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North Dakota ranks in the middle in obesity statistics

GRAND FORKS -- Millions of Americans wage a daily battle against excess body weight. A battle many are losing.

Two-thirds of adults and almost one-fifth of children in the United States are overweight or obese, according to the national Centers for Disease Control and Prevention. An adult with a Body Mass Index between 25 and 29.9 is considered overweight; an adult with a BMI of 30 or higher is considered obese.

Obesity rates in the United States have skyrocketed the past 20 years. The state with the highest prevalence of obesity is Mississippi with 34 percent; the lowest is Colorado with 21 percent.

So where do North Dakota and Minnesota fit in?

North Dakota falls in the middle, with an obesity rate of about 28 percent. In Minnesota, 24.8 percent of the population is considered obese, according to the CDC. Residents of Polk County rank above the state average, at 27.5 percent obese.

Grand Forks County also ranks above the state average, with 29 percent of residents obese by CDC standards.

"Overall, 60 percent of the [Grand Forks County] population is overweight," said Mandy Burbank, a dietitian with Grand Forks Public Health.

About half the county's population does not get the CDC's recommended 30 minutes of physical activity a day, and 78 percent do not receive the five daily recommended servings of fruits and vegetables, Burbank said.

North Dakota's obesity rate has almost doubled the past two decades, according to the CDC. In 1995, the state's obesity rate was 15.9 percent, while 46 percent of residents were at a normal weight.

Healthy People 2010, a national initiative launched by the U.S. Department of Health and Human Services, collected health data in the state between 2000 and 2009. It found that North Dakota is trending away from a goal of 15 percent obesity prevalence.

The statistics aren't all bad. The initiative did find that North Dakotans are becoming more active, with the percentage of adults engaging regularly in moderate physical activity increasing from 47 percent to 52 percent over the span of the study.

'We're all going to pay'

America's growing waistline brings physical and financial consequences.

Heart disease, some cancers, Type 2 diabetes, stroke, arthritis, breathing problems and psychological disorders such as depression are all associated with being overweight or obese.

Andrea Haugen, a dietitian at Sanford Health in Fargo, estimates 90 percent of her diabetic patients are overweight. She is seeing diabetes develop in patients as young as their 20s and 30s.

Treating chronic conditions like diabetes costs money.

In 2008, medical costs associated with obesity were estimated at $147 billion, according to the CDC.

"It [obesity] is expensive, and we're all going to pay for it," said Deanna Askew, healthy communities coordinator for the state Department of Health.

These costs can be broken down into direct and indirect costs, she said.

Direct medical costs may include preventative, diagnostic and treatment services related to obesity.

Indirect costs can be categorized into morbidity and mortality costs. The CDC defines morbidity costs as the value of income lost from decreased productivity, restricted activity, absenteeism and bed days. Mortality costs are the value of future income lost by premature death.

Medical costs paid by third parties such as insurance companies for obese people were $1,429 more than those of normal weight, according to the CDC.

Insurance plans often do not cover visits to a dietitian, Sanford's Haugen said. If this was the case, she said, she would probably see more patients.

How do we fix it?

Several recently released obesity action plans suggest the federal government can slim down the nation through a battery of public policy measures ranging from soda taxes, better school lunches and mandatory school gym policies to calorie listings on menus, fitness-friendly infrastructure and restrictions on "junk food" advertising.

In 2007, a bill to ban the sale of carbonated beverages during school hours at elementary and middle schools failed 14-33 in the N.D. Senate. The state does impose an additional sales tax on soft drinks.

The answer to the obesity problem also may come at a community level.

Public service venues, such as schools, child care centers, city and county buildings, prisons and juvenile detention centers are key venues for increasing the availability of healthier foods, the CDC says in an implementation guide for community strategy.

Burbank also includes concession stands on that list.

"A hot dog isn't always the best option," she said.

Though North Dakota does not have one program designated to combat weight gain, Askew said the state health department integrates healthy living into many of its programs.

"We've seen prevention success at the community level," she said.

One program, "Moving More, Eating Smarter" gives grants to communities that have successfully established health coalitions. These coalitions create communities capable of providing access to healthy choices, Askew said. Grand Forks, Cavalier, Nelson, Griggs, Steele, Rolette and Walsh counties are active in this program.

"People can't make healthy choices if the choices aren't available," she said.

These choices are about more than just eating well.

Establishing school wellness policies to ensure physical education programs and recess aren't cut is significant in fighting obesity in children. Creating walking and biking paths also encourages community members to become more active, Askew said.

"It's too easy for us to jump into a car," she said.

Haugen tells patients that losing just 5 percent to 10 percent of their body weight will improve their health, which may be about 30 pounds for some people.

"Losing 100 pounds just sounds daunting," she said.

McClatchy-Tribune contributed to this story.

Brandi Jewett is a reporter at the Grand Forks Herald, which is owned by Forum Communications Co.