Read more:The Shape We're In
CHARLESTON, W.Va. -- "Every week, I see 12-year-olds who weigh 300 pounds or more," West Virginia University pediatrician Dr. Pamela Murray said.
Whole families arrive at her office from rural counties with their children. Parents, aunts, grandparents -- they fill her office chairs, looking for help.
One heavy child after another walks through her door with high blood pressure and cholesterol. "They are at high risk of developing chronic diseases in the future, type 2 diabetes, heart disease, stroke and hypertension, among others," she said.
Nidia Henderson, wellness director of the West Virginia Public Employees Insurance Agency, sees the same thing. "It's heartbreaking," she said.
"We're seeing younger and younger people with type 2 diabetes and weight problems that put them at high risk of diabetes. I got a call about a 200-pound 11-year-old who lives in a remote area. We have nowhere to refer her. And that's just one example.
"The national obesity crisis is hitting West Virginia hard," she said.
"There needs to be serious discussion of this and soon," Murray said.
Every West Virginian is affected, whether they know it or not.
In 2009, health care economist Ken Thorpe warned West Virginia legislators that, if the state can't reduce the number of people of all ages with chronic diseases, its total health care spending -- public, private, everyone -- will double by 2018, to $22.5 billion a year.
Adult West Virginians are used to seeing themselves at the top of lists for heart attacks, strokes and one chronic disease after another: diabetes, heart disease, high blood pressure, kidney failure.
But how many realize obesity is a leading cause of each disease?
"Lower obesity, and you lower the rest," Thorpe told the Legislature. It's a domino effect, he said. Obesity leads to diabetes, diabetes leads to heart disease and so forth.
Children raise a red flag for West Virginia's future, said Jamie Jeffrey, director of the Children's Medicine Center at CAMC Women and Children's Hospital.
"It's just crazy," she said. "One in three children we see now is at risk of future heart disease and diabetes because of obesity.
"We're seeing hundred-pound 3-year-olds who can't walk." The extremes have become more common, she said. "Those children will die early, period, period, if we don't do something."
But "normal" has also become heavier. Jeffrey and her staff analyzed the statistics on their 9-year-old patients. "Forty-nine percent are either overweight or obese," she said.
"If we keep going this way, these kids are going to have adult diseases, including high blood pressure, diabetes and heart attacks in their 30s and 40s. It's ultimately going to lead to them dying younger than we are."
"I want to make this point," she said. "Children need to be included in every discussion of chronic disease reduction in this state. The discussion needs to start there. But when people talk about doing something about chronic disease, they usually talk about programs that will help adults," she said. "It doesn't seem to occur to them to talk about kids.
"It's a no-brainer," she said. "If we want to make a difference in the obesity epidemic we're seeing in adults, we need to start with the kids. It can be more easily prevented in childhood. They'll be adults in 10 years."
A deeper, widespread problem
For 13 years, West Virginia University pediatric cardiologist Bill Neal and his CARDIAC project have documented the very problems Murray, Jeffrey and Henderson see.
Each year since 1998, medical students have weighed and measured more than 135,000 West Virginia schoolchildren in all 55 counties. In classrooms, libraries and gyms, they have drawn blood samples, taken blood pressure, recorded height and weight.
Thirteen years ago, the CARDIAC project began in three counties. Neal intended to screen only for a rare inherited heart disease. "We quickly realized we were seeing a deeper, far more widespread problem," he said.
Last year, in 2010-11, CARDIAC found:
"It's not about their appearance," Neal said. "It's about their health."
"Many of these children are in the early stages of type 2 diabetes," he said. Type 1 diabetes, about 5 percent of cases, cannot be prevented. But type 2 diabetes can. It begins in the body about 10 years before it surfaces, he said. It can easily be prevented then by exercise and healthy eating, he said.