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Posted on Wed, Oct 5, 2011 : 9 a.m.

Improving Michigan's economy by uniting to curb obesity

By Washtenaw County Public Health

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Keven Mosley-Koehler

In 2008, Michigan spent $3.8 billion in obesity-related medical costs If obesity continues to increase at its current rate, by 2018 Michigan will spend $12.5 billion on obesity-related medical costs.

The governor’s Obesity Prevention Summit in Lansing on Sept. 21 invited 500 Michiganders from all sectors and regions to help develop a plan to increase the number of Michiganders who are at a healthy weight. Governer Synder issued a statewide “call to action,” and proposed a framework that uses partnerships, data and evidence-based strategies.

As a representative for Washtenaw County Public Health (WCPH), I brought an open mind to the Summit, eager to achieve consensus about causes and solutions to this critical issue, yet also some trepidation since the topic is often emotional. Since our “charge” was to reach consensus on key strategies for reducing obesity in Michigan, I knew the day would involve tension.

The governor started by re-iterating a fact that unified us: obesity is killing Michigan economically, physically and emotionally. He also conveyed an urgent need for positive action. We then heard two individuals eloquently summarize what’s known about obesity and what can be done about it. They established a few premises to guide the day’s work:

  • Obesity is complex and its causes are systemic
  • There’s no “magic bullet”
  • Individuals are responsible for making healthy choices
  • When the places where we live, learn, work, and play are intentionally designed to make healthier choices easier, people will make healthier decisions more often.

Next, Ms. Olga Dazzo, Director of The Michigan Department of Community Health, issued our challenge: work in small groups (defined by sector such as schools, childcare, healthcare, community, and worksite) and agree on three to five strategies most likely to reduce and prevent obesity. We were provided with a chart of “promising” or evidence-based obesity prevention strategies and actions recommended by the Centers for Disease Control and Prevention.

I attended a worksite group. Sparks flew early as opinions about causes, factors, costs, and solutions were offered and quickly picked apart. Our group facilitators were miraculous, and kept us on track (and in our chairs!) as passionate and often heated debate transpired over the next few hours. Finally, we found common ground on a handful of strategies that blended and balanced the group’s diverse philosophies.

Most importantly, and in our own way, we seemed to achieve consensus on how to approach obesity in the workplace:

  1. While employers should play a role in arming their employees with awareness and skills to make healthier choices about eating right and moving more, this alone is not enough to ensure employees will make healthy choices more frequently than unhealthy ones at work.
  2. Employers should consider creating work environments that make healthy choices easy and readily available.
  3. All sectors have a role in reversing obesity trends. If all worksites created a culture of health, without other sectors (families, childcare, schools, health systems, community, policy makers) doing the same, individuals will still struggle to consistently choose the healthier options over less healthy ones.

As all groups re-convened to share their strategies, it was clear our group was not the only one challenged by the exercise. We knew the next hour would be critical.

And this is where it got really interesting and frankly, quite exciting. As workgroups revealed their strategies, several things occurred:

  1. Similar themes emerged, signaling the achievement of common ground.
  2. Several strategies complimented, aligned, and supported one another, building bridges across sectors that traditionally functioned in silos.
  3. Accountability for obesity was balanced. Some recommendations focused on individual knowledge about healthy eating and physical activity, and others looked to create environments that make it easier for individuals to make healthy choices.
  4. The concept of applying partnerships, data, and evidence-based strategies kept surfacing, true to the governor’s original framework

As the summit concluded, the room echoed with enthusiastic chatter, signaling both a new respect for different opinions and relief at finding common ground. I left with new validation that Washtenaw County’s longstanding framework for improving community health — partnerships, data, and strategies — aligns with the direction our governor is taking Michigan.

This ends part one of Improving Michigan’s Economy by Uniting to Curb Obesity. In Part two, I will answer several questions including:

  • How does Washtenaw County use partnerships, data and strategies to address complex health issues like obesity?
  • What does applying partnerships, data, and strategies look like?
  • Why might this approach be one reason why Washtenaw County is one of the healthiest places to live in Michigan?

Keven Mosley-Koehler is the Health Improvement Plan coordinator for the Washtenaw County Public Health Department. She can be reached at 734-734-544-3078 or



Fri, Oct 7, 2011 : 2:25 p.m.

