Obesity’s Price Tag

These items relate to a subject often mentioned here: the societal cost of obesity. Every so often, along comes a news story that points out another example of how the system does not work as well as our society actually needs for it to work.

For instance, within the past year, India has been mentioned as a place where bariatric surgery has really caught on in a big way. Leaving all other factors aside for the sake of discussion, it is possible to question the benefit to society as a whole. It can’t be considered good for a society to have a large proportion of its members absorbed by the overwhelmingly intense preparation agenda for this sort of operation.

However much of a blessing it may be in a particular case, and in the long run, bariatric surgery is a very life-consuming project in terms of burning up time, energy, goodwill, money, and other resources.

But wait, there is more

Then, after the actual procedure, there is a similarly unproductive spell, as the patient is, to a greater or lesser degree, disabled for a considerable period of time. Even barring any unexpected side effects, there are new routines to learn and new norms to become accustomed to, on every side.

There will be medical self-care chores, and record-keeping, and check-up visits. Maybe time will be set aside for meditation. The patient actively participating in their recovery is unable to do very much else, at least for a while, if the newly required lifestyle is to “stick.”

To complete their usual work, or family caregiving, or volunteer activities in the community — effective participation in even one of those categories could prove to be too much to expect, and for quite some time. Somewhere along the line, a price is extracted from — and paid by — society as a whole.

A bit of history

By 2018, 60% of Americans — in other words, more than half of us, over 180 million people — were overweight or obese. That statistic was responsible for “$480.7 billion in direct health care costs in the U.S., with an additional $1.24 trillion in indirect costs due to lost economic productivity.”

The total amount of around $1.72 trillion was equivalent to almost one-tenth of the total Gross Domestic Product. As a risk factor, obesity accounted for close to half of the accumulated cost of chronic diseases in the USA. It should be, and is, possible to acknowledge this reality in a tactful, frank, non-judgmental way, not involving cruelty or injustice.

These words are worth repeating:

Whether or not it is their fault, and whether or not others spitefully blame them, and regardless of whether it is fair — in one way or another, obese people constitute an expense to society.

We also discussed whether poverty causes obesity, or obesity causes poverty, and concluded that both propositions are sadly and eternally true.

And another sad-but-true thing

If fat-shaming and fat-blaming have not been able to revolutionize the situation in all these years, those techniques are unlikely to bring about change in the future.

Your responses and feedback are welcome!

Source: “America’s Obesity Crisis: The Health and Economic Costs of Excess Weight,” MilkenInstitute.org,” 10/26/18
Image by bergy59/Pixabay

Drugs and Surgery — Reevaluation Is Inevitable

A person who lives for several decades is bound to notice something interesting, as time goes on — namely, that one generation’s scandal is the next generation’s yawn. Around the turn of the century in the USA, for instance, a decent man didn’t appear in public without a head covering; and not just any hat, but one with a hatband, a dent in the top, and a brim.

In 1900, women who initiated divorces were as rare as hen’s teeth. By the year 2000, it was quite ordinary to meet a woman who had divorced three or four husbands.

In some times and places, people are implacably set in their ways, while in others, they can’t stand to do things the same way from one week to the next. Philosophers have spoken millions of words about the human tendency to resist change, especially in instances where some members of the population are attempting to force others to act normally.

In that discussion, of course, one issue is all-important. Who is privileged to decide what is considered normal in society, as opposed to what is regarded as unacceptably deviant?

Today and us

“Who died and made you king?” is a sarcastic question that many people have good cause, several times a day, to telepathically ask a passerby some version of. More specifically, they cannot help wondering why they have to go through life hindered by the judgment of others regarding the size and condition of their bodies.

In a way, to be grossly obese is like having two heads — you just know that everybody is staring, and even if they don’t judge with hostility, they probably feel pity. So then, you spend the rest of the day mulling over the question of which is worse, hatred or contempt?

There may be nothing basically wrong, in an abstract sense, with the educational and medical establishments of society having concern about people’s health. In a general way, it is comforting to know that some of the people who run things are in charge of seeing that you don’t catch the plague or smallpox.

That is managed, in a civilized society, by having public health authorities in charge of identifying and sequestering people with a contagious disease, and convincing the healthy ones to get a shot or something, so they don’t catch the illness or spread it around. Even the most ideologically strict proponents of freedom can usually see the sense in that.

What authorities?

But when it comes to obesity, even the most convincing arguments about public responsibility for public health tend to break down. Many people feel that it is no one’s business, especially that of a government bureaucracy, to know how many pounds the scale registers when you step on it. Perhaps a valid civic-minded argument can be made for weighing a newborn baby, because at that age, weight is the most obvious characteristic that can be non-invasively measured.

But ought the authorities to care quite so much about a kindergartener’s poundage? Does the System really need to know the circumference of each 13-year-old’s waistline? Should the authorities embarrass your children at school by weighing them?

An overview

A while back, Childhood Obesity News quoted Southern California health official Jonathan Fielding:

Public health works by successive redefinition of the unacceptable.

Consider the saying, “First they ignore you, then they laugh at you, then they fight you, then you win.” Nobody is sure who first said those exact words. It is certain, however, that trade union activist Nicholas Klein expressed the same concept in different words, and many other people have, too. There was a time when nobody had ever heard of a five-day work week or a paid vacation.

