Weight of the world

No healthcare reform without food-system reform 8

scaleThe AP reports on a new state-level study of obesity rates. And the news is, well, terrifying:

Obesity rates among adults rose in 23 states over the past year and didn’t decline anywhere, says a new report from the Trust for America’s Health and the Robert Wood Johnson Foundation

...[W]hile the nation has long been bracing for a surge in Medicare as the boomers start turning 65, the new report makes clear that fat, not just age, will fuel much of those bills. In every state, the rate of obesity is higher among 55- to 64-year-olds - the oldest boomers - than among today’s 65-and-beyond.

That translates into a coming jump of obese Medicare patients that ranges from 5.2 percent in New York to a high of 16.3 percent in Alabama, the report concluded. In Alabama, nearly 39 percent of the oldest boomers are obese.

But wait, say the contrarians! This isn’t a crisis. The obese die sooner—they cost less to treat over their lifetimes so no need to worry. Right? Wrong.

Health economists once made the harsh financial calculation that the obese would save money by dying sooner, notes Jeff Levi, executive director of the Trust, a nonprofit public health group. But more recent research instead suggests they live nearly as long but are much sicker for longer, requiring such costly interventions as knee replacements and diabetes care and dialysis. Studies show Medicare spends anywhere from $1,400 to $6,000 more annually on health care for an obese senior than for the non-obese.

And when you start multiplying those thousands of extra dollars by the millions of obese baby boomers out there, pretty soon you’re talking about real money.

But it’s all about personal responsibility in the end, isn’t it? As corporate front groups like the Center for Consumer Freedom and lobbying outfits like the American Beverage Association incessantly remind us, if people just made the right decisions there wouldn’t be a problem. So, kids, it’s high time you started taking responsibility for yourselves—especially you all in Mississippi, Alabama and Georgia where childhood obesity rates are 44%, 37.5% and 37.3% respectively. There. I did it. Problem solved.

The study also reiterates the fact that the obesity epidemic is correlated fairly highly with income—states with lower per capita incomes have the highest obesity rates. And vice versa—Connecticut and Massachusetts have some of the lowest obesity rates in the country (although even in those states obesity has at least doubled since 1985). And when you think about it, it makes sense. Healthy food is expensive while junk food is cheap and, as I wrote about regarding food swamps, ubiquitous.

But the headline here is the fact that reforming health care can’t happen without reforming the food system. Indeed, it’s been observed that our health system may soon collapse in the face of the obesity epidemic—no system can handle diabetes rates of 25% or more. As a result, the only health care “cost control” that matters for obesity is attacking the root cause.  And reforming the food system means, among many other things, beating back the tsunami of high-calorie, low nutrient food products. At a minimum, we really need to stop pretending that we can surf the tsunami. Because sooner or later—directly or indirectly—it’ll drown us all.

Tom is a media and technology professional who thinks that wrecking the planet is a bad idea. He twitters madly and blogs here and at Beyond Green about food policy, alternative energy, climate science and politics as well as the multiple and various effects of living on a warming planet.

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  1. Quantum Shift Posted 9:28 pm
    01 Jul 2009

    What if we were to decide that the inherited wealth of biodiversity is a birthright to all human beings and other animals? We could decide, then, that those who do things on the Earth that have an adverse impact on biodiversity and ecological health generally, (such as plow meadows and plant monoculture), will be made to pay a fee to the people as compensation for the fact that the people are allowing some encroachment on or some taking of that which is the birthright of every citizen.This fee could be set at a level high enough to ensure that the practice of plowing or paving the Earth or doing some other damage to the environment is kept at overall levels that are not excessive, that do not offend the majority of citizens.If most people felt that the planting of monoculture sugar cane or corn or oil-seed crops or animal feed crops was contributing to a system where certain foods are overabundant to the detriment of human health and society at large, there could be an additional fee or higher rate, so that the perponderance of foods in the market roughly balanced what most people and most nutritionists believe is a healthy mix. Then there would not be an excess of those high-energy foods that we have evolved a strong appetite for, owing to their relative rarity through our evolutionary history.

