The year was 1977. I was sitting in seventh grade science when the teacher asked the class, “What is the function of body fat?” After several guesses from the students, he explained that one primary function was energy storage. The ability to store excess calories as fat was critical to our ancestor’s survival during periods of famine. He added, “Paul could survive several months without eating because of his surplus of energy storage.” Needless to say, I was very embarrassed.
I was overweight my entire childhood. My memories as a child are of always being tired, out of breath and hungry, even though food was consumed often and abundantly. I remember being picked last to play on teams at recess (if I was picked at all), being teased, feeling humiliated and alone. As a teenager, I developed high blood pressure as a result of years of being overweight.
I watched family members struggle with their weight, developing chronic health problems that required endless prescription medications. Several family members even required a machine to help them breathe at night. Some died young, while others struggled to have any quality of life, barely able to walk or even get through the day.
Forty years later, I am physically fit, due to my commitment to exercise and good nutrition. Today, obesity is the single greatest health threat in the United States and affects millions of Americans who are obese and suffer from related chronic conditions. This health crisis not only threatens the lives of millions, but also the U.S. economy and the future of our children.
The American College of Sports Medicine defines obesity as a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to decreased life expectancy and/or increased health problems. People are considered obese when their body mass index (BMI), a measurement obtained by dividing a person’s weight in kilograms by their height in meters squared, exceeds 30 kg/m2.
The incidence of obesity is increasing at alarming rates. The Center for Disease Control reports that more than 30 percent of Americans (100 million) are obese and more than 60 percent (200 million) are overweight (BMI is greater than 25 kg/m2). The CDC projects rates of obesity to increase to 42 percent by 2020 and that 50 percent of Americans will be at risk for diabetes. Think of the ramifications of this report –– in five years, nearly half of U.S. citizens will be obese and at risk for diabetes. South Carolina has the seventh highest rate of obesity at 33 percent.
Rates of childhood obesity are also increasing rapidly, along with increased incidence of chronic conditions including diabetes. Currently, more than 33 percent of U.S. children are overweight and/or obese. The situation is so bleak that experts predict the current generation will be the first in history to have a shorter life span than their parents.
Obesity is the number two cause of preventable death, trailing only behind smoking, and contributes to 300,000 deaths annually, according to the CDC. Obesity is a dangerous medical condition that significantly increases the risk of all-cause morbidity and mortality including heart disease, diabetes, hypertension, elevated cholesterol and triglycerides, cancers of the breast, prostate and colon, arthritis and sleep apnea. The Journal of the American Medical Association reports obesity increases mortality rates by 20 percent.
The “how and why” we have become increasingly at risk for obesity and related conditions is complex, but the simple answer is that technology and industry have created an environment which includes processed foods and labor-saving devices that have made us increasingly sedentary. Harvard University Paleoanthropologist Daniel E. Lieberman writes in his book, The Story of the Human Body: Evolution, Health, and Disease, that the obesity epidemic is directly related to our sedentary lifestyle and the Standard American Diet. He calls obesity and associated morbidities “mismatch diseases,” or conditions and environments that the human body was not made for. Lieberman warns that obesity is one of the greatest threats facing the human species.
While increased mortality and morbidity rates are troubling consequences of obesity, perhaps the greatest tragedy is the fact that obesity erodes the quality of life. Depression, low energy, social discrimination, poor self-esteem and loneliness are common. Depression increases the risk of self-destructive behaviors, such as overeating, thus perpetuating a viscous cycle.
When a person is obese or significantly overweight, the effects go far beyond poor health. Obese people may have a more difficult time finding a job, a relationship or the energy to simply take care of everyday demands. The medical industry has convinced society that headaches, gastric distress, body pain, fatigue and countless other ailments are normal and inevitable conditions as part of the aging process. The truth is, these conditions are the direct result of a poor diet and inactivity.
Many people blame obese people for being obese. Fat, lazy, undisciplined and gluttony are descriptive words used to explain why people become significantly overweight. Paul Zane Pilzer, economist and wellness expert, writes, “This is the same logic that blames poor people for being poor. Such accusations are often linked because obesity is strongly associated with poverty. Minority and low-income groups suffer from statistically significant higher rates of obesity, heart disease and diabetes. In the past, poverty was associated with thinness and overweight with wealth. Today, a rich fat man has become an oxymoron, while poor and fat has become synonymous.”
On my 40th birthday, Rosanna, my wife, surprised me with a trip to Santa Barbara, Calif. I remember seeing everyone out cycling, walking or jogging … and engaging in sports of all types. Nearly everyone I saw looked fit and energetic. At restaurants, healthy choices were the norm, and the number of overweight or obese people were virtually non-existent. Being from South Carolina, where fried foods, sweet tea and sugary desserts were normal, it felt as if I were visiting another galaxy. It was also equally apparent that most of the people I saw were from the upper socio-economic bracket.
Paul Zane Pilzer explains how powerful economic forces have contributed to the obesity crisis. The trillion-dollar food industry has created thousands of hyper palatable foods that are addictive. The food industry utilizes the same strategy as big tobacco companies, which engineered the chemical composition of their products to increase consumption.