But thanks to the efforts of millions of staunch labor supporters, the unacceptable was successively redefined and became the norm. A similar process occurred back when former First Lady Michelle Obama worked to warn against and prevent childhood obesity. Voices were raised against the tyranny of governmental interference in kids’ eating habits and of families’ responsibility in that area.

Still, after two presidential terms, fewer Americans were either ignoring or laughing at the concept that childhood obesity should be taken seriously. Now it appears that the same kind of gradual change might be taking place in regard to both weight-loss drugs and bariatric surgery for teens and maybe even children.

Your responses and feedback are welcome!

Image by Pat Hartman

Goodbye to 2025, and Try This

The facetious advice in the picture on this page has been seen millions of times online and is impossible to trace back to its source. But let’s lift a glass of sugar-free fizzy soda and drink to the health of its author. Yes, going forward into the new year, humans will continue to fight against our own best interests. Sooner or later (perhaps in 2026!) more of us will come to see the truth of another anonymous quotation:

You can fool some of the people all of the time, and fool all of the people some of the time, but — ultimately, eventually, inevitably — you can’t fool yourself.

This blog has pointed out many of the societal costs of obesity, so for the end of December, it gathers a little bouquet of talking points from the past year and the past few years, and some things to look out for in the coming months.

There are problems we don’t want to see our kids, or any kids, have to face in the upcoming year or any year subsequent to this one. In other words, let’s poke and prod ourselves to do something about looming obstacles and stop putting off the unpleasant tasks. To stall is to invite consequences that quickly outgrow the unpleasant stage and morph into real-life nightmares.

Interview with an expert

“Watchful Waiting Not Recommended For Childhood Obesity” is the title of a very recent piece by Tim Ditman, and let’s have a peek at what the expert he interviews has to say about the subject.

The American Academy of Pediatrics (AAP) has been taking a second look at some of its guidelines and softening its attitude toward surgery and medication. Some parents became nervous about venturing beyond the traditional guardrails of diet and exercise, and this is understandable.

Too often in life, the urge to “Do something!” becomes diverted or misapplied. The only thing worse than neglecting a problem is approaching it with the wrong tool. Maybe the error even lies in the mental construct of attack. Maybe “address” or “examine” is a better approach. So we do not want to start out with a misstep. When aiming for a compass bearing, even a single degree of error can lead to far, far from the intended destination.

One thing is for sure:

The AAP says waiting and hoping things get better is not a good choice.

Up until about age 12, sure, stick with the traditional methods, but beyond that age, “diet plus exercise” is not a sufficient prescription. The AAP is talking about, among other remedies, “in-person, family-based behavioral health treatment” for three months to a year. After passing that 12-year mark, the organization says, let’s start thinking about a pharmaceutical approach; and after the 13th birthday, in many cases surgery should not be arbitrarily ruled out.

Registered dietitian-nutritionist Carly Zimmer feels empathy for the difficulties that children face. Their lives are saturated with “activity” that involves mainly sitting on their ever-enlarging behinds, watching screens that glorify and strenuously recommend eating all the wrong stuff, and plenty of it. Yet and still, very often the food is not the enemy — the mind is.

Zimmer says,

Often our eating habits stem from events in our past, trauma or emotions. A mental health professional can dive into those topics and help establish a healthy relationship with food.

This is what needs to happen, not an eternal relationship with weight-loss meds acting as a band-aid, because a band-aid is glued to a person only to be replaced. That is why they are sold by the package. Commitment to a lifetime of regular injections of a very expensive drug is not a solution; not a win or a cure, or any other positive description of an outcome. It is a very poor alternative to what is ultimately possible, and many professionals are deeply committed to never settling for less.

Zimmer offers suggestions which, yes, have been heard before. That isn’t the point. If a concept has value, it is worth hearing a thousand times — until someone whose health hangs in the balance actually absorbs it. For parents, Zimmer suggests a technique that begins by adding, not subtracting. Go ahead and give the kid the same old cereal for breakfast, but offer fresh fruit, too. Maybe at some point, this particular individual will become more interested in the fruit and abandon the cereal.

Be the grownups

Get used to the idea that sometimes a child will be hungrier than other times, and don’t make a big thing out of it if they occasionally consume what you think is too much or too little. And forget that tired old “Join the clean plate club!” nonsense. Please do not set a heap of food in front of a kid. Let them start with a small serving of the fattening stuff, and maybe they will surprise you by scarfing down all the green beans.

Don’t let yourself be discouraged. You can place the same food in front of a child 20 times, only to see it scorned; and then, one day, they will eat it. When the child eventually caves and admits the stuff isn’t so bad after all, refrain from sarcasm. And now, Zimmer gives advice worth gold: “Don’t make exercise a chore.”

Parents, if there is some physical, active, calorie-burning activity your child enjoys, embrace it. Please. Find where the kid can go skateboarding or swimming, or learn gymnastics or Jiu-Jitsu, or whatever sort of exercise they can get behind. Please give them a chance to try an activity before committing to it. Make the time, find the money (it will probably not cost as much, ultimately, as weight-loss drugs or surgery), and figure out how to retain this as a major part of life, for as long as the child is into it. The rewards will be vast.

Your responses and feedback are welcome!

Source: “Watchful Waiting Not Recommended For Childhood Obesity,” RiverBender.com, 10/13/25
Image by JillWellington/Pixabay