What’s to blame for the obesity epidemic?

Obesity is a topic that literally hits home for me.  For the past two years, the website WalletHub has voted the McAllen-Edinburg-Mission TX metroplex as the “fattest city in America.”  As a health care provider, this is deeply disturbing because it puts my community at high risk for a wide variety of health problems, including but not limited to coronary artery disease, diabetes, stroke, and several cancers such as liver, kidney, breast, endometrial, prostate, and colon.  Not surprisingly, we also rank third for the highest percentage of diabetic (type 2) adults.

In a local news article published just after our unceremonious coronation, city officials were quoted as saying that WalletHub’s findings were, “… extremely misleading about the actual activities and health and wellness and well-being of our community.”  I’ve seen all of the strides that this area has taken to make exercise more accessible, with increasing healthy food options, gyms seemingly everywhere, and miles of paved paths for running and biking.  Each city hosts a number of races yearly, including marathons.  We even live an hour from South Padre Island, where there’s a wide variety of water sports available to enjoy.  Yet, the fact remains that our obesity rates still rank at the very top in the country.  So, what’s to blame for this health epidemic?  The plate is full when it comes to contributors, but we are missing out on the main dish.

Is it our culture?  Hispanic culture uses food as a means of celebration.  Whether it be for birthdays, graduations, weddings, football games, or simply just for a night out, food is symbolic of happiness.  We, as Hispanics, admittedly are accustomed to a diet high in carbohydrates, which also turns out to be a major reason for the high rates of fatty liver disease and diabetes that we see here.

Is it socioeconomic status?  Hidalgo County has a poverty rate of 30 percent, according to Census.gov.   So, with a third of the population living in poverty, most people aren’t looking to hit up Gold’s Gym and pick up a quinoa salad before going home.  No, they’re doing what is fastest, least expensive and the most bang for their buck.  Unfortunately, this effect trickles down to the children, who then grow up with poor dietary habits, and the pattern repeats itself for another generation.

But, do culture and socioeconomic status really tell the whole story?  Are we really that much different than the rest of the country?   Or are we simply a microcosm of what’s going on in the United States as a whole?

According to US News and World Report, 30.5 percent of American adults were obese at the turn of the century.  According to the CDC, obesity rates reached 42.4 percent in 2017-2018 – surpassing 40 percent for the first time.  In December 2019, an article in the New England Journal of Medicine predicted that an alarming 50 percent of the U.S. population will be obese by 2030.  So, McAllen-Edinburg-Mission isn’t alone at the table.

What else is contributing to obesity in my community and in America as a whole?   I believe technology, used excessively, has been the icing on the cake.  People drive to supermarkets, then rush to find the closest parking spot available.  Many prefer to use escalators or elevators as opposed to climbing the one flight of stairs.  For those with the means to do so, it’s now possible to shop for groceries, clothes, and even Christmas trees all from the comfort of your own bed.  And then there’s screen time.  We as a society are spending more time sitting down looking at a screen and less time outside, and it’s contributing to our obesity problem.

So, how do you fix such a complex issue as obesity in the McAllen-Edinburg-Mission area and in the rest of the country?  That’s the million-dollar question.  Healthy food options and increased availability of exercise facilities are a good start.  But is it possible to incentivize movement?  Would workplaces consider offering PTO hours in exchange for exercise time, miles walked, pounds lost?  The payoff would be happier, healthier, more energetic employees taking fewer sick days and, in turn, producing more for the company.  Imagine an insurance company partnering with a credit card company to provide a points system based on health parameters?

The possibilities are endless, but it does take some abstract thinking, a vivid imagination, and a side of passion.  As for me, I’m going to work on getting us off that WalletHub list.  Stick a fork in it.  It’s done.

Henry Herrera is a gastroenterologist.

Image credit: Shutterstock.com

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