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MILWAUKEE - The proportion of Americans who are severely obese - at least 100 pounds overweight - has quadrupled since 1986, according to a study released Monday.
In the latest bit of disturbing news on America's growing obesity problem, the rate of severe obesity rose from 1 in 200 adults to 1 in 50, or about 4 million Americans, from 1986 to 2000.
The rate of extreme obesity - generally those at least 175 pounds overweight - increased fivefold, from 1 in 2,000 to 1 in 400.
Previously, many doctors considered severe obesity to be an uncommon condition that largely represented a fixed percentage of people. However, the study's author, Roland Sturm, senior economist with the Rand Corp., said that as simple obesity increases, severe obesity grows even faster.
Overall obesity - generally those who are at least 30 pounds overweight - doubled during the study period.
"There is no evidence that it (the obesity rate) is flattening out," Sturm said. "It's full speed ahead."
Sturm has done projections showing that if nothing is done, the number of obese Americans will jump from about 20 percent of adults today to 80 percent by 2040, and the proportion of normal-weight people will drop from 42 percent today to 5 percent in 2040.
Sturm's study, which appeared Monday in the Archives of Internal Medicine, is based on nationwide telephone surveys conducted by the U.S. Centers for Disease Control and Prevention in which people are asked their height and weight.
Sturm said the trend largely is the result of the increasing affordability of calorie-dense food.
"We've reached Nirvana," he said. "Food is cheap and plentiful. You can stuff yourself on less than a half-hour of minimum wage."
The trend also is fueled by a substantial reduction in the amount of physical activity that Americans engage in, said Linda Baumann, a nursing professor at the University of Wisconsin-Madison.
School physical education budgets have been cut, suburban neighborhoods have been built without sidewalks and "children are driven instead of walking to school," said Baumann, who also is president of the Society of Behavioral Medicine.
Obesity researchers say the trend has to be reversed or the health consequences will be devastating.
"How can we put up with having this many people that large?" said James Hill, an obesity expert at the University of Colorado. "We have to do something quick. We are losing the battle quick."
James Paprocki, 57, of Mukwonago, Wis., has been severely obese for years. Because of his sales job, he travels a lot and eats in restaurants 50 percent of the time, he said.
In April, just before he joined Weight Watchers, he weighed 402 pounds. But after six months in the program, his weight is down to 320 pounds. He said he thinks he can eventually reach his goal of about 250 pounds.
Paprocki said he lost the weight, not by using trendy weight-loss programs such as the Atkins diet, but by eating smaller portions.
But losing a significant amount of weight and keeping it off can be extremely difficult, especially for those whose weight has ballooned to more than 400 pounds, said Theodore Weltzin, a physician and director of the eating disorders program at Rogers Memorial Hospital in Oconomowoc, Wis.
"What happens is they develop a sense of hopelessness," Weltzin said. "Their way of dealing with stress is eating. They just get overwhelmed and give up."
Obesity, especially severe obesity, can have serious health consequences, said Ahmed Kissebah, a physician, endocrinologist and obesity researcher at the Medical College of Wisconsin.
The obese have substantially higher rates of high blood pressure, diabetes, heart disease, stroke, cancer, arthritis and back problems, he said.
And once a person becomes obese, he or she easily can move to severe obesity, he said.
Kissebah said medical schools need to add programs that teach doctors how to treat the obese.
(c) 2003, Milwaukee Journal Sentinel. Distributed by Knight Ridder/Tribune News Service.