Obesity — the condition of being significantly above one’s healthy weight — is a health crisis in Delaware. Across our state, the number of overweight and obese individuals is rapidly increasing. In fact, almost 64% of the population of the First State is overweight or obese. Unsurprisingly, Delaware’s obesity rate tracks closely with its rate of physical inactivity: 59% of adults in Delaware say they do not exercise or engage in any type of regular physical activity.

Obesity can be one of the most difficult diseases to treat. Weight loss itself is a simple matter: once a person’s daily caloric intake falls below the number of calories needed to maintain life, the body begins to burn fat to stay alive, resulting in weight loss. The difficulty comes in restricting caloric intake – the primal urge to eat when hungry is almost irresistible.

Many obesity sufferers use eating as a substitute for emotional satisfaction. Others are food addicts and will continue to eat long after they have met their caloric needs. In essence, their “fullness meter” is broken. Sadly, many people who do not suffer from obesity see these behaviors as indicators of personal weakness on the part of the obese.

The truth, however, is that obesity is a disease, not a character flaw. Gimmicks, fad diets, or so-called weight-loss pills can cause a person to lose significant weight, but most that do quickly regain it – and often suffer damage to their health as a result of such quickie “cures”. The only way to successfully treat the disease of obesity is by a complete change in the patient’s lifestyle and eating habits. To beat obesity we must change the way we relate to food, enabling us to eat better food and less of it. For some, education and willpower are enough to accomplish this. For the rest, another option exists: weight loss surgery.

Weight loss surgery is performed under general anesthesia, usually laparoscopically. Three main types of surgical procedure are performed in the U.S.—malabsorptive, restrictive, and combination—each with different risks and benefits. In each, however, the principle is the same: to surgically alter the patient’s stomach and/or digestive tract in order to physically limit the amount of food the patient can eat at a given time. If successful, the surgical alterations will cause the patient to take in fewer calories each day than he or she burns, resulting in steady, safe loss of excess weight.

However, excess weight is only a symptom of obesity, and, while treating it is a giant step toward recovery, only a complete change in the patient’s lifestyle and relationship to food can cure the disease. Patients who fail to follow postoperative instructions may regain any weight lost. The surgical alterations are a powerful tool, but they can only be part of a comprehensive program of weight loss treatment, including counseling, medical and peer support, activity level changes, and psychiatric care.

Delaware – By Thanksgiving, all five Delaware Health and Social Services long term care hospital campuses will have banned smoking from their grounds. No smoking, anywhere — not even while sitting in your car. Starting on the date of the Great American Smokeout, November 15, the campuses of Herman Holloway, Sr. in New Castle, Stockley Center in Georgetown, Governor Bacon Health Center in Delaware City, Delaware Hospital for the Chronically Ill in Smyrna (including the Public Health Laboratory), and Emily P. Bissell Hospital in Wilmington will ban all smoking on hospital property. Employees and visitors are currently permitted to smoke in designated outdoor areas.

“As the guardian of Delaware’s public health it is our turn to take the lead in the movement to prohibit smoking in the workplace,” said Vince Meconi, Secretary, Delaware Health and Social Services. “As we see it, condoning tobacco use anywhere on our hospital properties sends the wrong message about a deadly product. The Department has a responsibility to be activists on this important public health issue,” he said.

About three-quarters of the 4,800 U.S. hospitals prohibit smoking on their grounds, said Rick Wade, senior vice president for communications at the American Hospital Association. Thirty-one states, including Delaware, have enacted laws restricting smoking in private workplaces, and 48, including Delaware, restrict it in government buildings, according to an analysis by the American Lung Association. Delaware’s Clean Indoor Air Act, which went into effect in 2002, prohibits smoking in all workplaces, as well as bars and restaurants.

“A growing number of hospitals are eliminating outdoor smoking areas because they see tobacco use as at odds with their mission to heal patients,” explained Meconi. “This November, DHSS will join Christiana Care Health System, Beebe Medical Center, Alfred I. duPont Hospital for Children and St. Francis Hospital in having smoke-free campuses.”

Tobacco use is Delaware’s leading cause of premature death and disability. Tobacco causes almost a third of all cancers; and is a major cause of heart disease, stroke, emphysema and other lung diseases. Cigarette smoking is the leading preventable cause of death and disability in the United States. It contributes to the risk of developing lung cancer, many other cancers, heart disease and respiratory illness. Of the estimated 48 million U.S. adults smoking cigarettes, about half of those who continue to smoke will die from a smoke-related disease. Tobacco use is responsible for approximately 430,000 deaths per year in this country. Secondhand smoke from a parent’s cigarettes increases a child’s chances for middle ear problems, causes coughing and wheezing, and worsens asthma conditions. The current Surgeon General’s Report concluded that scientific evidence indicates that there is no risk-free level of exposure to second hand smoke. Short exposures to second hand smoke can cause blood platelets to become stickier, damage the lining of blood vessels, decrease coronary flow velocity reserves, and reduce heart rate variability, potentially increasing the risk of heart attack.

The Delaware Division of Public Health works to prevent the use of tobacco products through its Tobacco Prevention and Control Program. The program is supported by a cooperative agreement with the U.S. Centers for Disease Control and Prevention (CDC) and appropriations from the Delaware Health Fund.

The Tobacco Prevention and Control Program collaborates with the IMPACT Delaware Tobacco Prevention Coalition, with more than 40 member organizations including health-care, youth and community groups, educational organizations, grassroots networks and state agencies.

Our Tobacco Prevention and Control Program offers two programs to help smokers quit successfully -the Delaware Quitline and the online Delaware QuitNet . The program also conducts media campaigns, and funds youth-led campaigns and peer-group organizations. Educational activities are carried out at all levels, including community and school programs.