Last week I had the daunting task of delivering a lecture to medical and pharmacy students at my alma mater-University of Cincinnati. My charge was to bring them up to speed re our nation's obesity crisis since that is what will probably have the greatest impact on their forthcoming practice of medicine.

The students (and faculty) were stunned by a CDC power point I showed them that powerfully illustrated the rapid advance of obesity in the U. S. I followed that up by reminding them that it was not long ago that Type II diabetes was called Adult Onset diabetes but the name was changed when so many young people developed the disease. Statistical data predict that these overfat youngsters can expect to lose limbs and face blindness from complications of this serious illness. Of course there are other ramifications of a nation where more than 65 percent of the population is over a realistic goal weight but I chose to focus on a couple other issues.

First I shared my perspective that our culture sets us up to be obese and that it's our children who will pay the price. Even the most conscientious parent cannot compete with the more than 10,000 food messages our kids see on T. V. If asked where they get their nutrition information they respond, "Ronald McDonald" (or Britney Spears or Shaquille O'Neal, etc.). Ronald may be preaching a healthy lifestyle but he's also doing a great marketing job for McDonald's where more than 600 million high fat, empty calorie Big Macs are sold every year. Franchises subsidize diminishing school budgets so kids don't stand a chance when it comes to choices re what they will eat in school. As one med student asked (after I told the audience that the U. S. Government entire budget for nutrition education is one fifth the advertising budget for Altoids mints) "If children don't have a choice in school lunchrooms, does that set the stage for suing these franchises later in life?"

I couldn't answer that provocative question. Americans don't like to be legislated. They sure don't like to be told what to eat. My weight management guru, Dr. Kelly Brownell who heads the weight management and obesity department at Yale University is preaching the "change the food and fitness culture" message and he showed me a postcard he received after his new, must read book, FOOD FIGHT, gained some media attention in recent weeks.

"Mind your own damn business. You're motivated - like nearly all liberals - by book sales, caring less about a person's diet. What a person eats is none of your business - or teachers - or the government! A pox on your house."

In a post-lecture discussion another student posed the question, "Should the insurance companies cover or should the government pay medical costs for people who choose to eat without regard for health and/or avoid the physical activity that can make them fit even if they are overfat?"

Regardless of where you stand on the food/fitness culture issue and the effort to change it, there's no denying that poor diet and a lack of physical activity are exacting a tremendous toll on our population. We've taken action to reduce breast and other forms of cancer, immunizations are required and if you don't buckle up you can get a ticket. We tend not to like to interfere with business but we interfered with the tobacco business because cigarette use was the source of illness and death for thousands of people. Smoking isn't gone but the decrease in smoking and the protection non smokers have from second hand smoke is one of health's greatest accomplishments.

Now we have another public health emergency on our hands. It's expected to take another twenty years to stem the obesity tide. Meanwhile, without action, many of our loved ones will pay the price.

What's our role when it comes to protecting our health-especially the health of our children? Robert Butler, M. D., Former., Former Director of the National Institute on Aging had the best anti-obesity perspective when he said, "If exercise could be packaged in a pill, it would be the single most widely prescribed and beneficial medicine in the nation." I agree. A little bit of exercise can improve health parameters significantly. And, if you're willing to go the extra mile, you just might live healthy for a long time.