Roll of $100 bills (Photo credit: Chris Potter/ - cc by 2.0)
Roll of $100 bills | Chris Potter | Courtesy of | Flickr CC 2.0

Over at Health Care Policy and Marketplace Review, the always insightful Bob Laszewski drew my attention to the release of a new report from The Trust for America’s Health, F as in Fat: How Obesity Policies Are Failing in America. This 120-page document, funded by the Robert Wood Johnson Foundation, provides an update on how obesity is ravaging America’s health and productivity.

The facts about America’s obesity problem aren’t new. They continue to be grim and worsening:

  • Two-thirds of American adults are now overweight or obese.
  • Adult obesity rates exceed 20% in 47 states.
  • In the past year,  the obesity rates increased in 31 states; no state improved.
  • Obesity is at the root of an array of our most expensive major diseases that will generate huge costs for care and lost productivity.
  • 85% of Americans believe obesity is a national epidemic.
  • So far, neither Congress nor our nation’s business leaders have recognized this problem as a priority or developed a comprehensive plan to combat it.


National action is warranted

Mr. Laszewski rightly argues that the insidious nature of this problem warrants national action and that we should develop a pro-health/anti-obesity campaign that follows the example of the very successful anti-smoking campaign a few years back. Absolutely true.

While The Trust for America’s Health (TFAH) report is honest and an honorable effort at consciousness-raising, I’m afraid I found their approach and call-to-action disappointingly vanilla and almost certainly ineffectual. TFAH focuses primarily on describing community-based programming that might promote healthy habits and discourage bad ones.

This is fine, I guess, as far as it goes, but it is a form of passive resistance that doesn’t really acknowledge or address corporate money and influence as at least partial roots of the problem. Except for a couple quick references, this report doesn’t really dwell on the fast, prepared and junk food industries, on the advertising techniques used to seduce children and adults, or on the business leadership that will be required to turn this around.

Mr. Laszewski refers us to the work of Ken Thorpe, an Emory University health economist who has done a good deal of work on the relationship between obesity and healthcare cost. He quotes Dr. Thorpe:

The obesity epidemic has caused a tenfold increase in the nation’s private health insurance bill for conditions related to being overweight, according to a self-funded study by researchers with the Emory University Rollins School of Public Health. According to the study, the cost of treating conditions linked to obesity increased from $3.6 billion to $36.5 billion between 1987 and 2002. The study concludes that the best way to lower healthcare spending is to target the rise in population risk factors — especially obesity.”

Current approaches to controlling healthcare costs are not working because they ignore the true drivers of those costs. Increases in the number of people getting treatment for serious health problems like diabetes, heart disease, high cholesterol, and mental disorders are directly linked to population increases in obesity. If insurers and employers are serious about reining in healthcare spending, then obesity prevention should be at the top of their agenda.”


The junk food problem is obvious

In a recent post, I recounted how a good friend, a preventive cardiologist, told me that, when it came to my body’s propensity to lay down plaque in my vessels, I wasn’t taking the problem seriously. That woke me up, and I’ve made a lot of efforts since then to turn the problem around.

The junk food problem is obvious and, in a sense, no less dangerous to the nation’s welfare than if it were crack cocaine. It will drain our financial resources and cripple the nation’s ability to be productive. Under our form of government, where lobbying dollars drive how policy works, the answer is clear. Our business leaders can take this problem seriously, overwhelm the food industry’s behaviors, and reshape policy to diminish the impact of advertising and make healthy living a positive cultural value. Or we can surrender the nation to the pushers who feed our addiction. It really isn’t a lot more complicated than that.

I have spent a good deal of my career synthesizing the terrific information created by researchers and translating it to decision-makers. At some point, problems and their solutions become extremely well understood, and further efforts to describe the problem are, in a sense, superfluous.

Like the larger healthcare crisis, the obesity crisis is now very well understood. While updates on the status of the issue are always welcome, what is really needed is a deeper understanding of the problem’s power dynamics, and the formulation of mobilization plans to address them. If we don’t intend to address the obesity problem directly, at the level of corporate power and influence, then all the updates in the world won’t matter.


  1. I’ve noticed a lot of information like this is making a difference. More people are more health concience than ever.

  2. Per the above suggestion of taxing foods that contribute more calories to obesity than to sustenance and health, there was a great TV show here in the UK called The Fat Tax which explored taxing food manufacturers and fat people themselves. Well worth checking out.Fat people are as addicted to food as smokers are to cigarettes, so taxing the food they buy is probably the only way to get them to contribute financially to the burden they’re placing on healthcare systems. And if a Diet Coke cost 75cents but a Regular Coke cost $1.50, I think a lot of folks would switch.

  3. At a conference yesterday, I heard Karen Ignagni, CEO of America’s Health Insurance Plans, say that a nickel tax on each can of soda or its equivalent could raise $12 billion per year in the U.S.. In light of the decrease in smoking that resulted, in large part, from steep cigarette taxes, perhaps the same approach could be applied to junk foods, though the design, implementation and collection of such a tax would be more challenging. I believe that the price of all products and services should reflect the full social cost of producing them, including, in this case, adverse health effects. If we are interested in lowering medical cost growth, improving the health of our population, and efficient resource allocation, we should consider targeted taxes on unhealthy food and drinks.

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