Saturday, June 03, 2006

A Big Issue

Obesity seems to be everywhere. An epidemic, they say. I think I believe them, whoever they are.

Driving through my city of employment yesterday, I was stunned as I saw what appeared to be a parade of obese individuals wherever I turned. Since I work in neighborhoods where a preponderance of poor people reside I am exposed to the lives (and dietary habits) of American's urban poor on a daily basis, and it seems that eating healthily may be beyond the grasp of many who subsist on welfare and food stamps. McDonalds appears to be stellar in its ability to ensconce itself in poor neighborhoods, as is Burger King, KFC, and other purveyors of fat-laden, carb-heavy, calorically-dense foods. Add to that the ubiquitous 99-cent fast-food sandwich enticements seen on billboards and signs across urban (and suburban) America, and you have the beginnings of the recipe for carbohydrate/fat addiction and rampant obesity, not to mention pre-diabetes and hypertension.

So, who's to blame?

Well, fingers can point in multiple directions simultaneously. Corporate Amerika does its best to super-size our populace by flooding the market with fast food. In the inner city, supermarkets and farmer's markets are often miles away and virtually inaccessible by public transportation, especially for the disabled, the elderly, and single moms with small children. If one does make it to the supermarket, more and more foods are packed with unnecessary extra carbohydrates through the ubiquitous use of high fructose corn syrup. Even as soy milk gains popularity as an alternative and "healthy" beverage, companies make their product more palatable by pumping it full of corn syrup or "evaporated cane juice", the new flavor enhancer du jour. Whether it's organic or not, evaporated cane juice is just another word for sugar, something the American public needs alot less of, especially children.

Public schools make financial deals with Coca Cola and other predatory companies who use the lure of "free" technology and computers to insinuate themselves into the educational environment, but the devil is in the details. In exchange for such faux largesse, schools deliver to their children carbo- and sugar-laden snacks and foods, often available ad lib through the venue of vending machines in the cafeteria. Interview any cohort of schoolchildren during lunchtime and many will be subsisting on Doritos and Coke as a main course and candy for dessert. Many groups in local districts seem to be fighting back, demanding the removal of vending machines from schools and the provision of healthy meals and snacks. It's an uphill battle.

Sadly, globalization has led not only to the sharing of technology and the opening of "call centers" for American companies in Bombay, it has also led to the globalization of the obesity epidemic to previously healthy societies. Asia is now seeing unprecendented obesity among all age groups, with fast food and Americanized high-sugar dietary choices becoming the norm, leaving traditional eating habits in the dust. Not only do we as Amerikans consume more energy per capita than any other society on earth, we also share our love of fattening foods, poor health, and gas-guzzling SUVs with the rest of the world as well. We tax the world economic and healthcare infrastructure with the weight of our addictions and the unsustainable habits which we so freely share with the world at large (pun intended).

Government can easily be implicated here, from poor public health planning, corporate hegemony, the influence of big business, and the Every Child Left Behind Act. Resources galore are wasted in preparing our students to pass rcailly biased standardized tests, while our children's nutrition is ignored and physical education funding cut in the interest of the bottom line.

So where from here? BigPharma is now rushing to create a "magic bullet" for obesity, pills that will curb appetite, burn more calories, or cause the consumer to retch violently when eating anything with high caloric value (I made that one up). Are pharmaceuticals the answer? Is gastric bypass the panacea for thousands of obese teenagers raised on X-Box, Doritos, and sugar-laden breakfast cereals? Is poor urban planning only going to increase our reliance on cars, erasing sidewalks and the idea of shopping on Main Street and walking to the store? As more and more entertainment is delivered to our homes without more than the click of a mouse or remote, Americans will be more than ever frozen in their recliners, the yard-sale exercise machine gathering dust in the garage. Eventually, robots will vacuum, wash our laundry, and pick up the mail, while we eat microwaved meals as we surf the InterTV-Net for infotainment.

Hyperbole aside, maps of obesity trends in the US show rapid growth in the obese population of our country, and the healthcare costs of such an epidemic are staggering. A study commissioned by the American Obesity Association (AOA) estimates the healthcare-related costs of obesity in the United States for 1994 was over $7 billion! And that was more than a decade ago. The AOA website states:

"The Lewin Group examined the costs of fifteen (15) conditions causally related to obesity. They included: arthritis, breast cancer, heart disease, colorectal cancer, type 2 diabetes, endometrial cancer, end-stage renal disease, gallbladder disease, hypertension, liver disease, low back pain, renal cell cancer, obstructive sleep apnea, stroke and urinary incontinence."

We obviously need to get this monster under control before it controls us, our economy, and our country's future. Public health experts believe that gains made vis-a-vis increased lifespans in the last 100 years may be eventually lost due to the health effects of obesity and its sequelae. It is an enormous problem of as-yet-unseen ramifications for the future, and if any of your children would like a career in medicine, let them know that the care of people with diabetes and heart disease and other complications of obesity is a sure bet for the future of medical careers and paychecks. That said, make sure your children are free of the epidemic, or they too will only serve to feed the medical machinery that devours the dollars needed to stem the tide of obesity-related morbidity and mortality.

Did I say it was a big issue? Big may be the understatement of the year.

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