South Carolinians must get real about their weight

South Carolina officials get credit for recognizing a very serious and costly health issue facing state residents -- obesity.

But if recognizing you have a problem is the first step toward solving it, officials have a much tougher job ahead of them than they might realize.

A Winthrop Poll released last month shows a big disconnect between residents' self-assessment of their weight and what the experts -- and our eyes -- tell us.

When asked about their weight, only 13 percent of poll respondents said they weighed "much higher" than their ideal weight, while 37 percent said their weight was "somewhat higher" than ideal.

That's in stark contrast to numbers compiled by state health officials based on actual weight. Those numbers indicate about 32 percent of South Carolinians are obese, and another 34 percent are overweight.

A group campaigning against obesity in the U.S. predicts that 62.9 percent of South Carolinians will be obese by 2030. In 2012, South Carolina tied for eighth among states in obesity rates.

You're not going to get people to "eat smart, move more," the name of a state effort aimed at healthy eating and active living, if people don't see that they need to do a lot more of both.

The Trust for America's Health and the Robert Wood Johnson Foundation make a strong monetary case for reducing our collective poundage. If South Carolina residents can trim their body mass index by just 5 percent compared with the projections, it would reduce South Carolina's projected health care costs by $9.3 billion.

The state Department of Health and Environmental Control's Healthy South Carolina Initiative has set a goal reducing the rate of obesity by 5 percent by the end of 2016.

Given the goals and the uphill climb state officials face, it's easy to understand why Gov. Nikki Haley is looking to food stamps as a way to make some progress on healthier eating.

About 878,000 residents receive about $1.4 billion in assistance through the federal Supplemental Nutrition Assistance Program. Haley wants to limit what can be purchased with food stamps. Right now, only alcohol and tobacco products are prohibited.

The trick will be determining a workable list that takes into account what food is readily available to many who receive food stamps. Stretching those relatively few dollars to feed a family doesn't always allow for buying the healthiest of foods, which can be expensive.

South Carolina also will have to get a waiver from the federal government. The U.S. Department of Agriculture, which administers the program, has turned down 10 states or municipal governments that have asked for waivers to the food stamp system in recent years. That includes New York City's request to ban using food stamps to buy sugary drinks. But surely, a better solution than just banning alcohol and tobacco is out there.

South Carolina has come around on one important point -- recognizing obesity as a disease. In 2005, the federal government began allowing state Medicaid agencies to do that, and in recent years, all but South Carolina and Nebraska had done so.

Dr. Marion Burton of the state Department of Health and Human Services said classifying obesity as a disease would allow health care providers to treat it more directly and allow Medicaid coverage.

But treating that disease begins with those who are overweight recognizing they have a problem. Only then is there a real chance of doing something about it.