Mission Possible

  1. James Levine
  1. From the Endocrine Research Unit, Division of Endocrinology/Metabolism and Diabetes, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
  1. Address correspondence and reprint requests to James Levine, Mayo Clinic, Department of Internal Medicine, Joseph 5-194, Rochester, MN 55905. E-mail: levine.james{at}

Every family across the U.S. is confronting the same questions as state governments and federal agencies: why have we all gained so much weight and what are we going to do about it (1–8)? The century-long, slow, silent, and deadly increase in body weight now impacts every family in the U.S. The world has caught the obesity bug, 1.5 billion times.

Obesity explains why Mom is injecting herself twice a day with insulin and explains why health care costs have erupted while the basic health care that U.S. prisoners get for free is unavailable to 45 million free-living Americans. The obesity explosion explains about three-quarters of health care costs in the U.S. The future, the Centers for Disease Control warn, is more alarming than the present. Not only is it Mom who cannot afford basic diabetes supplies, such as blood testing strips and insulin needles, but now John, her 10-year-old son, cannot either. The “new epidemic” of childhood diabetes will wash across America in the wake of the heaviest young America has ever raised. Obesity may cost $100 billion a year in the U.S., but that is nothing compared with the price tag of childhood obesity. When I grew up, I feared the doctor because I hated needles. John will grow up using needles every day but terrified as to how he will afford them. Without viable solutions to obesity, health care will become the exclusive right of the wealthy.

The predominant voice in the Perspectives articles published in this edition of Diabetes (9–11) is a shrill tone of retrospection, asking how we got to where we are today. Although these articles emit an odor of impending catastrophe, threading through the papers are rivulets of hope. “Hope” is a voice of consensus that speaks to the …

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