The Growing Realization of Horror

Following along in this retrospective look at the alarming cost of obesity in the U.S. and the world, we note that a 2010 article in The Lancet had already proclaimed obesity to be, globally, a larger health problem than hunger. Soon afterward, the head of England’s National Health Service sounded an alarm, stating that “we are sleepwalking into the worst public health emergency for at least three decades.”

The World Economic Forum followed up on this shocking turn of events in 2015 (in an article which has vanished from the web), by stating that almost one-third of the Earth’s human inhabitants — in other words, 2.1 billion people — were overweight or obese. Why was this characterized as a more significant problem than hunger? Because…

That is nearly two and a half times the number of adults and children who are undernourished.

At that moment in time, obesity was deemed to be responsible for approximately 5% of the total deaths taking place among the world’s population. But well-being was not the only area of concern. The entire global economy was taking a beating:

This crisis is not just a pressing health concern; it is also a threat to the global economy. The total economic impact of obesity is about $2 trillion a year, or 2.8% of world GDP…

As World Health Organization (WHO) Director-General Margaret Chan has noted, “Not one single country has managed to turn around its obesity epidemic in all age groups.”

To make matters worse, this crisis did not, as might be reasonably expected, affect only impoverished countries — because well over half of the world’s obese people were located in developing countries, in which many people enjoyed more prosperity than they had ever been accustomed to. In places like China and India, thanks to new economic opportunities, the inhabitants of cities were ballooning up.

When previously hungry people suddenly find that food is available and that they are able to afford it, that is what they go for. Here is a painful example:

In the mid-twentieth century, for example, a boom in phosphate mining transformed the Micronesian island state of Nauru from a land of food shortages and starvation to the world’s leader in obesity and type-2 diabetes. In 2005, according to the WHO, 94% of men and 93% of women in Nauru were overweight, and more than 70% of the population was obese.

The combination of money and availability made people sent people around the bend, and who can really blame them? But casting blame was never an issue. For the authorities in charge of public health, the only issue at hand was what to do about the situation. The crisis could not even be characterized as unforeseen, because statisticians and the entire medical profession had been noticing it all along.

One unfortunate circumstance was that countries where people suddenly could afford more food than they needed did not necessarily also have the funds to provide health services that they also desperately needed. Increased disposable income perversely led to obesity that “can lock in poverty and perpetuate inequality.”

To address the crisis, the McKinsey Global Institute (MGI) identified 74 potential interventions and classified 44 of them as possessing sufficient data “to be able to measure potential impact if scaled up to a national level.” These tantalizing alleviating actions included subsidized school meals, better nutritional labeling on food products, and built environments that encouraged walking and other types of exercise.

One element in particular would prove to be increasingly crucial but also increasingly impervious to any resistance: the advertising of high-calorie food and drink. Still, undaunted by ever more alarming reality, the MGI went ahead with projections of what might, in a better world, come to pass:

If the United Kingdom, for example, were to deploy all 44 interventions, it could rein in obesity rates and help roughly 20% of its overweight and obese population return to a healthy weight within 5-10 years… Over the long term, savings from reduced health-care spending and gains from higher productivity could outweigh the investment needed to deliver interventions… In the UK, reversing obesity trends could save the National Health Service about $1.2 billion a year.

Dream on, MGI! When there are fortunes to be made selling sugar-saturated fizzy drinks to everyone from infants to geriatric patients, nobody wants to hear about interventions and alleviation and better health and blah-blah-blah. The voices of earnest experts who tried to warn of impending doom were drowned out by ever more obnoxious advertising. Throwing money at the problem did not help — because almost nobody cared to listen. The article ended by stating a dismal fact:

Today, investment in obesity research worldwide amounts to some $4 billion a year — just 0.2% of the estimated social costs of obesity.

Source: “What’s the best way of tackling obesity?,” WeForum.org, 12/15/14
Source: “Why Obesity Threatens the Global Economy,” WeForum.org, 04/07/15
Image by marlenemgm (modified)/Pixabay

A Crucial Cost of Obesity

The theme of “obesity versus military readiness” did not fade from public consciousness. A 2013 headline stated the case: “Food a ‘national security issue’ for America.” A message can’t get much plainer than that. Despite the exemplary phrasing, an essay penned by Jason Miks has vanished from the web, though it is referenced on social media.

In it, Anthony Bourdain is quoted:

We are eating ourselves to death. We are largely an unhealthy and increasingly obese and increasingly diabetic country. One can well make the argument that it is eroding our military readiness! And I say that only half in jest.

We are not alone

This was far from being an exclusively American problem. Studying the records of 150,000 Swedish males in their 18th year, and then comparing later information, showed that obese males earned on average (over their lifetimes) 16% less than their normal-weight counterparts.

