Fat Epidemic : It's Real
In reply to “The Fat Epidemic: He Says It’s an Illusion. New York Times, June 8, 2004”
Kenneth R. Stanton and Zoltan Acs
A New York Times article, written by Gina Kolata, reports on obesity researcher Dr. Jeffrey Friedman’s claim that the obesity epidemic is a myth. This is our response:
The Fat Epidemic: Look around you. It’s real.
Make no mistake: In spite of Dr. Friedman’s protestations (The Fat Epidemic: He Says It’s an Illusion. New York Times, June 8, 2004), it is not a myth that the number of Americans who are getting dangerously fat is increasing and it is indeed by any definition an epidemic. Yes, the number of people who are overweight but not actually obese, is very likely on the decline already, because the overweight group is rapidly transitioning into the obese category. The severity of their weight problem is increasing. This is not news. Obesity researchers know these facts. Consequently, derailing the discourse into debating whether or not all Americans, including thin people, are uniformly gaining weight is completely counterproductive and diverts attention from what is undeniably a very serious problem.
Although current research does not rule out the impact of individual diet and exercise choices, contrary to the claims in the article, it does not create or convey the myth that it is simply the fault of individuals that they are obese either. That said, a purely genetic explanation of the obesity problem is also an unlikely candidate. Since obesity prevalence increased suddenly around the late 1970s, such a genetic explanation for the epidemic would have to include a sudden genetic change at that point in time. Although we do not ignore a potential genetic predisposition to becoming obese, our explanation of the epidemic is that it is the result of several factors combining to form an infrastructure of obesity. This infrastructure includes an oversupply of food production in general, an increased supply combined with near pornographic marketing tactics of processed food in particular, a growing fast food industry and our increasingly heavy reliance on exercise hostile urban sprawl.
Although Dr. Friedman points to a current obesity prevalence of about 31 percent, our projections place obesity prevalence somewhere above 35 percent. This represents more than a 52 percent increase over the 1991 level of 23 percent. The direct additional health care costs of obesity are in excess of $55 billion. Adding in the incremental costs for those who are overweight, but not obese, the direct additional health care costs are approximately $83 billion. Once we incorporate the indirect costs that result from health related lost workdays and other associated costs, the numbers are undoubtedly staggering. In truth, it is probably no longer worth arguing over the exact dollar value rather than just admitting that the number is huge and justifies prompt action.
Dr. Friedman is correct in the claim that we need to be clear about what the statistics on obesity do and do not say. In our view, an analogy that is perhaps more educational than the example of changes in IQ is based on the smoking example. If we found that American smokers had increased the number of cigarettes smoked by a pack per day, then we know that smoking related health problems would significantly worsen. Wasting time talking about the fact that non-smokers had not increased their tobacco habit would not only divert attention from a serious problem but would waste valuable time better directed to solving the smoking problem.
The public health crisis from obesity is far from over and indeed in a relatively short period might get much worse if we do not act quickly.
Kenneth R. Stanton is an assistant professor of finance and Zoltan Acs is a professor of economics at the Merrick School of Business. Dr. Stanton and Dr. Acs co-chair the interdisciplinary obesity research group at the University of Baltimore.