20 questions: Dr. Richard Carmona

Dr. Richard Carmona, who served as the 17th surgeon general of the United States from 2002 to 2006, has a lot on his mind these days — particularly when it comes to obesity. As the health and wellness chairman for the Strategies to Overcome and Prevent Obesity Alliance Steering Committee, he’s doing his part to combat what he sees as a serious problem in this country. An added bonus: He is the vice chairman of the famed Canyon Ranch spas based in Arizona and Massachusetts (Editor's note: The original story that appeared in The Hill indicated that Mr. Carmona did not currently work for Canyon Ranch spas).

Do you work with Congress?
“I used to work with [lawmakers] quite often. I still have inquiries from congressional leaders on both sides. Probably a carryover from when I was surgeon general.”

Are you still in touch with any lawmakers?
“Every once in a while I still get a call.”

So you have visited Capitol Hill?
“Oh, many times.”

There are a number of members of Congress with initiatives and legislation to stop obesity in this country. Do you think they are doing enough?
“Well, I’m encouraged that I’m seeing a lot more [legislative] activity. I don’t think we should become complacent; there is still a lot to do.”

How do you think federal law should address obesity?
“Well, I think federal leadership would be the way I would frame it. Not law or legislation, but certainly our officials should recognize that obesity is a problem, and provide funding. I don’t think it’s solely the federal government’s responsibility.”
So whose responsibility is it?
“I think it’s all our responsibility. It really starts with the individual, the family, the churches. It affects us all. Ultimately we all pay.”

You say that obesity is as real to Americans as weapons of mass destruction. What do you mean by that?
“I did say once that obesity is the terror within. That was because I was at a press conference after 9/11 and everyone wanted to talk about terror and I wanted to talk about a significant health problem of obesity. An estimated 9 million children are obese. Where will our soldiers come from?”

You are the health and wellness chairman for the Strategies to Overcome and Prevent Obesity Alliance Steering Committee. That’s quite a mouthful. What does that position entail?
“I chair a national coordinating group, a multi-disciplinary national organization whose goal is to address the issue of obesity. I meet with the groups periodically, have the discussions and make up the agenda, ultimately to eliminate obesity.”

Do you really think obesity could be eliminated?
“The goal is to eliminate obesity. We’d like to have people be in proportion to their height. Kids spend far too much time on PlayStations.”

How do you get the kids off PlayStations?
“There are a number of solutions. There are not simple solutions. It takes the parents, the schools, the teachers. We’re not saying get off the computer completely.”

What is dysfunctional about the morbidly obese? Isn’t it sometimes an issue of low metabolism or heredity factors?
“No question about it. There are some people predisposed to it. But they represent a minority. Most people who are obese are so because of a combination of sedentary activity and overeating.”

As the 17th surgeon general of the United States, you focused on anti-smoking and -obesity initiatives. Have you ever smoked?
“When I was 14 or 15 for a day or two. I was very poor. The 25 cents a pack was not even a possibility. I didn’t even like it.”

Have you ever had a weight problem?
“No, I’ve been physically active most of my life. I was in the military, in Special Forces. They’ve all involved being physically fit.”

What do you feel or think when you see someone who is morbidly obese?
“A lot of things come to mind. The physician in me says, How did that person get to be that way in life? As an adult you can’t wear the fashionable clothes. What happened in their life that this happened?”

So you feel sorrow?
“There’s a part of me that feels bad because I never met a patient who was morbidly obese who wanted to be that way.”

What are some practical ways to combat obesity?
“Well, the first thing is we have to have literacy. We have to raise awareness in the United States. The average person who has extra weight does not realize they are a time bomb for heart disease and other illnesses.”

You are vice chairman of Canyon Ranch, the famed Arizona and Massachusetts spa and wellness center. What are your favorite services at these places?
“I do a lot of cross-training, elliptical trainers. Five or six days a week I’ll do cardio for about a half-hour. In addition, I do stretching and push-ups on a daily basis. Every other day I add on a weight circuit.”

Wouldn’t it be great if the federal government could mandate everyone a weekend at Canyon Ranch?
“I’m sure the public would love that. We were on ‘The Martha Stewart Show’ and we gave 180 guests a three-day pass to Canyon Ranch to demonstrate our commitment.”

What did you think of Martha Stewart?
“Oh, she’s a nice lady. We had a nice conversation. She was very interested. She had been to Canyon Ranch.”

People are always so concerned with their weight. I was in the elevator today with a man who called out to someone outside the elevator, “A moment on the lips, a lifetime on the hips.” Do you think it’s troubling that American culture seems to be so obsessed with weight?
“Well, I think American culture is so obsessed with weight, but I think the obsession is for the wrong reason. The fashion models that walk the runway are supposed to be our models for health, but they are emaciated. The real goal should appreciate health and wellness, not trying to be 98 pounds. The runway models are the furthest thing from normal. Most people don’t wear a size zero.”

Betsy Rothstein