SUPER-SIZE NATION Cures sought for our burgeoning girth BY KERRY MILLER

While the economy is still easing toward some kind of recovery, the weight-loss business is a booming. Self-help books like The South Beach Diet and Dr. Atkins’ New Diet Revolution continue to top best sellers lists, and thanks to the popularity of these high-protein, low-carb diets, demand has pushed the price of eggs to a 20-year high. All told, the US Food and Drug Administration estimates that Americans spend about $30 billion a year on diet programs and products. Yet for all this dieting, Americans are somehow still getting fatter.

According to the US Centers for Disease Control and Prevention, Rhode Island’s population of obese adults has nearly doubled in the past 10 years, from 10 percent in 1991 to 18 percent in 2002. And because of obesity’s role in ailments like diabetes and heat disease, these extra pounds come with an equally hefty price tag. In 2002, more than $305 million in state medical expenditures were the result of adult obesity, reports the state Department of Health, with about 60 percent of the bill footed by Medicaid and Medicare.

The Monday night scene in the basement at the Calvary Baptist Church on Providence’s South Side offers a hint of the Health Department’s recently unveiled five-year plan for promoting a healthy weight. About 30 people marched in front of the television, mimicking the group of smiling blonde women in sports bras who encourage them via a videocassette to "walk away the pounds." A few minutes later, Dominican pachata began to blare from a corner boom box. The participants are packed in closely enough that collisions — and giggles — are inevitable whenever someone gets off beat. "¿Como se siente?" yells the instructor, to an enthusiastic chorus of "Ey!"

One of the more animated participants is 34-year-old Ana Guzman. For a long time, Guzman admits, she never really exercised at all, and "was kind of lazy around the house." Then, last November, she visited the South Providence Neighborhood Ministries for a nutrition program. She stuck around for the free classes in Latin dancercize and Pilates, and the "Walk away the Pounds" exercise video. She liked the exercise, she says, and the comfortable atmosphere. She’s been attending regularly for about three months, pulling in a number of her friends to attend as well.

Guzman is a prime example of the target population for the Health Department’s Initiative for a Healthy Weight, which helps funds the exercise classes. "There’s a lot of talk about the food police," said the Health Department’s Ann Thacher, "but what we’re talking about in increasing choices." What that requires, she says, is a number of varied approaches, based in schools, hospitals, worksites, and community centers. "If it works on the small group, we’re going to be able to expand that model," she says.

At the ground level, some of these models might be working. Bobbi Houllahan, health coordinator at South Providence Neighborhood Ministries, says exercise classes are generally a pretty hard sell for the people who show up at the ministries, most of whom are looking for food or emergency assistance with rent or utilities. But she’s seen some small successes along the way, in the form of people making lifestyle changes on a regular basis. A turnout of 30 people at the Latin dance class, she says, is "extraordinary." As Houllahan notes, "It’s hard to have people change their lifestyles when their basic needs are not being met. When you have people come back, it’s a pretty major achievement."