Land of Plenty – Overweight and Obesity in America

Terry D. Etherton

There is an ongoing overweight/obesity epidemic in the United States.  Estimates from the National Center for Health Statistics are that about 66% of Americans are either overweight of obese! This epidemic not only poses a health problem for overweight/obese individuals, but also represents a rapidly expanding burden on health care costs in America.

In a story, “Costs of Treating Obesity Soar“, published on July 28 in the Wall Street Journal it was noted that the medical costs for treating obesity-related diseases soared to about $147 billion in 2008.  By comparison, the medical costs of obesity in 1998 were about $78 billion.

Not surprisingly, overweight/obese individuals spend more on medical cost.  In fact, according to the article in the Wall Street Journal, overweight/obese individuals in the United States spend about $1400 more per year on health care costs, much of this being prescription drug costs.

It is evident that overweight/obesity reflects a gain in body weight, largely fat (adipose tissue is the scientific term).  Adipose tissue mass expansion reflects a positive energy balance, i.e., individuals either eat too much, exercise too little, or do both.  The challenge confronting the health care community is that effective intervention programs, on a population-wide scale, have not been very successful.

Encouraging individuals to eat less on a long-term basis is difficult.  In addition, portion sizes have increased dramatically in America, which contributes to increased energy intake.  To learn more about how portion sizes have changed over the years in America take a look at the Portion Distortion Quiz.  This is “neat” learning experience developed by the National Heart Lung and Blood Institute of the National Institutes of Health.

My observation over the past decades is that government agencies and health care organizations in the United States have spent large sums of money on obesity research and nutrition education programs designed to decrease the incidence of overweight/obesity.  Over this interval, the incidence of overweight and obesity has increased markedly.  One could conclude that this massive expenditure of money on prevention/intervention programs has increased the incidence of overweight/obesity.  This is not the point.  The important point is that successful intervention programs for combating overweight/obesity are very difficult to develop and effectively implement.

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