In terms of disadvantage, this is roughly equivalent to missing out on three years of college. Obviously, many of these Scandinavian hunks would not be accepted by any self-respecting military leadership.

In the same year, financial analysis techniques were also being applied in other areas. Are we ready to explore more costs of obesity that wind up being paid by everyone, regardless of whether they signed up for it? Probably not, but that doesn’t change a thing. Those expenses are woven into the fabric of society.

A multiverse of size

In 2013, a multi-author study (presented to the Tenth International Society of Sports Nutrition Conference) compared four popular weight loss programs in terms of their cost-effectiveness. The researchers started with 129 women of sedentary habits and randomized them into five groups: the Curves Complete 90-Day Challenge; Weight Watchers Points Plus; Jenny Craig; Nutrisystem Advance Select, or no program (the control group).

During the experiment, they averaged the program costs and the food purchase costs for each group. Each participant’s weight, waist circumference, hip circumference, bone mineral content, fat mass, fat-free mass, and peak oxygen uptake were analyzed. With no further suspense, here is the conclusion:

The WW group tended to lose a lot of weight and fat mass per dollar spent, but also lost more fat-free mass resulting in a lower change in body fat percentage. The CC group tended to improve peak oxygen uptake and lose more weight and fat mass while preserving fat-free mass resulting in the greatest change in body fat percentage per dollar spent. This analysis suggests diet plus exercise is more beneficial to health and weight loss than diet alone.

In the same timeframe, a substance called Bisphenol A (commonly known as BPA) was recognized as major-league bad news. In 2014, more than a decade ago, a study conducted by Health Affairs was the first to attach a dollar value to the damage done by BPA, as follows:

Author Leo Trasande found that $2.98 billion in annual costs are attributable to BPA-associated childhood obesity and adult coronary heart disease. Of the $2.98 billion, the study identified $1.49 billion in childhood obesity costs, the first environmentally attributable costs of child obesity to be documented.

The conclusion derived from this information at the time was that the FDA should insist that manufacturers find something else to put in their products instead.

Your responses and feedback are welcome!

Source: “Food a ‘national security issue’ for America,” CNN.com 09/13/13
Source: “Being obese can cost you as much as missing three years of college ” DailyMail.co.uk, 10/09/14
Source: “Analysis of efficacy and cost effectiveness of popular weight loss and fitness programs,” JISSN.com, 12/06/13
Source: “Health Affairs Web First: First-Ever Quantitative Data About The Toll Of BPA Exposure,” HealthAffairs.org, 01/22/14
Image by anaterate/Pixabay

All Sorts of Prices

After the turn of the century, it became more evident every year that spending a smaller amount in the present could avoid much larger bills later on. Teenagers were shuffling around looking like pathetic retirees, and once America had become accustomed to the idea that there were not enough physically fit youth to make an army, it quickly became clear that a large part of the national workforce might lose the capacity to perform any work at all, due to physical neglect and a reluctance to acquire better habits.

Over the century’s second decade, it became clearer every day that the obesity train had jumped the track. Dangerous body weight became a common media topic. Percentages and ratios were calculated, and inventive minds conjured ways to impress audiences with shocking conclusions:

Some 40 to 50 percent of food eaten by kids is consumed at school, and school cafeterias, which have to be financially self-sufficient, push unhealthy, packaged food at kids.

The average teenager was daily gulping down four containers of sugar-sweetened beverages, which, as statisticians and journalists warned the public, are…

[…] the equivalent of an entire extra meal in terms of calories… With a 90 percent profit margin on their products, the soft drink industry can spend millions on hyperactive advertising.

Point being, obesity was getting more expensive every day. The Federal Trade Commission banded together with several other distinguished agencies in an attempt to make the food industry adopt a few nutritional guidelines, but this concept was shot down. Dire and unarguable predictions were made:

Americans are doomed to pay even more for the cost of treating obesity-related illness if the weight epidemic is not addressed. And unless we’re willing to respond to the timely wake-up call […] many of us — and many of our children — will pay with their lives.

Those remarks were made in response to the acclaimed four-part TV series, “The Weight of the Nation.” Journalist Molly Creeden compares the obesity alarm response to the time years before when people began to react against the dangers of tobacco smoking. Again, bad habits correlated obviously with huge expenses:

Nearly 69 percent of American adults and 32 percent of children are overweight or obese… The U.S. spends nearly $150 billion on obesity-related healthcare annually, and the affliction costs American businesses $73.1 billion a year.

Ouch!

Those sugar-sweetened beverages were not the only villain. Blame should also be laid at the feet of “conglomerate food companies, whose marketing of unhealthy choices —particularly to children — is painted as merciless.”

