How obesity is a voluntary epidemic, and why we shouldn’t give up

As America comes to grips with the disastrous effects of a national obesity epidemic, there’s a new feeling in the air: defeatism.

Former Carter Administration advisor Amitai Etzioni seemed to succumb to it when he wrote an article entitled “dieting gets you nowhere” for CNN recently.

In it, the liberal sociologist citied a recent nutritional study that found 8 out of 10 Americans who try to lose weight fail. So in Etzioni’s mind, “all the hoopla about dieting” only diverts resources “from the one group in which healthy eating, especially if combined with exercise, can make a significant difference – children, the younger the better.” His message: adults should simply give in on obesity and move on to the next generation.

How individuals – and policymakers – react to claims like these is important to the future of the United States.

Obesity is a financial epidemic, since the collateral damage from obesity is driving health care costs out of control. Obesity is an economic epidemic, since a heavier workforce is a less competitive, less productive workforce. Obesity is a national security epidemic, since it cuts down America’s potential pool of military recruits before America’s future enemies have even fired a shot. Obesity is a tragic epidemic, since it shortens lives and crushes the self-esteem of millions of decent people.

But most of all, obesity is a voluntary epidemic. Most overweight people choose to eat poorly, and they make premature death more likely when they do. On the other hand, people who choose unhealthy diets today are equally free to choose a healthier diet tomorrow. Even a modest change can be important.

There’s no need for defeatism, for two reasons. First, preventing every new pound of excess, unhealthy weight is a victory, even though almost three quarters of Americans are already technically overweight. That’s as certain a fact as gravity.

In fact, it has a great deal to do with gravity. Bearing more weight than the human body was designed to carry puts premature wear on the joints, fuelling America’s rising quota of costly knee and ankle replacement surgeries. Being overweight makes muscles relatively weaker and breathing relatively harder, restricting a person’s ability to stay fit. Obesity increases pressure on blood vessels, with consequent risks for potentially lethal cardiovascular diseases. The greater your weight, the greater the risk of diabetes. And so on.

Those factors were at play in a study released this month in the New England Journal of Medicine. Researchers pooled data on overweight, non-smoking Americans to screen for the health impact of excess weight alone. Merely being mildly overweight increased the risk of premature death for women by 13% over periods of between five and twenty-eight years. Add more pounds, and the risk grows rapidly – to as high as 88% greater risk of premature death for obese women, and almost 250% increased risk for the morbidly obese.

These numbers give new meaning to the phrase ‘an ounce of prevention.’ The level of one’s excess weight is important, too. So obesity isn’t an either-or problem; keeping extra weight off even if you’re already overweight can make a real difference to your health.

But the flip side is also true. While crash diets, fad diets, and diet pills are sure to fail in the long run, medically overweight or obese patients should know that reducing weight  – gradually – is the surest way to bring immediate health benefits, too. Among the obese, even mild weight loss can dramatically reduce long-term diabetes risks. Mild reductions in weight can also have an immediate and positive impact on blood pressure and hypertension risk.

In short, even if just two in ten Americans are losing a little weight and keep it off, it’s more than worth the trouble – for their sakes, and for everyone’s sake.

“I am a student of public policy, not medicine,” Etzioni wrote. And it shows in his analysis, since he makes it seem as though it’s impossible for most adult Americans to gain anything from keeping their weight down.

Sure, it’s true that eating well and walking a block a day might not do much for a crash dieter who wants to fit into a new pair of jeans by next Tuesday. However, if we measure the fight against obesity the way it should be measured – by medical standards – then even a little progress can be a lot of progress.

David Gratzer is a physician and senior fellow at the Manhattan Institute. He is author of The Cure: How Capitalism Can Save American Health Care.

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