The big, fat truth about Americans
AS IF President Obama does not have enough on his plate, he should tell us to stop piling more on ours. The time is right for a national address to look us squarely in the eye and say, “You’re fat!’’
Now, no one wants to be shamer-in-chief, and Obama and his advisers might be tempted to sidestep the obesity crisis with delicate deli diplomacy, merely asking us to try a little hummus instead of that pound of pastrami. But the crisis is now so serious that he cannot attempt to finesse fat.
Last month, Obama told the American Medical Association that the nation needs to “invest more in preventive care so that we can avoid illness and disease in the first place. That starts with each of us taking more responsibility for our health and for the health of our children. It means quitting smoking. It means going for a run or hitting the gym and raising our children to step away from the video games and spend more time playing outside. It also means cutting down on all the junk food that’s fueling an epidemic of obesity, which puts far too many Americans, young and old, at greater risk of costly, chronic conditions.’’
But that was deep in the middle of his pitch for healthcare reform. Our national waistline has to be front and center. This week, researchers published a study in the journal Health Affairs that found that as obesity rose 37 percent over the last decade, the cost of obesity to the nation has nearly doubled from $78.5 billion a year to $147 billion a year. Obesity now accounts for nearly 10 percent of all healthcare spending. The per capita cost of medical care for someone who is obese is $1,429 a year, 42 percent more than for the care of someone of normal weight.
“Without a strong and sustained reduction in obesity prevalence, obesity will continue to impose major costs on the health system for the foreseeable future,’’ the study concluded. “And although health reform may be necessary to address health inequities and rein in rising health spending, real savings are more likely to be achieved through reforms that reduce the prevalence of obesity and related risk factors, including poor diet and inactivity. These reforms will require policy and environmental changes that extend far beyond what can be achieved through changes in healthcare financing and delivery.’’
Evidence of the possible imposition came in a study published a few weeks earlier in Health Affairs, one that found that the cost of obesity hospitalizations for children nearly doubled between 1999 and 2005. The money we now lose in just one year to obesity is five times the budget of Massachusetts. It is nearly 16 times what the federal government has made available to states from 1992 to 2008 for transportation enhancements such as bicycle and pedestrian paths.
It is nice that the first family has a garden at the White House, but Obama has made no dent in farm subsidies that help agribusiness overproduce worthless calories and help Coke, Pepsi, and McDonalds rank among the Fortune 500’s most profitable companies for trash food and drinks. Meanwhile, 24 million Americans have diabetes and 57 million have prediabetes, according to the Centers for Disease Control.
When a quarter of your population has diabetes or is at risk for it, that screams for a prime-time address. Obama is right that fighting against obesity involves smart individual choices (and I do hope he can find a way to finally quit smoking). But just as Americans need him to bluntly tell us we’re fat, Capitol Hill has to cut the fat of subsidies, impose taxes on trash food producers, and support cities and suburbs in redesigning streets and parks to support people who want to cycle or go out for a run and children who want to play outside. In a crusade against fat, flabby politics will not do.
Derrick Z. Jackson can be reached at jackson@globe.com. 
