"Honey, you're obese." These are not the endearing words of love and devotion one craves from a spouse. Yet these are the words my husband spoke to me one Sunday afternoon in late autumn as we sat at the kitchen table, he nibbling on a carrot, I shoveling in a cheese sandwich as I nursed our infant son and fed goldfish crackers to our two-year-old daughter.

My husband had lost twenty pounds after our daughter was born, and was occasionally obnoxious about it, and deservedly so: weight loss is equally difficult and admirable. I reflected on his two-year struggle briefly, but my immediate reaction was, well, a gut one: should I cry or slug him? My thoughts raced: Well, sure, I've put on a few pounds with each pregnancy. Who doesn't? How am I supposed to diet when I'm nursing? I'm supposed to eat a lot, right? I'm really hungry. I was sick for eight solid months - two times!! - and if I want to EAT right now, I am ENTITLED TO. I DESERVE THIS. And why don't YOU try dieting while you're totally sleep-deprived, caring for an infant, chasing a two-year-old, and working part-time? By the way, Mr. Perfect, who made YOU the dietmeister and, oh, yeah, did I happen to mention that YOU STILL HAVE A FAT ROLL? Huh? How about that?

I said none of these things. I could have. No one would have denied me the right to say that and a lot more. But instead, I finished chewing my bite of cheese sandwich, daubed at the mayo on my lips, and looked him in the eye. I thought about my height - 5'1" if I stretch - and my weight - 164 - and said, "Yup. You're probably right." And then I said the hardest thing of all: "Let's do something about it."

I have been varying degrees of overweight nearly all my adult life. Always fit, but overweight nonetheless. And yes, for a time, I was obese. And I am not alone. According to our Centers for Disease Control and Prevention - known affectionately as the CDC - 64% percent of U.S. adults are either overweight or obese. That makes us the fattest people on the face of the earth. Hardly up there with the Statue of Liberty or the majestic bald eagle as something for us to be proud of.

We here in the Keystone state are doing our bit to keep those numbers high. At least sixty-one percent of us Pennsylvanians are overweight or obese, but the increase in fat in PA is truly startling: the obesity rate among Pennsylvania adults increased by 92% from 1990 to 2002. That's the obesity rate, meaning people with a BMI, or body mass index, of more than 30. Overweight means someone has a BMI between 25 and 29.9. BMI is a quick and easy weight/height ratio calculation that health professionals use as a "tool for indicating weight status" says the CDC. If you're curious about yours, check out the BMI calculator at this CDC site: http://www.cdc.gov/nccdphp/dnpa/bmi/calc-bmi.htm

Clearly, neither BMI numbers nor weight alone are perfect indicators of health, but the sheer number of excess pounds themselves tell the collective story of a nation at risk. And the consequences of all this fat are simply staggering in human, health, and economic terms. The CDC lists some twenty ailments and categories of illness that the overweight and obese suffer in greater numbers, ranging from cancers to reproductive problems to heart trouble to diabetes. The U.S. Department of Health and Human Services adds psychological ailments, such as depression, to the already depressing list.

Equally depressing are the cost figures. HHS puts the economic cost of excess eating in the United States at about $117 billion in 2000. Pennsylvania follows only California, New York, and Texas in total Medicare and Medicaid costs attributable to obesity: over four billion dollars in 2003.

What's particularly frightening is that this expanding epidemic of fat gives no signs of shrinking. HHS, CDC, and other health organizations warn us that our kids are really fat, too. According to the American Obesity Association, over 15% of kids and nearly 16% of teens are obese. In the past twenty years, the number of overweight teens has tripled.

So if you think you've put on those holiday pounds - conventional wisdom put the average between five and ten - I have some heartening news. You've actually put on less than a pound, says National Institute of Child Health and Human Development Director Duane Alexander, MD. Americans probably gain about a pound during the winter holiday season, says Dr. Duane, but here's the problem: we don't lose it. Ever. And this pound becomes twenty pounds, or in my case, forty pounds over time, after children, under stress and whenever else we overeat.

Part of what makes losing weight so hard is that we can't walk away from food like we can alcohol or tobacco. We are forced to learn to live with moderation, which is not always fun and easy. I know that for the rest of my life, I will want to overeat; the craving, the desire, the sheer delight of great quantities of food will always be there.

Finally, though, weight loss worked out for me. Maybe it was having hubby call me "obese." Maybe it was not wanting to be the fat and old mom at playgroup. Maybe it was that my husband and I worked on it together. Maybe it was wanting to set a healthy example for my kids. Maybe it's because my husband and I feel a spiritual, moral, and civic responsibility to do whatever we can to keep our bodies healthy. Maybe I just ran out of excuses for what I knew was bad behavior.

Whatever the reason, I am forty pounds lighter, and have been for nearly three years, and chances are pretty good I'll stay that way - if I can keep this going for another few years. And that's huge if to maintain a smaller me. So I work at it. Every day. And when you're dieting and hungry and thinking how good a hot fudge sundae would taste, know that I'm right there with you, just as hungry as you are, trying to make our common ground a little less tamped down. But know, too, that the satisfaction and delight of being healthy is pretty sweet, too. Almost as sweet as that sundae. Almost.

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