This week brought yet another report on how Americans are continuing to pack on the pounds, with dire health consequences.
Earlier this year, the U.S. Centers for Disease Control (CDC) reported that 35.7 percent of American adults — 25.7 percent of Minnesotans — are currently obese. It also projected that more than 42 percent of Americans would be obese by 2030.
On Monday, researchers with Trust for America’s Health and the Robert Wood Johnson Foundation reported that their analysis of the data pointed to an even fatter future for Americans. They found that, if current trends hold, half of U.S. adults — including 54.7 percent of Minnesotans — could be obese by 2030. In fact, in 13 states, the rate of obesity could top 60 percent by that date.
Because obesity is associated with so many chronic diseases, these projections mean that an increasing number of Americans will be struggling with serious health problems. Here in Minnesota, the report notes, “obesity could contribute to 609,902 new cases of type 2 diabetes, 1,365,612 new cases of coronary heart disease and stroke, 1,312,110 new cases of hypertension, 844,916 new cases of arthritis, and 194,660 new cases of obesity-related cancer” over the next two decades.
Those added health problems have an economic as well as a personal price tag, of course. The report projects that Minnesota’s annual obesity-related medical costs could climb by 15.7 percent by 2030. Nationally, the rise in the rate of obesity would add an estimated $66 billion to our annual health care bill.
Recommendations for change
We know we’re getting fatter. That trajectory has been clear for at least two decades. We also know that obesity exacts a huge personal and financial cost.
What we don’t seem to know — or agree upon — is how to reverse this unhealthy trend.
The new report offers several recommendations, including “increase investments in effective, evidence-based obesity-prevention programs,” “make physical education and physical activity a priority” in schools, and “fully support healthy nutrition in federal food programs.”
None of that sounds particularly new. In fact, it isn’t all that new, as agricultural historian Martin Bruegel points out in an essay published Tuesday in the New York Times.
“While the alarm over obesity is fairly recent,” he writes, “the notion of using ‘scientific’ knowledge to guide the dietary habits of ordinary people — particularly the less well off — is not.”
Calorie counting began in France in the late 19th century, Bruegal reports, and eventually crossed the Atlantic.
“By 1920, Americans were so calorie conscious that a romance novel, Ethel M. Kelley’s ‘Outside Inn,’ featured calories as a prominent theme,” writes Bruegel. “In 1924, the Restaurant Owners’ Association toyed with providing diners with printed advice on well-balanced meals ‘from the point of view of calories.’
Childs Restaurant, which Bruegel calls “an ancestor of today’s global fast-food chains,” actually took that step, offering all sorts of nutritional information to its patrons, including calorie counts of its foods.
“None of these initiatives lasted,” notes Bruegel. “For European and American consumers, hearty and palatable meals outweighed scientific formulas every time.”
So what will work? Bruegel offers a provocative and structural suggestion, one that looks to society rather than to individuals for a solution. As I’ve pointed out in Second Opinion before, such approaches to solving the obesity epidemic are not welcomed by Big Food or even much of the American public.
The history of “scientific eating” offers several lessons. Nutritional campaigns can succeed in influencing consumer behavior only if they take into account the sensual joys of eating. The French continued to eat their red meat and drink their red wine because rich meals gave them a sense of belonging to a community. Similarly, American consumers after World War II saw access to plentiful, ever cheaper and ever less healthy foods as proof of the American promise — even if the impact on their waistlines, and well-being, has been disastrous.
In an era of stagnant wages, dystopian politics and cultural anomie, eating indulgent if unhealthful food has become a last redoubt of enjoyment for Americans who don’t feel they have much control in their lives. Higher incomes and better educations — in the classroom, not on the menu board — will do more to solve the obesity epidemic than mandating the disclosure of calorie counts.
Before we blame the poor and the overweight for their inability to manage their budgets or control their appetites, we might want to think not only about the foods they encounter in the supermarket and on television but about a culture that relies ever more on unhealthy foods to breathe meaning and purpose into everyday life.