举国之重

　　The obesity epidemic is one of the most pressing health issues facing the nation today. More than two-thirds of U.S. adults age 20 and over are overweight or obese, while nearly one-third of the nation’s children and adolescents age two to 19 are overweight or obese. Obesity contributes to five of the ten leading causes of death in America, including heart disease, type 2 diabetes, cancer, stroke and kidney disease.
　　An unprecedented collaboration of HBO and the Institute of Medicine (IOM), in association with the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), THE WEIGHT OF THE NATION takes an unflinching look at the severity of the crisis and its crippling effects on our health care system. Made in partnership with the Michael & Susan Dell Foundation and Kaiser Permanente and three years in the making, it is one of the most far-reaching public health campaigns on this epidemic to date, comprising four documentary films, a three-part series for families, 12 bonus shorts, a robust website and social media campaign, a book published by St. Martin’s Press, and nationwide outreach to more than 40,000 community-based organizations.

　　THE WEIGHT OF THE NATION kicks off with CONSEQUENCES, debuting MONDAY, MAY 14 (8:00-9:10 p.m. ET/PT), immediately followed by CHOICES (9:10-10:30 p.m.), with CHILDREN IN CRISIS debuting the next night, TUESDAY, MAY 15 (8:00-9:10 p.m.), immediately followed by CHALLENGES (9:10-10:15 p.m.).
　　In addition, the first part of the three-part series “The Weight of the Nation for Kids,” entitled “The Great Cafeteria Takeover,” debuts Wednesday, May 16 (7:00-7:30 p.m.), with all three parts to be presented during back-to-school season this fall.
　　“Obesity has become one of the most serious threats to the health of the American people,” comments Harvey V. Fineberg, MD, PhD, president of the IOM, whose work, including a new study on accelerating progress in obesity prevention, is featured in the HBO series.
　　“If we don’t succeed in turning this epidemic around, we are going to face, for the first time in our history, a situation where our children are going to live shorter lives than we do,” says NIH director Francis S. Collins, MD, PhD
　　“Obesity-related health care costs about $147 billion annually, and on average, it costs $1400 more a year to care for someone who is obese,” notes Thomas R. Frieden, MD, MPH, director of the Centers for Disease Control and Prevention. “To get healthy, we’re all going to have to do our part – individuals, communities, local, state and the federal government…We’re going to face steadily increasing health care costs, as well as more lives lost to type 2 diabetes, heart disease, many cancers and other complications from obesity.”
　　To reach the broadest possible audience, HBO will use all of its services, including the main HBO channel, multiplex channels, HBO On Demand, HBO GO and more. All films will be available in English and Spanish and will stream free of charge on HBO.com, as well as on multiple platforms by participating TV service providers.
　　The four films in THE WEIGHT OF THE NATION are:
　　Part 1: CONSEQUENCES
　　Debut: MONDAY, MAY 14 (8:00-9:10 p.m. ET/PT)
　　America is on the brink of a public health crisis that affects not only individuals, but the entire society. With more than 68% of American adults overweight or obese, CONSEQUENCES examines the scope of the obesity epidemic and explores the serious health consequences of being overweight or obese.
　　Obesity can lead to such health problems as: heart disease; type 2 diabetes; many cancers; high blood pressure; stroke; joint problems; sleep apnea; kidney, gallbladder and non-alcoholic fatty liver disease; infertility; and depression.
　　“Today, there are almost 26 million Americans with diabetes – seven million of whom don’t even know they have it – and more than 79 million Americans are pre-diabetic,” says Anthony Iton, MD, JD, MPH, senior vice president of the California Endowment. “A child born in 2000 has a one in three lifetime chance of having diabetes. If that child is African-American or Latino, it’s one in two.”
　　America’s collective weight has risen dramatically since the 1980s, with adult obesity rates more than doubling. All Americans pay the price in one way or another, from higher insurance premiums and lost productivity to higher taxes and unemployment.
　　CONSEQUENCES includes a look at a community in Bogalusa, La, which is home to the historic NIH-funded Bogalusa Heart Study, the first investigation to link early childhood weight problems with adult heart disease. The film also profiles Sam Klein, MD, who is conducting a novel study looking at the negative impact of excess weight on liver function at Washington University, and explores the work of David Nathan, MD as he explores the risks and dangers of weight gain and diabetes at Massachusetts General Hospital.
　　“This is preventable,” comments Jack Shonkoff, director, Center on the Developing Child, Harvard University. “This is not one of those unfortunate acts of nature that we just have to accept as reality. This is not the product of a tsunami.”
　　Part 2: CHOICES
　　Debut: MONDAY, MAY 14 (9:10-10:25 p.m.)
　　Obesity is commonly thought of as simply a matter of lifestyle and personal choice, but there are many factors that contribute to the problem – and many solutions are needed to fix it. In the meantime, millions of overweight and obese Americans struggle to lose pounds and keep them off. CHOICES provides “the skinny” on fat, sharing scientific insights into how to lose weight, and explores what needs to change in people’s lives, including where they work, eat, learn and play, while spotlighting individuals who are waging those battles successfully.
