SCALES TIP TO EPIDEMIC OF OBESITY.

Byline: Phil Davis Staff Writer

Drop the Twinkie. Put away the Haagen-Dazs ice cream. And do not - repeat, do not - super-size it.

America's insatiable appetite for calorie-rich foods is feeding what public health officials on Tuesday called a national epidemic of obesity.

Waistlines are expanding at an unprecedented rate in the nation, according to studies published in the Journal of the American Medical Association, which devoted today's entire issue to the obesity theme. Consider the numbers:

A Centers for Disease Control and Prevention study using the body mass index as a measure found that half of all Americans are overweight, carrying up to 30 pounds more than their ideal body weight.

The same study indicates more than 40 million Americans, 22 percent of the population, are obese, more than 30 pounds over their ideal weight, which puts them at serious risk for health complications such as heart disease, adult-onset diabetes and stroke.

In 1991, four states out of 45 participating in a CDC survey had obesity rates of 15 percent or higher. By 1998, that same obesity rate had spread almost like an infectious disease to 45 states.

Another JAMA article estimated that roughly 300,000 Americans a year die as a direct result of obesity.

``We've had a steady increase in weight over the 20th century, but this is a remarkable upturn,'' said CDC Director Dr. Jeffrey P. Koplan at an American Medical Association Conference at UCLA on Tuesday. ``It's likely to be worse. Most of us tend to underestimate our weight and overestimate our height.''

The CDC telephone survey of more than 700,000 Americans found that the weight gain crossed all socioeconomic and ethnic barriers, but was most significant among 18- to 25-year-olds, people with college degrees and those of Latino descent.

Koplan and the American Medical Association called for a concentrated, nationwide effort to reduce obesity levels. While they stopped short of calling for warning labels on fast food burgers, health officials said physicians, teachers and even ministers should preach fitness at every opportunity.

It's a familiar message often drowned out by news of quick-fix diets, a new weight-loss drug or plain old indifference.

``People don't like the message. They want a magic bullet,'' Koplan said. ``There's this idea we're getting bigger and bigger, and there's nothing we can do about it, and we need a magic bullet. But that just isn't going to work.''

His point was well illustrated Tuesday when the researcher who spoke after Koplan was mobbed by a throng of reporters after he said that a hormone called leptin shows promise as an appetite suppressant.

Dr. Steven B. Heymsfield of St. Luke's-Roosevelt Hospital in New York said that, in research on the newly discovered hormone, leptin injections successfully increased the rate of weight loss among both lean and overweight adults. Heymsfield said the discovery could ultimately let doctors ``turn off'' food cravings, which he admitted is pretty close to a magic bullet for treating obesity.

``I think in all of our lifetimes we're going to see advances in this field, but not next week,'' Heymsfield said. He quickly added that diet and exercise, not expensive medical therapy, is the key to good health for most people.

Koplan said Americans are being defeated by simple math: taking in more calories than they burn. Those excess calories are stored as fat. He said the average man takes in 2,455 calories a day, 216 more than he did in 1978. A typical woman consumes 1,646 calories, an increase of 112 calories. At the same time, both adults and children get less exercise.

Children are no exception to the weighty trend. Another JAMA article says 60 percent of overweight children show increases in risk factors for cardiac diseases. And the poor eating habits established in childhood will last a lifetime, leading to early development of diseases and driving up health care costs that are already out of control.

Koplan compared America's lackluster response to constant obesity warnings to the indifference the nation showed over studies in the 1940s on the health risks of smoking. It took decades, but the anti-smoking message finally gained widespread acceptance. He hopes the same will be true of the obesity message.

``When people finally realize that children are at risk, I would think as a society we're going to want to do something about it,'' Koplan said.

CAPTION(S):

box

Box: Are you obese?