California always seems to be ahead on things that matter. A CNN story this week highlights that state’s terrific anti-obesity TV campaign. The ads have cute kids sweetly asking “Dad, could you buy me some diabetes?” and “Can I drink another cup of sugar?” The goal is to shock adults into appreciating that the cheap, tasty foods they shovel down their children’s gullets will have real impact. In one of the CNN clips, Adam Sandler says the ads work so well that he and his little girl suddenly dropped their cheeseburgers. I passed along the link to folks in Florida’s government, and asked, “Why aren’t we doing something like this?”

It’s a fair question, but these ads, powerful as they are, are hardly a match for the food industry’s virtually unlimited resources and unrestrained marketing power. A well-intentioned state agency may place a few high profile ads, but the food companies can run theirs unrelentingly and in many different media. They’re all over kids’ TV programming, in children’s books, and at schools. They have product placements in the movies and are on Internet gaming sites. It’s difficult to go head-to-head and expect to win against such sophisticated techniques and on so many fronts.

We’re utterly losing the war on obesity. The disease and cost numbers make that abundantly clear. The other day, Bob Laszewski at The Health Care Policy and Marketplace Review reminded us of an important 2005 Emory University study on the topic. The team, led by prominent health services researcher Kenneth Thorpe Ph.D, analyzed the 20 medical conditions that accounted for most of the growth in health insurance spending between 1987 and 2002.

The conditions, in order of their influence, included:

  1. Newborn and Maternity Care
  2. Cancer
  3. Pulmonary Conditions
  4. Arthritis
  5. Mental Disorders
  6. Hyperlipidemia
  7. Hypertension
  8. Lupus
  9. Back Problems
  10. Upper Gasterintestinal
  11. Diabetes
  12. Kidney Problems
  13. Infectious Disease
  14. Heart Disease
  15. Skin Disorders
  16. Bronchitis
  17. Endocrine Disorders
  18. Other Gasterointestinal Diseases
  19. Bone Disorders
  20. Cerebrovascular Disease

During that 15-year period, the cost of treating obesity-related conditions rose tenfold, growing to two-thirds of our total healthcare spending. The number of people who became obese, the percentage of obese people with serious medical conditions, and the cost to treat each obese patient all skyrocketed.

The study’s authors had a simple summary statement:

“If insurers and employers are serious about reigning in healthcare spending, then obesity prevention should be at the top of their agenda.”

There’s no mystery here. Long term, the magnitude of the obesity crisis threatens our national health and economic welfare. The roots of obesity-related diseases and their costs lie in the marketing methods of the fast, prepared, and junk food industries. Look for the source, and you’ll find the food industry’s boardrooms and their DC lobbying offices.

California has taken the first step on this issue. We’ll soon see whether Washington takes it as seriously. On Wednesday, Dr. James Holsinger, the White House’ Surgeon General nominee said that, if he gets the job, he will focus on childhood obesity. It’s one right issue for our time, but talk is cheap. The real question is what he or someone like him would be willing to do. If he carries the torch for nutrition guidelines and curbs on food company marketing, then he’ll stand with our children and America’s future. But if he refuses to actively confront how foods are sold or what the obesity data say, then he’ll be standing with the food companies and their lobbying dollars.