The Weight of the Nation, Part 1: review & discussion

Obesity Campaign Poster

Obesity Campaign Poster (Photo credit: Pressbound)

Yesterday, “The Weight of the Nation” documentary premiered on HBO and free of charge online.  This 4 part documentary documentary looks at the obesity epidemic: causes, health consequences, the role of the government and food industry, child obesity, challenges of losing weight and maintaining it, physical activity and socio-economic influences on weight

Part 1: Consequences examines the health consequences of being overweight and how we’ve become a nation where 2/3 of our population is overweight or obese. It opens with a Southern family hosting a potluck in Bogalusa, Louisiana. The table is a cornucopia of obesity-inducing food: fried chicken, onion rings, garlic bread, desserts galore, second helpings inevitable.  You know we’re headed for trouble when the bucket-sized, red dye # 40-colored Jell-o, with pinapple, bananas and layers of Cool-Whip is considered the “healthy” dessert.

Interesting enough, this small Louisiana town is home to the Bogalusa Heart Study, which focused on identifying the early causes of coronary artery disease and hypertension in a child population.  The study started in 1972 and followed these children as they hit middle age around 2005.  Key findings from this study include:

  • 77% of the Bogalusa participants who were obese as children remained obese in adulthood
  • Only 7% of the ‘healthy weight’ children became obese in adulthood
  • Adult heart disease, atherosclerosis, coronary heart disease and hypertension begin in childhood, as early as age 5.  Autopsy results show atherosclerotic lesions in the aorta and coronary vessels, even in children.
  • Cardiovascular risk factors can be detected early in life.
  • Differences in disease progression and severity between different genders and races.
  • Environmental factors  (food intake, physical activity, alcohol and tobacco abuse) play a significant role  in high cholesterol, high cholesterol, hypertension, and obesity. This influence begins early in life. A majority of environmental factors are controllable.

Curious if this was just a Bogalusa phenomenon, other researchers and the documentary crew looked at various regional areas in the US to seek answers. New York. Philadelphia. Santa Ana. Nashville. Across the board, poorer neighborhoods in these cities all had higher rates of obesity, diabetes and heart disease compared to their wealthier counterparts. Vastly different, and yet the same, when it comes to obesity.  Sadly, we ARE one nation, obese, filled with heart disease and diabetes for (almost) all.  United we stand….or sit in front of the television.

How did this happen? It certainly didn’t happen overnight.  While CDC obesity maps show a gradual increase in obesity in all states since 1960, which a huge boom in the 1980s, especially in the morbid obese category and in children. Sure, there is a genetic component, but how much of a role do genes actually play? Or is it that, as one researcher suggested, our genes are just more susceptible to obesity in our current environment?

In general, we live in an obesity-centric society, in that society actually promotes obesity, rather than to discourage it or seek a permanent solution.  Processed, salt-heavy, calorie-laden fast food is cheaper and easier to get than fresh produce.  Unsafe neighborhoods discourage physical activity. Schools, where children spend the majority of their day, are filled with vending machines and unhealthy cafeteria food.  Children in wealthier areas are more likely to participate in after school activities or sports, as their families have the resources to pay for it.  We’d rather spend a half hour watching a reality tv show about obese people struggling to lose weight than to actually go for a walk.

All of these factors combined lead to individual health consequences, but impart a greater impact on our entire nation, if not the world, as the “Westernization” of other countries is beginning to take a toll on their health as well. In 2008, obesity-related costs in the US were estimated to be $147 billion dollars and are climbing.  The documentary estimates that about half of this comes from government-funded health care (Medicaid, Medicare), which are funded (at least in part) by our tax dollars.  The other half is paid for by private insurance companies or individuals.  Moreover, obesity has been shown to reduce employee productive and drive up health care costs for the employer. As the documentary points out, this can cause employers to move jobs to other countries, where labor and other expenses are already cheaper, to avoid the additional financial burden of an obese work force.  Of course, there are additional burdens of obesity than extend beyond an employer’s bottom line.

Clearly, something needs to be done if we want our current and future generations to survive. But what? And by whom? Of course, there is a level of individual responsibility but it’s not the only course of action that needs to be taken. Obesity causes are multi-faceted and so are the solutions.  Like it or not, our food plays the largest role in the obesity epidemic. But it’s not so simple as “eat less, exercise more, no white foods”, is it? If it was, would we have an epidemic of this magnitude?  Part 4 of the documentary, which looks at the combination of forces that have caused the obesity epidemic, will hopefully provide some answers.

Please share your thoughts on “The Weight of the Nation” and the obesity epidemic.

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