Governor Snyder has stated that Michigan is getting emotionally killed by obesity. Is that observation evidence-based? How could you expect to arrive at evidence-based strategy when there is no evidence for your observation? Kindly define your concept or understanding of emotional well-being. Evidence suggests that people could be eating more to support their emotional well-being. If there is no emotional satisfaction, why would they be eating more? When a person becomes obese, the dissatisfaction is often related to the effects of that obesity, and the person would still continue to satisfy his food cravings. To prevent obesity, man has to understand the substance called food and define the nature of his relationship with food. A smoker's craving for tobacco, and an alcoholic's craving for alcohol are similar to food craving. The relationship between man and food is influenced by his attitude. To know food and drink as a spiritual medium that could be used to develop an association, a partnership, a relationship, and bonding with the Creator would formulate an attitude that gives emotional satisfaction without overindulgence. <a href="" rel='nofollow'></a>

A. F. Jackson

Thu, Oct 6, 2011 : 10:49 p.m.

While I agree that there are psychological factors involved, there are also many environmental and cultural factors -- and those are the areas where we can, as a society, improve. Meanwhile, some individuals may also need therapy to assist them in transitioning to a healthy lifestyle.


Thu, Oct 6, 2011 : 3:05 p.m.

FOOD AND SPIRITUALITY : Firstly, I do not believe in the numbers that describe health care costs that may pertain to the problem of obesity. There is too much of corruption as hospitals and medical care providers could be intentionally inflating the costs of their services. We need to understand the functions of food to find a solution to the problem associated with excessive eating. The causation of obesity could be difficult to explain. Obesity is the commonest effect of continued over consumption of calories. A person could become obese even if he chooses to eat healthy foods. Obesity develops if physical activity or energy expenditure becomes very low and the person is not able to reduce the food intake or energy intake. The physiological mechanisms that control and regulate hunger and feeding behavior are not adequate as eating is to some extent influenced by man's sense of satisfaction about his condition called living. The desire to eat or consume food and experience a sense of gratification is similar to other desires like the desire for sex, or for material possessions. At a fundamental level, the desires of man are never fully satisfied. Man exists with a sense of unknown dissatisfaction in life. A person who lives in a state of self-contentment experiences a little less hunger, and derives a sense of satiation more easily after a routine meal. Such a person who is self-contented is not genrally prone to food cravings. He is more likely to maintain a steady body weight without changing his physical activities. A contented person is more likely to meet the daily requirements of calories for optimal physiological functioning without gaining body weight. It is easy to measure body weight. It is not easy to quantify characteristics like satiation, satisfaction, or contentment. There is no acceptable scale to measure these attributes. However, we understand that eating behavior, like other human behaviors involves interaction of senses, mind, and intellect.


Thu, Oct 6, 2011 : 2:47 p.m.

Easy - a great idea. There is just too much of me. Ways to off set eating too much are not that interesting. 1- Walking always dis-liked it. Running worked; but now at an advanced age not so much. 2- Working out is just far enough away that it becomes expensive to visit the Y everyday or even every other day. Waer &amp; tear &amp; fuel costs not counting the Medicare increases on a fixed income. 3- Cooking is a shared hobby with the spouse. It's challenge &amp; fun to try dishes from around the world. We reduce, eliminate,items we know are not good for us in excess. 4- The source of the numbers is observation in grocery stores. Patrons &amp; their shopping carts. Observation in American excess served by feeding only what the family likes. 5- Failure to read labels. Failure to know that a little bit extra butter tastes good; but may not be good for you. 6- Never forget the the Chef saying: &quot;Add salt &amp; fat to make it taste good&quot;.

A. F. Jackson

Thu, Oct 6, 2011 : 12:09 a.m.

I agree that all sectors have a role in reversing obesity trends. It surprises me that the governor is on top of this issue! Thanks for posting the info.

Ruth Kraut

Wed, Oct 5, 2011 : 3:47 p.m.

It's always good to know the source of statistics. Here is the source of those numbers: Overweight and Obesity in Michigan: Surveillance Update 2011. The document is found online here: <a href="" rel='nofollow'></a>

Sarah Rigg

Wed, Oct 12, 2011 : 1:14 p.m.

Chalking those costs up to &quot;obesity&quot; is misleading. The references in the pamphlet you linked to say the health care costs are due to &quot;inactivity&quot; NOT obesity. You can be thin and unfit, and you can be &quot;overweight&quot; and fit. Everybody needs to exercise, not just the &quot;overweight&quot; and &quot;obese.&quot;

Sarah Rigg

Wed, Oct 5, 2011 : 2:07 p.m.

What's the source for the claim/numbers at the top? Those kind of precise figures always make me EXTREMELY skeptical, because it's hard to pull out exactly what conditions and expenses are &quot;obesity-related.&quot; Here's an article about the flaws in studies that purport to show skyrocketing costs associated with obesity: <a href="" rel='nofollow'></a>