The Cheerful Oncologist

Obesity now a ‘lifestyle’ choice for Americans, expert says

Waistline grows along with economy

Wealth and Waistlines – A new book explains how the obesity epidemic has been shaped by economics, and what we can do to reverse the trend

The Fattening of America, by Eric A. Finkelstein and Laurie Zuckerman, is a fascinating new book proffering an economic explanation as to why more and more Americans are obese – I think. I haven’t read it but that didn’t stop me from perusing the news stories coming out on Dr. Finkelstein’s analysis of obesity and its relationship to our modern economy.

If I may sum up his theses on why we’re getting fatter:

1. The evolution of our diet, as manifested by what foodstuffs make a nice profit for those involved in its creation, has made it more costly to buy healthy foods than mass-produced fattening junk food that is flavored with ingredients from the corn and soybeans farmers are getting dough to grow.

2. The evolution of our economy, as manifested by what our employers are looking for, has forced gazillions of Americans to work in sedentary jobs in search of better wages than can be found in active jobs (think lawn maintenance) that don’t pay as well.

3. The evolution of modern health care, as manifested by our ability to keep obesity-induced diseases from prematurely bumping off citizens before their time, serves to reinforce the attitude that obesity isn’t really all that bad for us because our talented doctor will certainly keep us going with new, exciting pills from Big Pharma.

4. It’s just too damn hard to find the time to cook smart meals, avoid fast food and exercise – unless, of course, you pay us to lose a few pounds. Grease our palms (or put us on network television) and we just might interpret this as the afflatus to deflate us.

5. Leisure time activities centered around sitting on our behinds provide us with much more comfort and joy than things such as say, bullfighting, mountain biking or anything else that denies us the divertissement housed within the latest iPod-DVD-Internet-PS3-Gameboy device.

As Dr. Finkelstein summarizes: “A lot of people just aren’t interested in carving out the time it would take to be physically active. Plus, it’s cheap and convenient to consume lots of great-tasting food. I argue that obesity is a side effect of any advanced economy. When you mechanize a society to the degree that no one has to do anything, no one’s going to do anything. Combine that with cheap, prevalent food, and the result is bound to be weight gain.”

I never thought of obesity as anything but a public health disaster, but perhaps I am being too harsh. As long as our economy can afford to pay for the medical care of obesity-related illnesses, maybe we should let folks expand their waistlines and not criticize them.

Of course, there is another way to slim down the population. As sinophiles know, Chairman Mao proved to be a genius at getting people to eat less – the only problem is that this was an unexpected consequence of a ‘separate plan’ – leading to the starvation of over 20 million of his own people. Oops.

Until folks realize that the best way to maintain a healthy weight is to not eat so doggone much and (as annoying as it is) reserve some time each day to do something physical, they have no chance to avoid plumping up – unless our government decides its time for the Amercian version of The Great Leap Forward.

Comments

  1. #1 As long as our economy can afford ..
    January 11, 2008

    Dear Cheerful Oncologist, have you been sleeping in the past 20 years? Who said the US can afford to pay for all the health care needed to treat obesity caused diseases? What do you think is causing the bickering about health care? It is true that the US health care does have a problem in distribution. But it is mainly because of soaring insurance premium, which is in turn caused by increasing claims. Suppose 1/3 of the cars in your city had accidents. How much would your auto insurance premium be? Did you go to college? Do you have any basic concept of economics?

    I don’t criticize the obese people. I just think they should try to improve themselves. They may never be thin. But one can be over-weight and still have a reasonably healthy life style. In my health club so many people told me that they had had heart attack or bypass surgery. Now they are reformed, and they really enjoy their new life. A healthy life style is not painful. Being sick is like hell.

    As a highly educated health care professional, you disappolinted me. I pity the educated you received.

    Quote from your comments:
    “I never thought of obesity as anything but a public health disaster, but perhaps I am being too harsh. As long as our economy can afford to pay for the medical care of obesity-related illnesses, maybe we should let folks expand their waistlines and not criticize them.”

  2. #2 Penny
    January 11, 2008

    Other possible reasons for obesity:

    We do have clean water, and we do not have intestinal parasites.
    We don’t smoke, but we do take SSRIs.

    In other words, we’re so dang healthy and medicated that we aren’t burning up calories fighting diseases, feeding parasites, and being depressed and anxious.

