William H. Dietz

By:Phil Lawson Issue: Biennial of the Americas 2010 Section:The Americas Roundtables

What has caused the obesity epidemic? “Everything.”


William H. Dietz, M.D., Ph.D., Director of the Center for Disease Control, served as a contributor at the Healthcare Roundtable where he expounded on the causes of obesity throughout the Americas and their effects on the healthcare system.

His comments about obesity—that the causes are not really known were central to the discussion. He said, “I’m often asked what has changed to cause this epidemic and the answer is ‘everything'- the way we eat, the way we produce foods, the way we get from one place to another. Thirty years ago most children walked to school… I am not sure that trying to think about what the cause is, is as productive as trying to identify effective solutions.”

Dr. Dietz outlined target behaviors and strategies that the CDC has identified to help promote change. They included simple things like physical activity, increased rates of breast feeding, increased fruit and vegetable consumption, reduced television viewing, reduced consumption of sugar-sweetened beverages, and the reduced intake of fast foods or high-calorie foods.

Dietz further elaborated on these strategies. He said, “The key to increased fruits and vegetables is improving access; about 30 percent of this country does not have access to supermarkets where they can buy healthy food at reasonable prices or where there are healthy foods. Dietz explained, “Alternatives to sugar-sweetened beverages, like water in schools, is also very important. But, it turns out in Boston many schools can’t use their water supply because it comes through lead pipes.”

Other strategies involve social support for breast feeding—what Dr. Dietz described as, “Baby friendly hospitals where breast feeding is the expectation, and where formula is not the default.”

“What we are trying to do with respect to these strategies is think about environmental changes driven by policy,” Dietz said, zeroing in on an additional challenge expressed by another speaker during the July 8th session. “We heard today that this is often characterized as an ‘issue of personal responsibility.’ Well, people need to make the right choices, but in order to make the right choices they have to have those choices to make. And in many cases those choices are not available—the easy choices are not readily accessible. So we are focused on ways to make that an easier choice.”

Because obesity, which is a singular issue, is wrapped in a complex interconnected set of actions, what is one to do? Dietz says that, “Systemic changes are going to be required. The environment is what has changed, and what has led to the issue of obesity. Changing that environment in a healthier way is what our goal has become.”

William H. Dietz, M.D., Ph.D., is the Director of the Division of Nutrition, Physical Activity, and Obesity at the CDC. Prior to his appointment to the CDC, he was a Professor of Pediatrics at the Tufts University School of Medicine, and Director of Clinical Nutrition at the Floating Hospital of New England Medical Center Hospitals. He received his medical degree from the University of Pennsylvania in 1970 and a Ph.D. in Nutritional Biochemistry from the Massachusetts Institute of Technology. He is a member of the Institute of Medicine, a recipient of the Holroyd-Sherry Award from the American Academy of Pediatrics for his contributions to the field of children and the media, and the recipient of the 2006 Nutrition Research award from the AAP for outstanding research in pediatric nutrition.