The health problems associated with obesity and physical inactivity have a significant economic impact on the U.S. health care system and a considerable influence on costs related to decreased worker productivity, restricted activity, and time missed from work. To address these issues, the American College of Sports Medicine (ACSM) today held a special scientific session on the economic cost of physical inactivity and obesity during its 54th Annual Meeting in New Orleans.

The session, chaired by Geoffrey E. Moore, M.D., cites CDC reports that obesity cost the nation an estimated $117 billion in 2000. Also that year, a paper published by session panelist Michael Pratt, M.D. MPH, estimated that direct medical costs related to physical inactivity costs are about $76 billion.

Inactivity doubles the risk of developing heart disease, type 2 diabetes, and obesity. It increases the risk of hypertension by almost one third, and doubles the risk of dying from cardiovascular disease and stroke. Being overweight or obese increases the risk of many diseases and health conditions, including hypertension, high total cholesterol, high levels of triglycerides, type 2 diabetes, gallbladder disease, sleep apnea and respiratory problems, back pain, osteoarthritis, and some cancers. Although one of the national health objectives for the year 2010 is to reduce the prevalence of obesity among adults to less than 15 percent, current data indicate that the situation is worsening rather than improving.

"The economic impact of inactivity and obesity are critical for us to consider," said Moore. "If we look historically at the rise in health care costs, we can see that these costs currently represent 16 percent of the gross domestic product (GDP) in the United States. These costs are expected to reach 20 percent of GDP by 2016. How high can it go and how these growing costs will be met are questions that must be addressed."

The current U.S. medical model usually involves approaching health from an individual standpoint. However, Moore believes there is a limit to the practicality of this model. "We have to look at solving the health issues related to obesity and inactivity at the behavioral (lifestyle) and community level." He points out that some areas of opportunity include schools and the built environment.

The panel suggests schools are an opportune place to start. "A good deal of infrastructure is already in place in schools. They are somewhat controlled environments, and typically schools have access to health professionals such as nurses and dieticians," Moore said. He adds a caveat, "While schools can be a keystone in building healthier communities, there needs to be enough political will to allocate the resources to address complex issues, including what children are eating and their opportunities for physical activity."

Commenting on the built environment, Moore explained, "People need places where they can be active and safe. These might involve sidewalks, trails, and parks, as well as the general design of communities." In most cases, initiatives aimed at making communities more activity-friendly require collaboration between public and private entities. Moore pointed to the example of the "Rails to Trails" program, which works to create a nationwide network of trails from former rail lines and connecting corridors. Rails to Trails promotes trail-building policy at the national and state levels. And the organization catalyzes action at the community level by providing information, technical assistance and training that local trail builders need.

Pratt notes that improving access to places for physical activity such as trails and parks, and enhancing neighborhoods and communities, are recommendations from the CDC's Task Force on Community Preventive Services Community Guide. "The analyses presented in today's ACSM session demonstrate that enhancing access to places for physical activity, coupled with informational outreach, is a cost effective strategy for increasing physical activity," he said.

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 20,000 international, national, and regional members are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.