  3. #3 Debara
    January 11, 2008

    Interesting how ‘tongue in cheek’ and ‘nuance’ can be lost in the interpretation. Oh well! Happens to the best of us. (Now, please excuse my smile)

  4. #4 The Cheerful Oncologist
    January 12, 2008

    Dear Mr. or Mrs. “as long as our economy can afford..”:

    I am happy to answer your questions. Please accept my apology if they were meant to be rhetorical.

    1. In a series of lousy beds until I got a Select Comfort mattress.
    2. I said it.
    3. Socialists who want Uncle Sam to provide free health care for all with no fiscal consequences for those who suckle at the teats of Mother Piggy more than they would if they were paying for their medical care just like they have to pay for their groceries instead of getting them free from M. P., too.
    4. Probably higher, but then again I am an excellent, law-abiding driver with a fabulous safety record – do I get any credit for this?
    5. Yes, but only because my acting career stalled after appearing in “Arsenic and Old Lace” as Aunt Abby in drag, to a profoundly embarrassing chorus of boos.
    6. I think so, but you probably could whip me in a quiz, so I’ll just say “No”.

  5. #5 JLowe
    January 12, 2008

    As long as our economy can afford to pay for the medical care of obesity-related illnesses, maybe we should let folks expand their waistlines and not criticize them.

    That’s the problem though, our economy can’t. Two years ago, a group from Harvard reported that half of the bankruptcies in the US were medically-related. Close to a third of those were from diagnoses of cardiovascular diseases, diabetes, cancer, conditions which have a lifestyle component. Another statistic I’ve heard is that health care is around 16 percent of our total economic output. Isn’t there something wrong with spending even a fraction of that amount of money on repairing the ravages of “lifestyle choices”?

    I’ve got lots of better reasons for eating well and getting to the gym (I like the way I look and feel, more stamina, more strength, great sex, etc.), but the big problems with health insurance and health care financing are also in the back of my mind in the grocery store when I reach for the whole wheat bread rather than the fudge-frosted sugar glazed Krispy Kremes.

  6. #6 laurasf
    January 12, 2008

    “3. Socialists who want Uncle Sam to provide free health care for all with no fiscal consequences for those who suckle at the teats of Mother Piggy more than they would if they were paying for their medical care just like they have to pay for their groceries instead of getting them free from M. P., too.”

    Oh come on. Most Americans would be happy to pay for health insurance, but are unable. Have you looked at what the premiums are for, say, a 50 year old with a few minor health issues? I have great insurance, but am paying about $11,000 a year in premiums and co-pays. Not everyone can afford it.

    “Close to a third of those were from diagnoses of cardiovascular diseases, diabetes, cancer, conditions which have a lifestyle component.”

    Oh screw you. I exercised, ate well (was a vegetarian), and generally lived a healthy life but still got breast cancer at age 32. I hope there is a special place in hell for people like you, who believe that people deserve their diseases. A small percentage of cancers might be related to “lifestyle choices,” but believe me, most are NOT.

  7. #7 Penny
    January 14, 2008

    jlowe, when they counted up those bankruptcies, they inlcluded as “medically-related” ones that were the result of drugs and alcohol problems, and ones resulting from gambling, since these are all considered diseases by some people. I’d like to see what the real numbers are when you don’t include those.

    laura said “Most Americans would be happy to pay for health insurance, but are unable.” Most is a pretty big word.

    There are 47 million uninsured americans. 1/3 of those are people who make over $50k a year and could probably afford some kind of insurance, or get a job with insurance. Many of that 1/3 are people who opt out of getting their employer-paid insurance because they don’t want to pay the copays or for some other reason.

    Another 1/3 are people who actually qualify for medicaid or medicare but have not done the paperwork to get it. When they go to an ER, the hospital tries to help them with the paperwork, but most do not followup.

    The final 1/3 are people who genuinely cannot afford private ins and who don’t qualify for current programs, these are the people we should focus on helping by helping them pay for insurance.

    Japan, Holland, and France have systems that do that, and they are quite successful. Countries where the gov’t runs the hospitals are having huge problems.

  8. #8 Dave Briggs
    January 15, 2008

    Interesting how ‘tongue in cheek’ and ‘nuance’ can be lost in the interpretation. Oh well! Happens to the best of us. (Now, please excuse my smile)

    Posted by: Debara | January 11, 2008 9:29 PM

    Yes, it’s a topic of ambivalence! At least we live in a society where this kind of thing is possible, and that’s got to evoke some degree of gratitude!
    Dave Briggs :~)

  9. #9 youtube
    February 22, 2008

    thanks very nice