What makes the obesity problem so difficult is that it pretty much came out of nowhere and we, in essence, have no reliable solutions to pursue.
The singular feature of American obesity is its steep, out-of-nowhere rise. For most of the 20th century, U.S. obesity rates were stable, with a slight upward trend through the late 1970s. Suddenly, they spiked across all demographic groups and have continued to rise unabated. In sheer body mass, the entire population is heavier than it used to be, and the heaviest are much heavier. Just between 1998 and 2006, obesity rates increased by 37%, according to the CDC.
The costs are nearly as startling. In a study published this week in the journal Health Affairs, CDC researchers estimate that obesity now accounts for 9.1% of all medical spending—$147 billion in 2008. The Milken Institute estimates that chronic disease costs more than $1.2 trillion every year. On top of the medical resources devoted to preventable illness, a fatter and sicker work force is a drag on economic growth. In effect, we’re eating money. (link to Health Affairs study)
Last week the CDC held its wittily named “Weight of the Nation” conference to discuss obesity in order to game plan its approach to fighting the problem. What’s been tried/suggested (a few): discourage auto transit, eliminate agriculture subsidies, ban food advertising, interventions in the school, family, and community. Read about them here in a piece by Megan McCardle; her summary of obesity-fighting efforts indicates most interventions up to (right) now have been rather unsuccessful:
But the political opposition these actions would face is absolute(ly) enormous. Americans were not blindly seduced into an auto-based lifestyle by the paver’s union; they voted for lots of roads because they like their cars. Every president since Reagan has wanted to eliminate farm subsidies, and every president since Reagan has thoroughly, utterly, entirely failed. Similarly, the food and entertainment industries are not going to stand idly by while you do away with 10% of advertising revenue. “Fix the schools” and “fix crime” are two agendas that society is currently aggressively pursuing, with limited success. And I’m skeptical that you’re going to find something north of $30 billion a year for the kind of early-child interventions that really seem to make a difference.
Addressing the obesity problem at the point of (health) care is too late. It’s (mostly) a problem of individual choice and it seems the solution likely falls in the same hemisphere. But that’s rhetoric, now onto the implementation…
RELATED UPDATE: Guess we’ve been “shaving the bear…”