Not long ago, the number on the bathroom scale was a private matter. Many people would sooner have revealed the details of their sex lives and finances than their weight. In the last decade, however, weight has crossed over from being a private matter to a public one.

Airlines triggered a visible shift by proposing a surcharge on overweight passengers who required an additional seat. The logic was simple: Airlines sell seats. Customers who require more than one seat need to buy a second seat.

Another major milestone occurred when Americans learned that their body mass index would be recorded, along with height and weight, in the electronic health records mandated by the 2009 stimulus law.

Yet another blow occurred when United States military officials estimated than over one-third of Americans aged 17 to 24 would not qualify for military service because of lack of fitness. Curt Gilroy, a director at the Pentagon, says that the obesity crisis now represents a threat to our national security.

Economists further escalated the shift from weight as a private to a public matter when they began assigning costs for the treatment of obesity-related medical conditions. Experts estimate that 80 percent of illnesses are lifestyle related, including the deadly quartet: diabetes, cardiovascular diseases, cancer, and stroke.

The resulting numbers are astronomical in their implications: Over $150 billion is spent each year on medical care related to obesity-related conditions. Twelve percent of our annual spending on medical care is obesity related, up from 6 percent in 1998. From 1999 to 2008, medical insurance costs for a family of four increased 119 percent. And if future projections materialize, the annual premium for a family of four ($13,375 in 2009) will climb to $23,842 in 2020.

Employees’ weight is also moving into the spotlight at the workplace. Employers began quantifying obesity-related costs related to absenteeism, work injuries, and increased insurance premiums. Medical expenses for obese employees are estimated to be between 29 percent and 117 percent greater than medical expenses for employees with a healthy weight. In addition, obese employees spend 77 percent more on necessary medication than do their healthy-weight counterparts.

Employers are increasingly being encouraged to address their employees’ weight through preventive programs. The Centers for Disease Control is encouraging this trend by launching an online resource site called LEAN Works! (Leading Employees to Activity and Nutrition). The site features a calculator that computes the cost of employee obesity in higher medical bills and absenteeism and allows employers to measure their return on investment in employee health.

The epidemic of obesity was also the subtext in the heated debate over healthcare reform. The unspoken question reflected a growing concern: As wealthy as our country is, can we afford healthcare for all if we do not curb the epidemic of obesity?

An increase in lifestyle-induced illnesses and disabilities, combined with an inexorable rise in medical care costs, is quickly making the task of building healthier communities a national priority.

In 2004, a few of us in our small community in Northern California pioneered the concept of community weight-loss programs by creating the Nevada County Meltdown, an eight-week program during which over a thousand of our neighbors and friends lost nearly four tons of surplus weight. The ideas, instructions and sample forms we used are captured in The Fat to Fit Meltdown Manual so that others can create similar programs in their own communities. The program is based on three FIT principles:

F: Focus on fun. Creating the event needs to be as much fun for organizers as it is for participants. Contributing to others will help you stay in touch with your vision, and the experience will lift the spirits of participants.

I: Innovate and improvise. Every community and every individual is unique: one size will not fit all. To achieve maximum impact, your program must be relevant, timely, and tailored to your community, and the content must be responsive to the particular needs of the individuals.

T: Team up. Everyone needs to participate: medical experts, the media, fitness clubs, food markets, hospital personnel, employers, government officials, educators, religious leaders, employees, and family members. The goal is promoting community-wide fitness for everyone, independent of age, size, and time of life.

These three principles will help organizers create a low-cost, fun-filled, grass-roots event.

Be assured that your efforts don’t have to be perfect. Instead, adopt an open-minded attitude—one that encourages experimentation. You can even view the project as a theatrical production and include the elements of drama, action, and surprise. The program can also be seen through the lens of a sporting event by creating competitive teams. You can add additional meaning by linking weight loss to a donation to a worthwhile local charity.

Organizing a group intervention to promote healthier lifestyles and appropriate weight also involves education and skill building. Leaders who step forward to create events quickly discover others who are willing and eager to contribute their talents and expertise toward a common goal—helping members of the community and each other lead healthier lives.

In the past few years, over 400 community weight-loss events have occurred in communities across the United States. Marge Delozier, for example, organized a spring 2010 community weight-loss program in Lewiston, Pennsylvania. Marge says, “We are all so excited. It has been a great exercise in pulling talents from the whole community. If anyone is thinking about creating an event, just do it!”

We are at a crossroad. We can view obesity as an overwhelmingly intractable program and throw in the towel. Or like Marge Delozier, we can take concrete, practical actions to help our neighbors and friends adopt healthier lifestyles and lose those surplus pounds. When you step forward in this way, I can assure you that, just as our Nevada County Meltdown did, your actions will reverberate beyond your community’s borders and touch people’s lives in ways you will never know.

Carole Carson is the author of From Fat to Fit: Turn Yourself into a Weapon of Mass Reduction and the national coach for the AARP Fat 2 Fit online community. Visit to learn how you can create your own community meltdown.

Note: This blog has a book review of Carson’s book:  “From Fat to Fit.”  Go to the July, 2010 archives or type “Carole Carson” in the search box. You can also check out the review by visiting my blog’s Guy Thing Book Corner.