Shoppers and Trends
June 28, 2007
Being fat is expensive, according to a study of national costs conducted by the Medical Expenditure Panel Survey (MEPS) and the National Health Interview Surveys (NHIS). Total U.S. medical expenditures related to obesity and its associated health problems may have reached as high as $92.6 billion in 2002. That's $105.4 billion in 2007 dollars. Obese people spend more money on gas, miss more work than their non-obese counterparts (costing employers around $4 billion annually), and force airliners to spend more in jet fuel. And then there are the social costs.
Technically, obesity is a label for a range of weight that is greater than what is generally considered healthy for a given height. This range is calculated using a number called the body mass index or BMI. The target BMI for a healthy adult is between 18.5 and 24.9. An adult with a BMI between 25 and 29.9 is considered overweight. A 30 or higher index indicates obesity. Young people that start off at risk for being overweight or obese are more likely to be overweight or obese adults.
Since the mid-70s, the number of persons who are overweight or obese has sharply increased, from 15 percent to 32.9 percent in adults, five percent to 13.9 percent in children aged two to five, 6.5 percent to 18.8 percent in children aged six to 11, and five percent to 17.4 percent in teens aged 12 to 19. Worldwide, there are 1.1 billion overweight people.
This is bad news for the Center for Disease Control (CDC), who has set a national health objective to reduce the prevalence of obesity among adults to less than 15 percent by 2010. Unfortunately, current data clearly indicates that the situation is worsening rather than improving.
Dr. Jamy D. Ard, Assistant Professor of Nutrition Sciences and Internal Medicine at the University of Alabama at Birmingham, says that in addition to detrimental lifestyle and economic effects, being overweight or obese increases the risk of many health conditions, including Type 2 diabetes, heart disease, stroke, hypertension, sleep and respiratory problems, and cancer.
Ard attributes the rise in obesity rates to a number of factors he refers to as obesogenic or factors that work together to prime a person for obesity. For example, physical environment plays a huge role in this process, as current urban and suburban sprawl is not conducive to being physically active.
Food trends are also at fault. The increase in competition for inexpensive, palatable energy-dense foods is kicking up obesity numbers in both the U.S. and in other countries across the world, he says. Additionally, there are genetic, socio-economic and cultural factors. Currently, African American women have the highest rates of obesity in the U.S. Native Americans are not far behind.
"We're seeing the beginning of a continual rise in obesity rates over the next several decades," Ard says. "It's extremely alarming, but if we start to treat obesity as a chronic disease rather than a short term situation that can be easily cured, we may start to see some improvement in these numbers."
In the U.S., programs to make school lunches healthier, decrease screen time (that's time spent in front of the TV, video game or computer), and encourage healthier snacks are important, even if they are just scratching the surface of a much larger problem. Real lifestyle changes have to be put in place, at school, home and work to see long term results. Losing five to 10 percent of your body weight can actually improve chances for avoiding a number of risk factors, like heart disease and diabetes, but keeping the weight off requires more than a simple, trendy diet.
"Prevention is a great idea in theory, but it's not enough to make changes just at an individual, or even at a community level," says Ard. "Changes have to be at a macro and micro level to see some real success in combating obesity. Better labeling is only part of the process. If you don't make changes in the health care system, you won't get enough traction for sustainable long-term prevention. Most health care systems don't pay for prevention and don't pay for treatment of obesity. We need system-level changes."
Proposed changes range from a fat tax to altering the USDA food pyramid. However, food policy statements from the U.S. tend to be non-threatening so as not to alienate any one section of the food industry. While the U.S. has been somewhat conservative toward making comprehensive policy changes, the World Health Organization (WHO) has been more aggressive. They are focusing a majority of their energy on the elimination or reduction of sugar-sweetened foods an option that U.S. policy-makers are not fond of discussing.
At the store level, offering larger and easier to find selections of prepared fruits and veggies is a great option for people looking for healthy and convenient choices. Promoting a healthy item of the week is another idea. Ard suggests that retailers get creative to help their customers live more healthfully and fight the obesity epidemic.
"My patients tell me that they want to eat better, but that they have trouble finding the right foods at the market. The typical U.S. grocery store is set up in a way so that less healthy alternatives like high sugar cereals are more prominent because they are situated at eye level. This is a common strategy because these are the foods that grocers think people want. Let's change this strategy."