The Impact of Obesity on Healthcare

Strictly defined, obesity is "a condition in which the natural energy reserve, stored in the fatty tissue of humans and other mammals, is increased to a point where it is associated with certain health conditions or increased mortality."

To be sure, the negative connotations of "obese" and "fat" are fairly new in human history. Much of the world has regarded oversized bodies as evidence of personal wealth and access to food and water resources that most others were denied and without which left to live decidedly undernourished (albeit perhaps healthier) lives. Seventeenth century Europe equated obesity with social status, a sentiment echoed in the ancient cultures of China, Russia, and the Middle East, clearly on display in much of their surviving art and literature. (Think about it: when was the last time you heard of a skinny sheikh or czar? And the old stereotype of the happy "fat" Buddha seems to have a strong basis in Chinese lore.)


But as food has become more readily available and produced in hitherto unimaginable mass amounts, the problems of famine and undernourishment have translated into a global malady where economic health foreshadows a downturn in physical well-being. Ergo, while the United States may be the wealthiest nation on Earth, its citizenry ranks embarrassingly low in terms of physical activity, stress, diet, and longevity. The current economic booms occurring in "sleeping giant" nations like China and India are leading to similar health trends in their middle-class populations which have grown accustomed to mass-produced foods and less physical exercise.

And here's something else to consider: the United States spends more health dollars per capita than any other nation on Earth, yet it ranks 42nd in terms of overall longevity. Individuals living in other nations which spend far less on citizen healthcare, including Japan, Jordan, Singapore, the Cayman Islands, and most of Europe, enjoy healthier and longer lives.

All of which has taken its toll on the healthcare system, which is fighting a losing battle with American obesity.

Twenty years ago, the United States ranked 11th in the world in longevity. But the last two decades have seen an alarming rise in the number of Americans considered obese and overweight — twice the number of American adults were classified as obese in 2002 as were in 1980, while the number of obese children and teens has tripled. The impact on American healthcare has been severe — and in many cases devastating.

In 2000 the United States spent $117 billion on efforts to combat and remedy obesity. That same year, over 300,000 deaths were attributed to obesity-related conditions including hypertension, dyslipidemia, type 2 diabetes, coronary heart disease, angina pectoris, congestive heart failure, and stroke. Since then, obesity-related deaths and overall costs to the system have only risen.

The increase in obesity has also posed new problems for healthcare professionals who never received the proper training to deal with patients who are in some cases 50, 100, even 200 pounds overweight. And the popularity of weight-loss procedures like gastric-bypass and lap-band surgery (the former of which carries a significant mortality rate) has led some to believe that they are quick and easy fixes for long-standing, difficult conditions. Many insurers will not cover the cost of such procedures, and some will go so far as to deny coverage for obese clients whose health concerns will likely require significant and invasive procedures.

Behind all of the bad news is the plain fact that going forward from the current situation will require much more than a medical understanding of patient health. After all, "obesity" is not the same thing as "stupidity"; it is safe to assume that most adults know that eating a cupcake is much worse for their health than eating an orange. Overeating is an addiction and should be treated as such. The answer lies in understanding the motivation behind the decision to opt for the less healthy choice: is it purely desire, or economics, or both? Or is it something else altogether?

I can readily attest to having spent most of my childhood snacking on Fritos and RC Cola, interrupted only on the weekends by a vast array of sugary breakfast cereals I inhaled while watching Saturday morning cartoons at six-hour stretches. And surely many of you reading are nodding in agreement. The consumption of synthetic and genetically modified foods designed to last longer on store shelves rather than provide serious nourishment in tandem with our national sedentary obsessions with television, the Internet, and video games have left us with a grave concern: that the next generation of Americans may be the first to witness a decrease in life expectancy.