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  2. Steven Earl Salmony Posted 6:00 am
    02 Jul 2009

    "When I give food to the poor I am called a saint.  When I ask why the poor have no food to eat, they call me a communist"{or worse} ----- Dom Helda Camera Steven Earl SalmonyAWAREness Campaign on The Human Population, established 2001http://sustainabilitysoutheast.org/index.php

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  3. nikkitish Posted 8:27 am
    02 Jul 2009

    Our food systems definitely need an over haul! With the correlation between wealth and obesity something has to be done.  Fast food giants not only direct the impoverished, but also our children.  I think one of the biggest contributors to youth obesity is the placement of fast food restaurants within 1/10 a mile of schools.  How can we expect that our children won't eat fast food when they can see it from their class room windows? check out Corporate Accountability International's "Value [the] Meal" campaign - they have a ton of great information about the corporate abuses committed by the fast food industry: http://stopcorporateabuse.org/value-meal

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  4. Tyler Durden Posted 1:55 pm
    03 Jul 2009

    I fully agree that the U.S. food system is geared toward profits for agribusiness, not growing healthy food.  But why denigrate personal responsibility?  It is exactly that attitude that creates problems to begin with.  If those in power took personal responsibility, things would be vastly improved.  Not being rich or powerful is no excuse for failing to take responsibility for one's actions.  We are all responsible for what we do, it's just that the rich & powerful are that much more responsible.  The only thing you have to do once you're born is die; the rest are all choices, albeit some very difficult ones.

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  5. cook_food Posted 7:28 pm
    05 Jul 2009

    This focus on obesity is reakky frustrating. The public health issue is not at all that people are fat (reality check: many many fat folks are perfectly healthy, eat well, and exercise; some medical studies have shown that being too thin carries as much or more of a risk of death than being what our culture considers too fat). The problem, to oversimplify things hugely, is processed foods and environmental toxins.

    But obesity is a target because it plays into our culture's obsession with thinness and hatred for fat.

    I'd like to see the pro-food movement become more skeptical of the medical industry's claims about obesity. Weight loss is a multibillion-dollar business. We're already skeptical of Big Ag; it's time to widen our view and see that there's more to the story on obesity as well.

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    1. Quantum Shift Posted 6:49 pm
      06 Jul 2009

      "some medical studies have shown that being too thin carries as much or more of a risk of death than being what our culture considers too fat"What studies have shown that? Can you put a link to them here, (put a web address)?I understand that people who are extra thin tend to live a lot longer.We have too many growth hormones in the food supply. AND we eat too much protien and too many calories... for our own good.... on average. 

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  6. cook_food Posted 7:48 am
    07 Jul 2009

    Here's a NYT article about one of the studies: http://www.nytimes.com/2005/04/20/health/20fat.htmlAnd another, focusing on the elderly: http://www.dimensionsmagazine.com/news/thin_elderly.htmAlso, info on indications that the link between fat and heart disease is FAR from as straightforward as conventional wisdom would have you believe:http://health.usnews.com/articles/health/healthday/2008/08/11/studies-refine-obesitys-risk-for-heart-troubles.htmlhttp://www.bloomberg.com/apps/news?pid=20601124&sid=a892HASUU_4w&refer=homeEvidence that physical activity, not weight, is key (these articles are not available online, unfortunately):“Physical Activity, Relative Body Weight, and Risk of Death among Women,” New England Journal of Medicine, December 24, 2004"Physical Inactivity Is Risky, Even if You're Lean," same source.
    I'm not trying to prove that being "fat" is better than being "thin"--I don't think that's a productive way to think about bodies *or* health. And I agree that U.S. eating habits are unhealthy for people and the planet. My point is just that all this focus on obesity does two things: It obscures the root problem, because it lets people think that only fat people are at risk from unhealthy eating (which not only is not true but also scapegoats an entire population--and MANY MANY fat people eat healthily and are active); and it supports discrimination (overt and covert) against fat people.Here's a wikipedia entry on the Health at Every Size movement, which contains a lot of useful links as well: http://en.wikipedia.org/wiki/Health_at_Every_Size

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  7. Mad Chemist Posted 11:58 am
    07 Jul 2009

    Just say no.  Nobody has a gun to their head and is forced to drink soda or eat foods with high fructose corn syrup or lots of salt and grease.  People eat this food because they choose to eat this food.Junk food is not cheap.  A 12 oz soda costs most of a dollar, a glass of tap water costs a few cents.  If you insist on buying bottled water, most stores sell it in gallons for less than a dollar.  A one ounce bag of potato chips cost about a dollar.  You can buy three or four pounds of potatos for a dollar.  You can eat rice and beans like most of the world, but that would mean you would have to get off your arse and cook.Take charge of your life and stop being a victim,

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