obesity rate.)

In a few weeks, the first adolescents will be seen at our center to begin preparing for bariatric-metabolic surgery to treat end-stage obesity. Although surgery provides durable and sustainable weight loss, for 15 years I have quibbled with putting adolescents through that radical option. I was hoping that we would have come up with a better strategy for population health. But delaying surgery would only delay the inevitable and progressive worsening of obesity and certainly does not answer the pressing pleas of parents and pediatricians for an effective intervention for the crippling complications of obesity.

Lessons learned from my career in obesity surgery in a consumerist society are valuable and sometimes quite depressing: Surgery is not a cure for the epidemic of obesity; the federal government cannot raise children; state governments lag in preventing generational obesity; and parents are at the end of their rope. There are no silver bullet medications and certainly we cannot wait until every child is obese and rely on surgery to save them all.

Whatever we have done has not moved the needle on adolescent obesity, yet we have to prevail and save our children by declaring obesity prevention as our community's top priority and make healthy living our top choice.

Here are some thoughts on how to get there:

• Mandate nutritional education and physical fitness in all school and colleges.

• Promote healthy, affordable and locally grown foods.

• Design neighborhoods that encourage physical activities for pedestrians.

• Reward innovative technology that serves humanity, health and fights obesity.

• Build strong community-industry coalitions with a mission to prevent obesity.

• Fund scientific proposals that integrate delivery of care to include medical, nutrition, mental health and community organizations.

• Sustain the mission by talking to your kids, loved ones, friends and employees about obesity.

We should act now. It is our kids who are ill with obesity. Their burden is our opportunity to make life better for them (and us). An ounce of prevention will reduce health care expenditures and will improve their quality of life and increase their longevity.

It has been 10 years since the University of South Florida and Tampa General Hospital hosted the Obesity Summit with former Arkansas Gov. Mike Huckabee, who has publicly addressed his own struggles with weight, to raise awareness about obesity. In preparation for another Obesity Summit later this year, please send me your ideas on how to stem the obesity epidemic by drawing on the support of your community, local businesses and governments.

I will select the best ideas for a healthy Tampa Bay, and those top ideas will be at the core of the discussions in the proposed summit.

My email address is the bariatriccenter@tgh.org. I look forward to hearing from you.

Dr. Michel Murr is co-director and founder of the Tampa General Hospital + USF Health Bariatric Center and is also a professor in the USF Health Morsani College of Medicine. He wrote this exclusively for the Tampa Bay Times.

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