Obesity

I recently read an article by David Freedman in the Atlantic titled How Junk Food Can End Obesity. He had an interesting viewpoint that I wanted to share and explore.

This year, the American Medical Association voted to classify obesity as a disease.  According to its classification, currently over 78 million adults and 12 million children in the United States are obese. I am ambivalent regarding the disease classification, however, as a physician in an urban emergency department I regularly encounter the insidious long-term sequelae of obesity and am keenly aware of the catastrophic implications to public health.

Obese young adults and middle-agers in the United States are likely to lose almost a decade of life on average compared to their non-obese counterparts. “Given our obesity rates, that means Americans who are alive today can collectively expect to sacrifice 1 billion years to obesity” (Freedman 2013).  The reason for this is because obesity is not only positively correlated to pre – disease states such as hypertension and hypercholesterolemia, but it is also linked to chronic diseases such as heart disease, stroke, cancer, and diabetes.  According to the Centers for Disease Control, these chronic diseases are among the most common, costly, and preventable of all health problems in the United States. Seven out of ten deaths among Americans each year are from chronic diseases. Heart disease and cancer account for 75 percent of the dollars spent on health care. According to Freedman (2013), “for the first time in modern history, our health prospects are worsening, mostly because of excess weight.”

The scale and scope of the burden in front of us is enormous and the solutions – either in sum or singularly – must be equally scalable and cost effective.  While the slow food, organic food, and farm-to-table movements are all impacting the dietary intake for a segment of the population, the processed food industry is uniquely positioned to develop solutions that can impact the masses. Through years of research, the processed food industry has developed the technological and marketing acumen to dramatically alter our relationship with food. “Americans get 11 percent of their calories, on average, from fast food” (Freedman, 2013). The processed food industry has created food that is calorically dense and biologically pleasing but at the same time does not create the sensation of fullness. This not only deceives us to eat beyond satiety but also to crave the food that we eat, thus maintaining the profits of the food industry. Additionally, the processed food industry has also perfected their marketing acumen to imbed these food sources into our cultural eating traditions. Foods offered by multi-national corporations such as Taco Bell, McDonalds, Burger King, and Kentucky Fried Chicken are brand names intricately woven into our eating culture.  The processed and fast food industries “have developed extraordinary facility for nudging the masses to eat certain foods, and for making those foods widely available in a cheap and convenient form” (Freedman, 2013).

Therefore, rather than participate in shunning and scapegoating the industry, we must utilize its engineering and marketing prowess to impact caloric intake on a mass scale. We must enact policies that will subsidize and incentivize the industry to create more nutritious and less calorically dense foods.  This will align the goals of the industry to maximize shareholder value with the goals of policies designed to improve the health status of Americans. The dreadful implications of the obesity epidemic are just beginning to be recognized and we must utilize technological and public policy innovations to mitigate the impending crisis.