At Mary's Center for Maternal and Child Care we spend much of our time these days "pushing a rock." The moment we get some leverage and propel it forward, some calamity gets in the way and pushes it right back. Nonetheless, we know that our holistic approach is the only way to combat many of the health, social, environmental and educational challenges faced by every family that walks through our doors.

Obesity, for instance, is one menacing pandemic that is draining the health care system in this country of billions of dollars a year treating the consequences of diabetes, heart and renal disease to name a few. Unfortunately, even with this exorbitant price tag we continue to examine obesity through a very myopic lens. First of all, we treat it instead of preventing it because we know in our hearts that to prevent it we will have to face the economic disparities in our nation. When we provide the appropriate nutrition education, the culturally appropriate diets and exercise regimens and our patients still do not lose weight, we feel we have done our job and the onus is put back on the individual patients or parents. Once again blaming the already injured parties!

In our 19 years of doing home visits at Mary's Center we know that the problem of obesity is about poverty. It is about our families living in doubled and tripled-up housing; it is about our families living in substandard housing - which means no kitchen amenities; it is about our families not being able to afford the cost of gas when they do have access to a kitchen; it is about our families having to move so far out to find affordable housing that they move away from a walking-distance grocery store; it is about our school systems doing away with gym class because it is unaffordable; and it is about our families having to work two full-time jobs to be able to make ends meet. Yes, my friends, it is about us continuing to debate over what is the best way to educate our children and delaying the investment.

Of course I applaud and support wholeheartedly the food stamp and WIC program – two excellent programs that have done the most to combat malnourishment and address the issue of obesity through education and food selection. Yet with every reauthorization of the farm bill we have to justify the extent of these incredibly cost-effective programs. At the same time, this nation cannot afford to continue watching more and more of our children failing to graduate from high school and starting their own families too young and in poverty - continuing the cycle of poverty all over again.

We can continue to fool ourselves and say that obesity (a form of malnutrition) is a medical problem. We can continue to pour billions of dollars into treating it while corporate stocks swell with expensive new drugs, renal dialysis centers and experts in the field of obesity on their paid engagements telling us what a pandemic obesity is in our country, as well as worldwide. I believe the answer is about economic equality and it starts with the opportunity to be born healthy and ready to learn and the opportunity to receive an excellent education. I know; I have lived that life of hunger and poverty pangs. Today I am on the other side, unwilling to be silent but, more importantly, willing to roll up my sleeves and do whatever it takes to have others join me on this slightly more safe and comfortable side.