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John E. Hall, PhD, leads the Department of Physiology and Biophysics at the University of Mississippi Medical Center, where a comprehensive obesity center is being developed.

As a new administration takes the reins in Washington, it represents a new chance to invest in obesity prevention — instead of simply treating its many related problems once they've set in.

"We see obesity as the biggest health risk for Mississippi at this time and for the future," said John E. Hall, PhD, Arthur C. Guyton professor and chair of the University of Mississippi Medical Center Department of Physiology and Biophysics.

While obesity's connection to heart disease, high blood pressure, diabetes and myriad other chronic diseases is well documented, the question of which prevention strategies will work best is one that's still yet to be tested, Hall said.

"We haven't had a lot of funding in that area, so we don't know how to succeed," he said.

"We think that testing these strategies in children and young adults will be the most productive way to go, since it's very hard to treat obesity once it's developed. But we still need to understand what strategies will work best."

Through small-scale programs and regional efforts, the programs already underway in many Mississippi communities are providing some early lessons, though.

Victor Sutton, PhD, MPPA, director of the Office of Preventive Health for the Mississippi Department of Health, said he's encouraged by the partnerships that have developed so far around the issue. Those include efforts like the Mississippi Department of Transportation's Safe Routes to School grant program, aimed at improving options for kids to walk or ride their bikes.

"We've been working with the Office of Healthy Schools, along with superintendents, principals and districts around the state," Sutton said. "We've also been working with mayors and municipalities on their building and zoning policies, with the goal of providing safe and accessible places for physical activity and promoting walkable communities."

While not directly health-related, those kinds of efforts are a complement to the awareness messages which the media and other agencies keep on hammering, Sutton said.

"You can talk about exercise and eating healthy," he said. "But unless you have access to healthy food and safe places where you can exercise, it's hard to get across."

A 2006 study of Mississippians' public perceptions of childhood obesity found that, at the very least, the message of concern is getting across. Nearly 95 percent of survey respondents considered childhood overweight to be a serious problem, as cited in a 2007 overview study of obesity prevention efforts across Mississippi. Respondents were nearly evenly divided, though, when asked whether reducing the problem was a personal issue to be handled within the family, or a community issue which calls for action by schools and community groups.

In the latter category, the efforts which gain traction in real life are typically the ones whose messages and impact are ongoing, Sutton said, rather than those which boil down to a one-time push.

It's also clear that one the biggest challenges is simply engaging a culture whose ways and habits have become contrary in many ways to the goal of good health.

"I think what we've really got to get into is the social norms and values of our culture in the South," Sutton said.

"There's a belief that if it's not fried, it's not really good. And there is some evidence to support that at a very young age, you're taught to eat until you can't eat any more — as opposed to until you're satisfied."

Meanwhile, the biochemical side of eating and satisfaction is a current topic of study at UMC, where Hall and fellow researchers are exploring the role of the hormone leptin in regulating appetite.

"It does a good job in lean individuals," Hall said. "But in obesity, somehow the brain resets to this hormone, at least in terms of regulating the appetite. It doesn't seem to do a good job of that, but it does raise blood pressure, so you end up with the worst of both effects."

As they work to understand the biochemical pathways involved in this process, researchers at UMC are preparing for the institution of a comprehensive obesity center on the campus. Space has been dedicated for that purpose inside the new eight-story Arthur C. Guyton Research Center, which was dedicated in September.

"We want to cover not only the physiology but also some of the clinical aspects of obesity treatment and, most importantly, the various strategies that will help us prevent obesity in our state," Hall said.

To that end, UMC will be looking to the federal government for funding support as it seeks to lead the statewide effort to fight obesity.

"We have great hopes that we will be able to put together a comprehensive statewide plan for developing not only the tools but also strategies for the prevention of obesity," Hall said. "If we can succeed in doing something about obesity in our state, we'll be a laboratory for the rest of the country."

For healthcare professionals around the state, being part of that effort includes simply being upfront with patients about the risks of being overweight and, if possible, helping them to lose weight, Hall said.

Nevertheless, he said, fewer than 50 percent of people who are obese get that message from their physicians, while those who do are three times more likely to make changes and lose weight.

The importance of talking to patients about their weight is also a central message Sutton brings to the doctors and nurses he speaks with.

"You have an opportunity to actually see patients and see the problem up close," he said. "You would be amazed that oftentimes doctors feel uncomfortable saying certain things, but that trend is changing.

"Giving them a prescription to exercise more, eat healthy, become more active and change their behaviors is a great prescription to give."

Tags:

Arthur C. Guyton Research Center, John E. Hall, Obesity prevention, Office of Preventive Health for the Mississippi Department of Health, Safe Routes to School grant program, University of Mississippi Medical Center Department of Physiology and Biophysics, Victor Sutton

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