Of course, the available food itself is not the only source of blame. There is always a need to look at what inspires a child to eat too much. In various posts, Childhood Obesity News pointed out that sometimes a history of abuse causes a young person to deliberately become obese in order to deflect unwanted and unwelcome physical attention, and this can be true of both girls and boys.

A male child who was bullied in his younger years might grow to a massive size to intimidate hostile others by his sheer bulk. A youth who does not ever want to be inducted into the military might, consciously or subconsciously, decide to become obese to avoid that fate. When psychological depths are plumbed, anything might happen.

A child might feel that layers of fat provide a sort of cushioned armor that can protect her or him from the world’s perils. Sometimes a young girl will discover this on her own. In other unfortunate cases, there may be misbehavior or a threat of assault on the horizon. An anxious, misguided mother who holds the belief that chubbiness will protect her female child from unwanted male attention might purposely overfeed that little girl to provide protection in the only way she knows how.

Many different kinds of mistakes can be made, and they all come with a price attached.

Your responses and feedback are welcome!

Source: “’The Weight of the Nation’ review: Obesity crisis,” SFGate.com, 05/10/12
Source: “American Emergency: HBO’s The Weight of the Nation,” Vogue.com 05/11/12
Image by trtasfiq/Pixabay

Obesity, Expenses, and National Security

In 2010, Air Force Major Gen. Frank R. Faykes made a speech in support of passing the Child Nutrition Bill, which was drafted with the intention of removing junk food from vending machines and taking other measures to improve nutrition in schools. The retired officer was anxious to bring certain facts to the attention of America: mainly, that one-fourth of all high school graduates in the country were too fat to be accepted into the armed services.

This stumbling block to the nation’s security and military readiness he characterized as “very troubling,” because once the 17-to-24-year-old high-school dropouts and people with criminal records were factored in, only seven out of 10 theoretically eligible recruits would actually be acceptable. In other words, the majority of the nation’s youth were not in good enough shape to be trained to destroy enemies while preserving their own lives.

Gen. Faykes also advocated for early learning opportunities that would result in improved graduation statistics, and also reduce teen criminal activity. Most importantly, he urged Americans to find the political courage to invest in people long-term. The news story concluded,

“You don’t see a return on it for a decade,” he said, but every dollar applied to early education results in a savings of $16 later in the criminal justice system. “Today’s military may be high-tech, but our real asset is our people.”

Around the same time, journalist April Wortham quoted U.S. Surgeon General Regina Benjamin on the subject of the U.S. workforce overall. Benjamin addressed a crowd in Nashville, Tennessee, a state in which more than one-third of the kids from 10 to 17 were either overweight or obese, on the specific subject of childhood obesity. One of her remarks was,

If kids are having high blood pressure or heart disease when they’re 19 or 20 years old, you’re not going to have a work force out there.

Two years later, many Americans watched with alarm the HBO four-part series entitled The Weight of the Nation. Its purpose was to inform Americans about the causes of the obesity epidemic, and which symptoms to look out for, what treatments and solutions were available, and what the future might hold.

The four episodes were titled “Consequences,” “Choices,” “Children in Crisis,” and “Challenges.” The challenges then were much the same as now. Obesity opponents are up against cultural factors, dieting myths, the inadvertent causing of harm in pursuit of improvement, the noisy debates against drug use, extreme dieting, bariatric surgery, and more. The series also took a hard look at the future of such professions and public services as soldiering, firefighting, police work, and other fields, in the face of ever-diminishing fitness.

Points were also made about popular preferences, industrial imperatives, and “government policies dating back decades.” The piece included the words,

The relatively inexpensive food that most Americans consume every day may seem like a good deal, but in fact is a very expensive proposition. Unaccounted for in the price are, among other things, the future health care costs associated with heart disease, diabetes, and other obesity-related diseases. This examines a long-term strategy for trying to improve the American diet.

SFGate reporter David Wiegand characterized the series as “a chilling look at physical, financial costs of a U.S. crisis.” Obesity contributes to five of the 10 leading causes of death in America, costs businesses more than $73 billion a year, adds $150 billion to health costs now, and may hit $300 billion by 2018.

Your responses and feedback are welcome!

Source: “Childhood obesity has huge impact on military readiness,’ PilotOnline.com, 11/10/10
Source: “Surgeon General: Childhood obesity endangers future workforce,” BizJournals.com, 11/16/10
Source: “The Weight of the Nation,” HBO Max, 2012
Source: “’The Weight of the Nation’ review: Obesity crisis,” SFGate.com, 05/10/12
Image by BrianPenny/Pixabay