Expanding Waistlines

It's easy for those of us who live in major metropolitan areas on the "liberal coasts" to forget. But head out into many communities in the US (or simply your local Walmart) and you'll get an idea of the extent of the problem. Last month, I left the cultural bubble of the Miami area and drove north into the South, to Orlando. I know the stats about obesity in America, but it was still startling to get back into a more "typical" area again. We are a nation of incredibly fat people.

One moment in Disney World really epitomized the state of the collective US waistline, and our eating habits in general. In the restroom at a buffet restaurant, I entered to find a father and his son standing in line to use the stalls - both of them were incredibly fat, and the father actually had food smeared all over his shirt, like a baby without a bib. I could hear the sound of someone throwing up in the bathroom. As I was washing my hands, the person in the stall came out - an obese kid of about 12 - and waddled over to the father and son. "You all right, buddy?" asked the father. After another stall opened up, the father and older son took leave of the youngster, closed themselves into the two adjoining stalls, and both proceeded to puke their guts out in unison. After that collective family purge, they were probably back at the buffet line.

Anecdotes aside, the stats on America's decline into obesity are truly shocking. In 1985, when I was four, only eight states had an obesity rate of 10-14%, the highest level of the day; today, not a single state has a rate that low. In 2008, three states have an obesity rate of around 30% (Alabama, Mississippi, and Tennessee); the majority are in the 25-29% range. And a quick definition of terms here: "obese" refers to someone with a BMI of 30 or more: when merely "overweight" people are factored into the equation (BMI of 25-29.9), the national percentage is a staggering 66%.

You might ask: "Zach, why do you care how fat other people are? They don't effect you - mind your own business." Our national obesity epidemic very much effects me, however; if effects every American, regardless of what pants size we wear. I don't hope to take on the whole issue here (I hope other writers will jump in and help me out on that count), but I would like to address two costly components of the obesity problem. Our increasing waistlines are both a public health disaster and an act of environmental irresponsibility.

Despite all the fancy dieting techniques and expensive surgeries out there to help shed some pounds, the trick to weight loss is stupidly simple: eat a balanced, nutritious diet and exercise regularly. A doctor a hundred years ago could have given the same advice, but it's disturbing now how illusive this solution is to many people. Instead of following these two simple strictures - which would require changes in lifestyle - people are instead turning to "something for nothing" schemes to make themselves healthy without making any real sacrifices. Not only is this dishonest, it doesn't work. Moreover, it is an abdication of responsibility for the root causes of the affliction in the first place: gluttony and sloth. That may be politically incorrect - some might even say "fattist" - to say, but that's the truth, folks. Barring thyroid conditions and other legitimate medical problems, obesity is entirely a choice.

In extreme instances, overweight people have tried to place the blame for their conditions on others, most notably the class-action lawsuit against McDonald's in 2004. Thankfully, the judge laughed at the argument that McDonalds is to blame for making you fat, effectively setting a precedent that a lawsuit of this nature is the very definition of frivolous.

There is a creeping danger in the obesity stats beyond the obvious the health problems associated with the condition. The more something becomes "normal," the less inclined people are to recognize it as a problem. In Mississippi, where 1 in 3 people is categorically obese, where is the motivation for losing some weight? Also, as my Disney story suggests, weight problems very often run in the family: if your whole community, included your sister and your father, are fat, then what's wrong with being fat? This perpetuates a false sense of security about the very real risks associated with obesity. And the risks are many. For example: type 2 diabetes (an epidemic now), hypertension, osteoarthritis, high cholesterol, heart disease, increased risk of strokes, gallbladder disease, sleep problems, and even some forms of cancer.

Treating an ailment which is entirely within the control of the individual has put a huge strain on our health system. According to a recent study, obesity costs health care providers (and taxpayers) $61 billion annually; it also costs the US economy $56 billion annually in indirect expenses (loss of productivity, etc.). For those of us who think that the explosive increase in fat people only affects those with the big guts, think again - your health insurance is as high as it is, in part, because of the diabetes treatments you're subsidizing for an obese woman in Birmingham.

Recently, in fact, the state of Alabama (#1 in obesity) has adopted a measure that requires obese state employees to pay a monthly fee for the health insurance that would normally come free in their payment packages. It is encouraging news: those who bring increased liability into an insurance risk pool should contribute more to it. We don't let smokers off the hook for their habits, and we shouldn't let obese people either.

Another important component of obesity is its effect on the environment. Like our fuel-consumption habits, Americans eat more than any other nation in the world. But as the world becomes increasingly more crowded and resources grow scarcer and scarcer, we can't keep eating like hogs. The Earth Policy Institute estimates that the average American eats the equivalent of 800 kilograms of grain per year (100 directly, as bread, pasta, etc., and 700 in the form of feedstock for cows, pigs, etc.). Let's contrast that with a couple other countries: Italy, by comparison, consumes 400 kilos per person. Indians eat 200 kilos of grain per year. In the words of EPI director Lester Brown, it's time for Americans to move down the food chain.

A couple of conclusions emerge from this data: 1) we eat too much in general, and 2) we eat too much meat. Neither of these things is good for our individual health, and as it turns out, it's not good for the planet either. In the last fifty years, world meat consumption has gone from 44 million tons a year to 240 million tons, more than doubling consumption per person. And with more livestock, we have more of the problems associated with it: deforestation, overgrazing leading to erosion, huge amounts of methane gas (20 times as potent as CO2), pollution to water sources, etc. It is also an incredibly inefficient way to get nutrients, as 7 kilos of grain are required to grow 1 kilo of beef. With populations growing and forests shrinking, is a fiercely carnivorous diet really that wise anymore? Eating lots, with plenty of meat, is unsustainable both from a personal and a global perspective.

Combating deeply ingrained eating habits will be difficult. Despite rises in the prices of staple foods over the last couple years, the obesity rate has remained unaffected, so entrenched are our current eating patterns. We've come to expect huge portions at our restaurants, and retreating from this ideal will take some getting used to. But we're going to have to suck in the gut and deal with it.

To me, one of the big reasons the obesity epidemic has gone unchecked for so long is because of mass complacency. The more fat we become, the more acceptable it is to be fat. I don't suggest socially stigmatizing overweight people per se, but I do believe that we need to recognize the problem for what it is - obesity is not simply a voluntary choice that should be respected: it is a destructive and unsustainable lifestyle.

Update: Here's some great commentary about our current eating problem by a NYT food writer. A bit long, but well worth the time. Thanks for the link, mFin!