　　“Fad diets — diets that haven’t been scientifically tested and that promise miracles — shouldn’t be trusted, because there really isn’t such a thing as a miracle here,” says Kelly Brownell, PhD, director of the Rudd Center for Food Policy & Obesity at Yale University.
　　Scientists understand that maintaining weight loss is about more than willpower –bodies and brains sometimes work against such efforts. Why and how this happens is still being studied. Highlighting the work of Rudy Leibel, MD, co-director of the New York Obesity Research Center at Columbia University Medical Center, CHOICES examines the “set point” theory, which suggests that after an individual gains weight, the body establishes a new set point that it considers its new weight, or “new normal.” According to the set point theory, because bodies fight to maintain the highest weight, or set point, it’s necessary to consume fewer calories and burn more just to keep that weight off.
　　CHOICES also spotlights: weight-loss tips from a supervised program at Washington University; the history and myths of dieting; the benefits and drawbacks of bariatric surgery, which can reduce stomach size; and the importance of losing weight, even just a little, to prevent or reverse diabetes.
　　The film also looks at how stress can affect eating habits and contribute to obesity. “It’s really not just about what we’re eating, but it’s about what is eating you,” says Elissa Epel, co-director of the Center for Obesity Assessment, Study & Treatment at the University of California, San Francisco. “We have an epidemic of obesity. We also have an epidemic of stress. And the two are feeding each other.”
　　Part 3: CHILDREN IN CRISIS
　　Debut: TUESDAY, MAY 15 (8:00-9:10 p.m.)
　　America’s children may be the first generation in history to have a shorter lifespan than their parents. Approximately 32% of America’s young people are overweight or obese. CHILDREN IN CRISIS tells the heart-wrenching stories of young people struggling with excess weight and facing serious medical complications at an early age, and takes a hard look at the marketing practices of the food and beverage industry, which often undermine efforts of parents and others committed to keeping children healthy.
　　“If you were told your child is at risk for cancer, that would get your attention,” comments NIH director Collins. “If you were told your child is at risk for some sort of brain disease, that would get your attention. Well, obesity ought to be on that list.”
　　While the food and beverage industry has voluntarily made some progress in improving the nutritional value of the products it markets to children, an ongoing debate over the definition of good nutrition continues among industry, researchers and government. CHILDREN IN CRISIS highlights efforts to persuade policymakers to do more to protect children.
　　“Government has a responsibility to act, but they’re not the whole answer,” says Margo Wootan, DSc, director of Nutrition Policy at the Center for Science in the Public Interest. “We also need companies to step up, to reformulate their products, to change their marketing practices and to make healthy options available in restaurants.”
　　Families face an uphill battle in getting their children to be physically active and eat the right amount of healthy foods. Dr. Elsie Taveras, MD, who runs the One Step Ahead Program at Boston Children’s Hospital, says that “more and more research is showing actually that children are exposed to pretty toxic advertising.” This advertising, combined with little advertising for fruits and vegetables, fuels cravings for sugary food and beverages. Sodas and fruit drinks are the largest sources of added sugar in the diets of American children and adolescents.
　　America’s schools are a great place to set strong examples about healthy eating and living, but a U.S. Department of Agriculture (USDA) study found that 94% of schools served a lunch that failed to meet their own standards for healthy school meals. Students have access to a variety of foods and beverages high in calories, added fats and sugars at school. Furthermore, most U.S. school districts have eliminated physical education programs, while there is no federal law requiring physical education.
　　Part 4: CHALLENGES
　　Debut: TUESDAY, MAY 15 (9:10-10:15 p.m.)
　　Some experts project that by 2030, between 32% and 52% of American adults may be obese. CHALLENGES examines the driving forces behind the obesity epidemic, including agriculture, economics, evolutionary biology, racial and socioeconomic disparities, physical inactivity and the strong influence of the food and beverage industry. “In the future, it wouldn’t surprise me if people look back on the early part of the 21st century and call this the obesity era,” says Dr. Thomas Farley, New York City’s health commissioner.
　　The film shows how food is produced and marketed, which can have severe consequences for the nation’s health. For example, national farm policies, including subsidies for corn and soy, have contributed to an abundance of processed foods that are high in calories and low in nutrients. However, fruit and vegetable farmers get little support, and only 3% of American crop land is used for fruits and vegetables. Furthermore, the vast majority of Americans fall short of meeting recommendations for daily servings of fruits and vegetables. High-calorie food is often much cheaper than vegetables and fruit.
　　CHALLENGES also reveals that the industry’s emphasis on taste and cost has resulted in large, low-price, high-calorie portions, fostering a culture of excess and contributing to the spread of obesity. Philip Marineau, former president of the Quaker Oats Company, Pepsi-Cola North America comments, “Food companies are trying to sell more today than they did yesterday. And if they don’t, then they’re not considered successful. And ultimately, if we are going to be successful in reducing obesity, people are going to consume less. And that’s the conundrum.”