The Fattening of America

Everyone knows that many Americans are fat — among the fattest people in world. And nearly everyone knows that Americans are getting fatter. It is an epidemic that ruins the health of many overweight people and costs hundreds of billions of dollars to the health care system, to employers and to health-food businesses.

The extent of fatness has moved from the troubling toward the frightening, according to new research. The Trust for America’s Health and the Robert Wood Johnson Foundation in their “F as in Fat: How Obesity Threatens America’s Future 2012” forecasts that:

For the first time, the annual report includes an analysis that forecasts 2030 adult obesity rates in each state and the likely resulting rise in obesity-related disease rates and health care costs. By contrast, the analysis also shows that states could prevent obesity-related diseases and dramatically reduce health care costs if they reduced the average body mass index of their residents by just 5 percent by 2030.

And:

If obesity rates continue on their current trajectories, by 2030, 13 states could have adult obesity rates above 60 percent, 39 states could have rates above 50 percent, and all 50 states could have rates above 44 percent.

But the body mass index will not go down. America, the land of the free, and more specifically its government, will not set any penalties for obesity, despite its national costs. Neither will insurance companies or doctors. Health care premiums based on weight are discriminatory and are about to become a “pre-existing condition” under new laws.

The fruits of fatness, according to the study, are a rise in Type 2 diabetes, heart disease, hypertension and arthritis. Even faced with those prospects, millions of Americans eat themselves into the grave. Like almost any other addicts, they claim they cannot help themselves. Absent any penalties, why would that change?

Fatness, geographically, is a bit like housing, education and poverty. Several states have concentrations of obese people. In August 2012, the Centers for Disease Control and Prevention released information indicating that 12 states had an adult obesity rate of above 30%. Mississippi was the worst at 34.9%. Louisiana was second on the list, followed by West Virgina and Alabama. The reported added:

Twenty-six of the 30 states with the highest obesity rates are in the Midwest and South.

All 10 of the states with the highest rates of type 2 diabetes and hypertension are in the South.

Fatness is not entirely a regional problem, but it does lean in that direction. For some reason, the fattest states are disproportionately among those with the highest poverty rates. The Trust for America’s Health report did not render an opinion on why that is so. Some experts believe that the poor do not have as much access to healthy food as those who have higher incomes. That analysis somehow seems incomplete since not all poor people are obese.

The federal government has at least done a little to curtail harmful behavior in the past. People who are drunk cannot drive. Many cities do not allow smoking in public or inside some buildings and restaurants. Cigarette packs carry grim warnings. Despite all of those deterrents, people continue to smoke and drink themselves to disease and death in great numbers.

Among the core problems of obesity is that it is allowed to go on even at an epidemic rate. No matter how high the cost, both financial and human, in a democracy people can kill themselves in huge numbers as long as they do not directly kill anyone else. And, in the American democracy, they have decided to do so.

Douglas A. McIntyre