Obesity: A Major Health Crisis

By Maxim W. Furek, MA, CADC, ICADC

obese women getting on scale

As the most affluent country in the world, America should know better. We are suffering a decades-long health crisis- obesity, that is, bite by bite and pound by pound, killing us. We are gorging ourselves to death like zombies lined up at the all-you-can-eat smorgasbord.

Obesity rates in the United States are among the highest in the world. Two out of every three Americans are overweight or obese, and the Centers for Disease Control and Prevention (CDC) estimated 21 percent of teens, and 14 percent of preschoolers are obese. The Journal of American Medicine reported that non-Hispanic blacks have the highest age-adjusted rates of obesity (48.1%) followed by Hispanics (42.5%), non-Hispanic whites (34.5%), and non-Hispanic Asians (11.7%). Obesity is higher among middle age adults age 40-59 years (40.2%) and older adults age 60 and over (37.0%) than among younger adults age 20–39 (32.3%).

In 1985, no state had an obesity rate higher than 15 percent, but in 2016, five states had rates over 35 percent. The latest federal data show that nearly 40 percent of American adults were obese in 2015–16, up from 34 percent in 2007–08. The prevalence of severe obesity also went up during the same period, from 5.7 percent to 7.7 percent.

Major health issue

Obesity, a major health issue involving an excessive amount of body fat, is defined as a body mass index (BMI) of 30 or higher, whereas extreme obesity is defined as a BMI of 40 or more. 

According to a recent scientific report from the 2015 Dietary Guidelines Advisory Committee, our eating habits as a country are making us sick. “The economic and social costs of obesity and other diet- and physical activity-related chronic disease conditions are enormous and will continue to escalate if current trends are not reversed,” the report concluded. Personal health columnist Jane Brody has warned of a continued rise in obesity, including severe obesity, among American adults. She writes: 

A prestigious team of medical scientists has projected that by 2030, nearly one in two adults will be obese, and nearly one in four will be severely obese…In as many as 29 states, the prevalence of obesity will exceed 50 percent, with no state having less than 35 percent of residents who are obese, they predicted.

The Organization for Economic Co-operation and Development (OECD) estimated that 3/4 of the American population will likely be overweight or obese by 2020 and an earlier CDC study (2019) concluded that half of U.S. adults will be obese by 2030. The U.S., with the highest rate of obesity within the OECD, will tally severe obesity as the most common weight category among women, non-Hispanic black adults, and low-income adults nationally, in the next decade

America’s health crisis has led to a dramatic increase in a cluster of chronic diseases such as hyperlipidemia, cardiovascular disease, and cancer. Obesity is a primary contributor to over 120,000 annual preventable deaths in the U.S. including:

Cancer: Excess body weight causes about 40,000 cancer-related deaths each year, such as cancers of the colonbreast (after menopause), endometrium (the lining of the uterus)  and esophagus. Studies have also reported links between obesity and cancers of the ovaries, pancreas, cervix, endometrium, rectum, liver, and prostate. Research published in the British Medical Journal discovered links between an increase in BMI and a higher risk for cancers of the pancreas, kidney, bone marrow and biliary tract. 

Premature Death: Obesity raises the risk of premature death and accounts for 18 percent of deaths among Americans ages 40 to 85. It kills as many people as cigarette smoking which kills one of five Americans and is the leading preventable cause of death in the United States.

Gallbladder Disease: Obesity increases the likelihood that you’ll develop heartburn, gallbladder disease and liver problems. Ironically, weight loss itself, particularly rapid weight loss or loss of a large amount of weight, can make you more likely to get gallstones. Losing weight at a rate of about 1 pound a week is less likely to cause gallstones. 

Heart Disease: Obese people are between 1.5 to 2.5 times more likely to die of heart disease. The Metabolic Syndrome is a combination of excess body fat, abnormal cholesterol levels, and physical inactivity, leading to type 2 diabetes, high blood pressure and abnormal blood lipids, greatly increasing the risk of heart disease and stroke.  

Type 2 diabetes: An estimated 86 million Americans have prediabetes. Most people who have type 2 diabetes are overweight or obese. If you have type 2 diabetes, losing weight and becoming more physically active can help control your blood sugar levels and reduce your need for diabetes medication. Obesity can affect the way your body uses insulin to control blood sugar levels. This raises your risk of insulin resistance and diabetes.

Osteoarthritis. Obesity increases the stress placed on weight-bearing joints, in addition to promoting inflammation within the body. These factors may lead to complications such as osteoarthritis.

Quality of life: Obesity contributes to depression, physical disability, sexual problems, shame and guilt, social isolation, and lower work achievement. You may not be able to do things you used to do, such as participating in enjoyable activities. People with obesity may even encounter discrimination.

Financial costs: The economic costs of obesity are staggering. An obese person in the U.S. incurs an average of $1,429 more in medical expenses to Medicare, Medicaid, and private insurers, and, according to the CDC (2008), the annual medical cost of obesity in the United States was approximately $147 billion in direct and indirect costs. Direct costs included preventive, diagnostic, and treatment services related to weight, while indirect costs captured absenteeism and loss of future earnings due to premature death. 

Opioids: There are striking parallels between obesity and the opioid crisis. The obesity epidemic may be partially responsible for the high prevalence of prescription opioid use in the United States. Opioids accounted for around two-thirds of the 64,000 deaths related to drug overdose in 2016, and obesity, through its association with pain, including back pain, joint pain, and muscle/nerve pain, represents an important contributor to prescription opioid use. 

Weight-loss market

The obesity epidemic is not relegated to the U.S. Mexico has the second-highest rate of obesity (after the U.S.), followed closely by New Zealand and Hungary. Obesity is also on the rise in middle-income and poor countries: China, India, and Brazil are struggling with the epidemic.

Obesity can result from disease and hereditary factors, but most people become obese simply because they eat too many unhealthy foods and do not exercise. 

We are searching for answers. Numerous studies indicate that diet alone are not effective in controlling or reversing weight gain. There is no evidence that the thriving U.S. weight-loss market (worth $66 billion in 2017) and diet-related programs will curb obesity. More needs to be done. Former Surgeon General of the United States, David Satcher observed that:

Many people believe that dealing with overweight and obesity is a personal responsibility. To some degree they are right, but it is also a community responsibility. When there are no safe, accessible places for children to play or adults to walk, jog, or ride a bike, that is a community responsibility.

What is needed are community policies aimed at promoting behavioral change. The solution is to promote healthier lifestyles that include increased physical activity. It means turning off the TV and going outside for a stroll and parking further from the job site and walking a bit longer. It means piling more fruits and vegetables on our dinner plates, and eliminating caffeinated, sugary drinks and calorie-laden carbohydrates. The message is clear: In order to turn this alarming and deadly epidemic around, we need to embrace a healthier lifestyle  of losing weight, eating a balanced diet, getting adequate sleep, and exercising more. And it all begins with that first step.

Maxim W. Furek has a rich background that includes aspects of psychology, addictions, mental health and music journalism. His book The Death Proclamation of Generation X: A Self-Fulfilling Prophesy of Goth, Grunge and Heroin explores the dark marriage between grunge music and the beginning of the opioid crisis.