Americans grew more obese last year in every state except Oregon, and state governments grew more fervent about fighting flab with an expanding array of snack taxes, soda bans, weight-monitoring for school kids and carping about extra pounds that are costing taxpayers money.
One of the newest tactics is to provide more insurance to treat the dangerously obese. Maryland, Georgia, Indiana and Virginia enacted laws this year targeting "morbid obesity" - defined by an exceptionally high Body Mass Index (BMI), a calculation based on weight and height. Maryland now requires insurers to cover treatment for morbid obesity, while the other three states require an insurance policy option for the extremely obese, according to the National Conference of State Legislatures (NCSL).
Another pivotal change requires weigh-ins for students in three states to track the aggregate health of pupils and alert parents to dangerous trends in a child's weight. Joining Arkansas' 2003 decision to begin tracking the BMI of students, Tennessee will require each student's BMI to be reported to parents in a confidential health report card. West Virginia will include a BMI measurement in regular physical education screening.
States' track record in fighting obesity is improving. Researchers at the University of Baltimore issue state-by-state report cards for performance in combating obesity based on legislation passed. While no state earned an "A" from the researchers this year, 11 did receive a "B" and only 5 states failed.
Last year, Arkansas was the only state to earn a "B" and 23 states failed, indicating that they took no action toward combating obesity in 2004.
Lawmakers face a hefty challenge. Almost a quarter of Americans are obese, and another 40 percent are not as heavy but are considered overweight, according to the latest report from the Centers for Disease Control and Prevention. Trust for America's Health (TFAH) calculates that obesity-related medical expenses add up to nearly $120 billion each year, a health care bill footed in part by taxpayers through higher public health spending and state employees' and retirees' medical bills.
An Aug. 23 state-by-state ranking by TFAH showed that obesity rates increased last year in all states but Oregon. Mississippi topped the list, with nearly 30 percent of its population termed obese. Of the 10 states with the highest obesity rates, seven are in the Southeast: Alabama, Kentucky, Louisiana, Mississippi, South Carolina, Tennessee and West Virginia.
Faced with a citizenry of expanding waistlines, governors are getting personally involved. Twenty-one states have created obesity commissions, according to the study by the University of Baltimore, making these task forces the most common form of state action.
Arkansas Gov. Mike Huckabee (R) is credited with the most high-profile state weight-loss initiative, "HealthyArkansas." The governor became interested in promoting healthy weight in his state after he lost more than 100 pounds and authored a book, "Quit Digging Your Grave With a Knife and Fork."
Huckabee's mission has caught the attention of other state chief executives around the country, and not always by choice. At a recent Arkansas fund-raising conference with Republican governors, only low-fat, healthy foods were served at the behest of Huckabee. As chairman of the National Governors Association, Huckabee is launching a " Healthy America " initiative in September to involve other governors and raise nationwide awareness of lifestyle changes Americans can make to fight obesity.
Fitness-icon-turned-politician Gov. Arnold Schwarzenegger (R) of California launched a $6 million obesity initiative as part of the recently passed state budget, motivated in part by the chilling statistic that Californians have gained 180,000 tons in the past decade. The initiative includes obesity prevention in schools, communities and the workplace through better eating habits and more physical activity.
Virginia Gov. Mark Warner (D) introduced a "Healthy Virginians" program in November to combat obesity among state employees, school children and families who receive Medicaid benefits
Other state approaches to combating obesity include creating ways to pay for its consequences. Seventeen states now have "snack taxes," which target junk foods with minimal nutritional value. These taxes have a dual purpose: discouraging snack foods that may lead to obesity and raising revenue for the state. In two states - Arkansas and West Virginia - proceeds from the tax are directed to health-related expenses.
Junk food also is being phased out of school cafeterias, as the lunch line has become the new frontline in the fight against childhood obesity.
Fifteen states enacted laws this session to set new nutritional standards for schools, according to NCSL, including policies such as banning fried foods from the lunch line and replacing the candy and soda in vending machines with juices and granola bars. Lawmakers hope that the availability of nutritious foods will help students learn better eating habits and develop into healthier adults.
Other state laws passed this year to reduce childhood obesity through schools call for diabetes screening, requirements for physical activity and nutrition education.