Epidemiologists paint a gloomy picture of the health of our young people. During the past two decades, a significant increase in obesity and obesity-related disorders such as type 2 diabetes, hypertension, and dyslipidemia has occurred among people in their teens and 20s (1,2). Those of us who are middle-aged have difficulty accepting chronic disease in our own lives; seeing it prematurely affect the younger generation is even more distressing.
Little progress has been made in controlling or preventing obesity, because the cards are stacked against us. Obesity is a complex adaptation to existing environments that greatly favor high energy intake and low energy expenditure (3). Food is everywhere, and it is generally inexpensive, flavorful, large-portioned, and high-calorie. In addition, we rely on energy-saving devices and technology throughout the day, and most of our waking hours are spent sitting.
No medical breakthrough is on the horizon. Even with continued advances in genomics and molecular medicine, scientists are unlikely to discover an effective, safe, and affordable drug that would cure or prevent obesity. From a public health perspective, the best solution remains encouraging positive behavior changes associated with diet and physical activity. However, although obesity is generally acknowledged as a serious problem and difficult to solve, many college and university leaders view helping overweight students as being outside the purview of higher education.
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Recognizing the Need for Action
Concern about student behaviors related to alcohol, drugs, and sexuality overshadows the need to emphasize the mundane but important habits of eating healthfully and exercising regularly. Campus student services have long been established to manage the perennial coming-of-age issues associated with substance abuse and sexual behavior. These programs are continually updated to guide students toward responsible decision making and to minimize crises. Let the good work continue. However, excess body weight has emerged as a new challenge. The data are convincing. Findings from a national survey conducted in 2005 indicate that 3 of 10 college students are either overweight (body mass index [BMI] 25.0–29.9 kg/m2) or obese (BMI ≥30.0 kg/m2) (4). Behaviorally, 9 of 10 students eat fewer than five servings of fruits and vegetables per day, and nearly 6 of 10 students participate fewer than 3 days per week in vigorous-intensity (20 minutes or more) or moderate-intensity (30 minutes or more) physical activity (4). Although excess weight, poor nutrition, and insufficient physical activity are not emergencies that require immediate action, their urgency should not be underestimated.
The predominant way obesity is thought about and confronted — particularly at research universities — is far removed from the current needs of overweight students. The emphasis is on scientific inquiry; researchers focus on unraveling the biological complexities of obesity and related medical conditions. Although universities assemble top-notch biomedical teams to conduct basic research, the institutions often ignore the problem of obesity on their own campuses. This type of disconnect is not new to academia, and the explanation is straightforward. Universities are increasingly dependent on external dollars to remain solvent, and eminent research teams bring in major funding from federal agencies and biotechnical companies.
Simply put, a