Former Surgeon General C. Everett Koop Tuesday urged doctors to view obesity as a dangerous and chronic disease that can be treated with diet, exercise, drugs and even the Internet.
Known for waging war on smoking and tackling a then-controversial public education campaign on AIDS in the 1980s, Koop has turned his attention to the ballooning fat problem through his organization, Shape Up America, which developed new medical guidelines for doctors and is introducing a "cyberclinic" for obese people on the Internet.
Koop said at a news conference that doctors have to become more involved in treating obesity, which he called "the second leading cause of preventable death" in the United States.
He noted that when he became surgeon general in the 1980s, one out of four Americans was overweight. Now one in three people is obese.
Obesity has been linked to heart disease, diabetes, hypertension, gall bladder disease, arthritis and certain cancers, including colorectal and prostate cancer for men and endometrial, cervical, ovarian and breast cancers for women.
For people who are at low to moderate risk, nutrition and exercise are the keys.
For those at higher risk for serious health problems because of obesity, weight-control drugs also can be used. In extreme cases surgery may be an option, according to the Shape Up guidelines, which have been reviewed by several medical and public health groups.
To figure out whether an individual is just carrying around a few extra but relatively harmless pounds or whether he or she is obese, Koop urged patients and doctors to rely on the Body Mass Index, or BMI, a fairly simple formula based on height and weight.
Koop said doctors should give it as much importance as blood pressure or cholesterol checks.
BMI charts are available to doctors and will also be seen soon on an Internet web site Shape Up is setting up, www.shapeup.org/sua.
The web site also will include a "cyberclinic" where people can figure out their BMI and also click on to a virtual gym, where they can get advice about fitness and an exercise routine as well as background information on nutrition and health.