Obesity and the Economy: From Crisis to Opportunity

Abstract

To the authors of this article, the economic stimulus program in Washington provides a unique opportunity to develop and institute a comprehensive national obesity initiative with immediate and long-term benefits to public health and the economy. They believe that part of the estimated $700 billion economic stimulus program should be invested in a national initiative to prevent obesity. This article provides an overview of the factors responsible for the obesity epidemic and highlights lifestyle choices among Americans that lead inevitably to obesity and obesity-related diseases, thereby addressing the need for a long-term national initiative to prevent obesity. An increasingly unhealthful lifestyle among the US population in the last 50 years has led to an obesity epidemic as a consequence of national economic, social, and policy decisions. During this time, government subsidies to industrial agriculture have supported low-cost high-calorie commodities―highly processed fat and sugar-based products―that have largely displaced a wide range of more expensive nutritious whole foods, such as fresh fruits and vegetables, once grown at low cost on family farms. One consequence of these policies is the increasing popularity of low cost fast food that contains a high amount of fat and low-quality carbohydrates and has little nutritional value or fiber. Coincident with increased energy consumption, the level of energy expenditure in the form of physical activity has sharply declined. In cities and suburban communities, there has been a reduction in consumer use of recreational or other facilities involving physical activity and limited money allocated to build or improve upon such facilities. Changes in family lifestyle contribute to obesity. Parents prepare few meals at home due to busy work schedules and the need to commute. Children have little time for recreational physical activities because of academic pressure; any free time available is used for sedentary activities such as television or computers. Reduced physical activity combined with psychosocial stress leads to an unhealthy diet, overeating and ultimately to increased fat deposition and obesity and greatly increase the risk of chronic diseases such as diabetes, myocardial infarction, and cancer. Current obesity-related costs amount to more than $100 billion per year, which represents 5% to 7% of annual health care expenditures. The authors suggest implementation of several projects that could be part of a planned national strategy to promote a healthy life style and reduce obesity. For Americans, addressing the obesity crisis will require a long-term integrated national program involving restructuring of US food production and distribution, together with major investments in social infrastructure. The authors believe that failure to act now will have devastating consequences for society much worse than the mortgage crisis.