The American Fatness Epidemic; the Reasons and Solutions to the problem.

Obesity has become an epidemic in this country. The American Fatness Epidemic has become our #1 health problem in the United States as nearly 2 out of every 3 American adults are overweight compared to about 1 out of 4 in the early 1960s. Obesity accounts for greater than 280,000 deaths annually in the United States and is running neck and neck with smoking as the #1 preventable cause of death in this country.

Medical expenses and loss of income related to The American Fatness Epidemic exceeds about 68 billion dollars annually. We spend over 30 billion dollars annually on diet products. So how did we get into this predicament?Let’s take a look at the basics for a moment. It has to do with our ancestors thousands of years ago. It goes back to our genetics. Our ancestors were hunter-gatherers. Their “job” was to look for food, protect their families and merely survive. They were nomadic in nature for the most part, and hunted and collected seeds, nuts, berries, and perhaps planted a few crops as well. When food was plentiful, they ate more and stored it as fat to keep them from starving when food was scarce. When food was scarce and they ate less, their bodies recognized this and their metabolism slowed. Well, guess what? The physiology has not changed! We still have that urge to keep eating more than we need; and we do! The problem is that we do not have any times when food is scarce and we continue to store the excess as fat. Our bodies are very efficient at doing this. We have more food than we know what to do with and we keep on eating more than we need. The result: The American Fatness Epidemic.

We are a convenience-minded society that eats too much and moves too little. That’s it! Remember our hunter-gatherer ancestors? Hunting now consists of finding our favorite fast food restaurant and we gather by taking the bag of food from the person at the drive-up window. We do not even have to leave the car.

The two biggest problems which have contributed to the American Fatness Epidemic and have become a "norm" in our society are:

1. Portion sizes. Portion sizes have gotten out-of-hand in the past couple of decades. Here is an example. I walked into one of our favorite fast food establishments and wanted to order a sandwich and small drink. No fries; just the sandwich. The young lady who waited on me informed me that I could purchase a “meal” with fries and a medium drink CHEAPER than for the sandwich and small drink. Well, that’s a deal! Why not? More food for less money! That is what our society is up against. More is better! No it isn’t. Not when it comes to calories, fat intake, and our health.

2. We do not move enough! We watch too much television, computers have become such a huge part of our lives along with remote controls and video games. Here are some sobering statistics to ponder:

20% of Americans are completely sedentary. 60% get no regular exercise. 80% are not exercising appropriately to achieve the desired outcomes. 64% of school age children have no daily physical education anymore.

We’ve got an American Fatness Epidemic which is worsening. A recent study showed that the risk of death from all cancers is 62% higher for obese females and 52% higher in obese men compared to women and men of normal body weight. It is estimated that around 90,000 deaths a year in the United States could be prevented by maintaining a healthy weight.

So what is a “healthy weight?” We use the BMI (body mass index) as an indicator for healthy weight determination. It consists of your weight in kilograms divided by your height in meters squared. 18.5-24.9 is considered normal (healthy) weight, 25-30 overweight, and greater than 30 obese. The advantage of using the BMI is that it is one set of numbers for all people of both sexes and it is linearly related to health risk. In other words, the higher your BMI is above normal range, the greater chances of serious health disorders.

We have to adapt a lifestyle that is more like our hunter-gatherer ancestors. We are creatures of habit and habits are difficult to break; especially bad ones. So, what do we do about it?How about visiting your doctor? Unfortunately, I wouldn’t count on his or her help. Doctors should be your coach, but in reality your doctor is too busy most of the time to go into any depth when it comes to diet, exercise, and weight loss. Here is how it goes. Tell me if I am right. You visit your physician and he or she asks you how you are doing and what your problem is. He or she listens to your heart and lungs, checks your throat or whatever else bothers you, writes out your prescription, and maybe, just maybe, tells you to lose weight and eat a more healthy diet and exercise more. Sound familiar?42% of obese patients are told by their physicians to lose weight. 45% do not receive any diet counseling.

Most of our health care dollar is spent treating the outcomes of poor lifestyle choices. We do not have a health care system; we have a sick care system. Think about it. The insurance companies will pay for the treatment of those outcomes with medications and surgeries and procedures, but very little is covered or devoted for prevention.

There is no magic pill to lose weight; at least not yet. There are a lot of reasons that we eat that has nothing to do with hunger. There are many emotional and social cues which cause us to eat when we are not hungry. That is another HUGE problem! The easiest way to avoid this pitfall is to rid your environment of the “bad foods” that you grab and eat in these situations. If it isn’t available, you can’t eat it! If it is bad for you, then don’t bring it home! That is what I tell my patients. At the same time, you shouldn’t deprive yourself either. It is stupid to tell yourself that you are never going to eat another piece of chocolate cake again. That is a set up for failure.

Finally, don’t get hung up on your weight! Take care of your lifestyle and make sensible choices and the weight will take care of itself. You want to concentrate on losing fat and becoming a healthy individual. By eating a healthy diet and exercising regularly, you will build muscle mass and lose the fat. I use the analogy of an automobile when explaining this concept to patients. When you are overweight and sluggish, it is because your engine is out of tune and operating like a puny 4 cylinder Pinto. When you give your body the proper fuel and begin exercising, you gain more muscle converting your engine into an 8 cylinder sports car which burns more fuel (fat) and operates more efficiently. Keep that comparison in mind and you should be on your road to a healthier happy life.