Pilzer describes how large processed food companies employ the brightest minds in demographics and consumer psychology to determine the best strategies to increase product sales. These companies understand that the best customer is the customer already sold on a product. Called the “potato chip marketing equation,” the processed food industry knows that 90 percent of product sales are purchased by 10 percent of the population. Translation — it is more effective to persuade a consumer who purchases their product to consume more of their product than it is to target new consumers for whom the product is novel. Demographic studies further demonstrate the average consumer of processed foods weighs more than 200 pounds and earns less than $35,000 annually.
The goal is to get this group, the target market, to increase consumption, for example, from three bags of chips per week to four bags of chips per week. Company chemists then work with sample consumers, called focus groups, to have them sample foods engineered to increase consumption.
Make no mistake about it, the “can’t eat just one” slogan is based on the biological fact that sugar, fat and salt are hard wired into our DNA as substances we crave. In his book, The End of Overeating: Taking Control of the Insatiable American Appetite, David A. Kessler, M.D., former FDA head, revealed in studies that these processed foods are as addictive as crack cocaine.
Once over consumption of these processed foods, along with a sedentary lifestyle, have progressed to the point of obesity and chronic conditions such as diabetes, the consumer (i.e. patient) turns to the medical industry for help. Unfortunately, current medical strategies to treat chronic health issues are symptom based, dangerous and ultimately ineffective. But, it is lucrative!
Medications for high blood pressure, elevated cholesterol, diabetes, reflux, pain killers and countless other drugs are distributed like candy on Halloween to patients to alleviate the symptoms of the toxic “American lifestyle.” Pharmaceutical companies like Pfizer, Novartis and others generate billions in profits but do not address the cause of conditions like obesity and, therefore, only treat enough symptoms to allow the patient to return to work … and consumption.
The bill for health care expenses in 2014 was $3 trillion, nearly 20 percent of the U.S. Gross National Product. The CDC reports 50 percent of this expense is the result of preventable chronic conditions:
- Obesity – 90 percent preventable
- Heart Disease and Stroke – 80 percent preventable
- Diabetes – 80 percent preventable
- Cancer – 60 percent preventable
Pilzer writes, “The U.S. health care system has been unable to solve this crisis of voluntary poor health. Health care is a misnomer, as 95 cents of every dollar is spent after the disease is present. At the beginning of the last century, discoveries in inoculation and antibiotics allowed physicians to develop preventive measures for diseases including tuberculosis, smallpox, typhoid and polio.”
This is no longer the focus. Treating symptoms of disease has become more profitable. Consider:
- It is more profitable for pharmaceutical companies and medical suppliers to produce products consumers use the rest of their lives than to create products consumers use only once. This means spending research and development dollars on products that treat the symptoms of disease rather than the causes or cures.
- Third party payers of health care industry benefits — insurance companies and employers — do not have a long-term stake in the health of their employees.
- Until recently, most individuals bear little or no responsibility for their medical expenses. Almost all expenses to prevent diseases from occurring in the first place are disallowed by insurance.
- Most physicians, like obese consumers, are targeted by medical and pharmaceutical companies to provide treatments and prescription medications that are most profitable as opposed to interventions that are clinically most efficacious. Medical technology changes so quickly that much of what is learned in medical school is obsolete by graduation.
Often, physicians learn much about new treatments and medications from multi-billion industries utilizing highly trained salespersons. Physicians receive free samples and other incentives to use their product. These pharmaceutical’s carry a heavy price tag and generate staggering profits but do little if anything to address the causes of obesity, diabetes and heart disease.
There is no conspiracy between the food industry, which causes most of the problems, and the medical industry. Rather, they both are operating on the basic laws of economics. Yet, the profit at all costs mentality operates as if the two industries were cooperating.
Meanwhile, many consumers are left to fend for themselves. Even if research is unveiled which provides strategies to improve health, often big businesses responded by producing products to capitalize on the studies, yet do not deliver healthier options.
For example, when research was released stating less dietary fat intake was advantageous to our health, the food industry responded by producing foods that were “reduced fat” or “fat free” but actually were worse than the products they replaced (i.e. margarine). Sometimes products that were already fat free were repackaged with fat free labels to increase sales to unsuspecting consumers hoping to make healthier choices.
Not to be outdone, the pharmaceutical industry spends millions on marketing campaigns promising solutions to our health issues. Take the cholesterol-lowering drug Lipitor. We have been bombarded by marketing campaigns that statins, like Lipitor ($20 billion annually), lower the risk of heart disease. Yet a study in JAMA demonstrated that intensive lifestyle intervention of exercise and nutrition therapy improved cholesterol levels as much as 40 percent without the use of medications and without the dangerous side effects. Lipitor, for example, has been linked to increase risk of diabetes in women. Why then is lifestyle intervention not on the medical menu of treatment options for patients?
The good news is that research from the National Institute of Health, ACSM, and others has proven comprehensive lifestyle interventions including exercise, nutrition and behavior therapy can prevent and reverse obesity as well as associated conditions like hypertension, diabetes and heart disease.
Paul Lomas, who earned his Bachelor of Science degree in Exercise Physiology and associate degree in Physical Therapy, is a Certified Strength and Conditioning Specialist. He has 30 years experience in physical therapy, cardiac rehabilitation, weight management, risk intervention and corporate medicine.