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Tuesday, March 19, 2013

Obesogenic Nation

The causes of being overweight or obese are multifaceted.  At the bottom line, it's about consuming more calories than the body burns off in energy.  However, this imbalance may be triggerd by many interconnected factors, including environment, psychological, cultural and socioeconomic factors as well as overeating, lack of exercise, slow metabolism, and genetic makeup.

On its Overweight and Obesity webpage (, the Centers for disease control states that, “Behavior and environment play a large role causing people to be overweight and obese. These are the greatest areas for prevention and treatment actions.”  In fact, the CDC calls American society “obesogenic” because it is characterized by environments that promote increased food intake, unhealthy foods, and a sedentary lifestyle.

Obesity not only takes a toll on people’s health, but it also it places a financial burden on the nation’s healthcare system.  A study by Cornell University that appeared in the January 2012 issue of the Journal of Health Economics calculates that obesity currently accounts for almost 21% of total U.S. healthcare costs—more than twice that of previous estimates. 

As delineated in F as in Fat:  How Obesity Policies are Failing in America, 2012, the latest of nine annual reports by the Trust for America’s Health and the Robert Wood Johnson Foundation, the medical cost of adult obesity in the United States is difficult to calculate but estimates range from $147 billion to nearly $210 billion per year. Most of the spending is generated from treating obesity-related diseases such as diabetes.  Medicare and Medicaid are responsible for $61.8 billion of the $147 billion.

At the CDC’s Weight of the Nation conference in May 2012, a new report presented by Study leader Eric Finkelstein, a Health Economist at Duke University in Durham, NC and published in the May 2012 issue of the American Journal of Preventive Medicine projected that the ranks of obese Americans would swell even further in the coming years, rising to 42% of the adult population by 2030 and adding nearly $550 billion in additional medical costs over the next two decades.

Due to obesity’s scope as a national healthcare problem, it has also become a political issue, as federal, state and local governments try to help bring the crisis under control through new new legislation, nutritional guidelines, and public health initiatives.

In 2009, the Obama Administration took aim at obesity—particularly childhood obesity—with its Let’s Move program, which brings together several federal agencies to focus on improving nutrition and encouraging exercise.  State and local governments are also trying to combat obesity by legislating policies and food environments to make healthy nutrition and physical activity choices more available and affordable.  Some local governments are providing tax breaks and streamlined permits to encourage fresh-food grocers and farmers’ markets to set up shop in neighborhoods that need them, and zoning neighborhoods to encourage more sidewalks and bicycle paths. 

Public health experts believe that the best way to attack the obesity crisis is to prevent people from becoming obese in the first place.  They especially emphasize children, based on a finding from the landmark Bogalusa Heart Study conducted by Tulane University between 1972 and 2005:  77% of obese children go on to become obese adults, while only 7% of non-obese children do.  Other studies show that school-based programs can help prevent and reduce obesity.  Currently, Packaged Facts estimates that U.S. retail sales of the weight management products and services  (foods and beverages, meal replacements and diet aids, and commercial weight management programs) topped $36.9 billion in 2012.  Commercial weight management programs are projected to pick up steam by 2015 and grow the fastest through 2017, based on expansion to online and new markets and cyclical innovation. 

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