The scope and impact of obesity in Vermont - Strategies for change.

Obesity is a complex, multi-faceted condition amplified by a confluence of socio-economic and environmental forces. Even in Vermont, a state long ranked as one of the healthiest, 25% of adults are obese, a rate better than 44 other states, but more than double that in 1990. Obesity puts people at greater risk for a number of serious health conditions, and may soon overtake tobacco as the #1 real killer if the current trend is not reversed. Beyond the cost to an individual's health, the projected financial impacts of an increasingly obese population are great. Nationally, the estimated direct and indirect costs of obesity add up to more than $190 billion each year. In public health terms, the challenge we are facing with obesity can well be compared to our experience with tobacco. We can easily track advances in policy, counter-marketing and other changes that together have created an environment in which smoking is no longer the norm. The Vermont Department of Health is beginning to apply strategies similar to those used to successfully cut smoking rates. This commentary describes Vermont's efforts to increase physical activity, decrease caloric intake, and enlist partners to help make healthy choices easier and more accessible for everyone.