If you look hard enough, there are signs that
Americans are finally getting the message about how heavy and out-of-shape they
are.
Consumption of diet drinks is increasing, and the
calories Americans consume from regular sodas are on the way down.
More than half of Americans (55%) say they are
trying to drop some weight, up significantly from 43% in 2011, according to a
recent survey conducted for the International Food Information Council
Foundation.
But while the concern about obesity may have hit
the national consciousness, it hasn't really shown up on the bathroom scale for
most Americans yet.
The reality is that the nation is now entering a
fourth decade of weight gain. The obesity rate — those who are 30 or more
pounds over a healthy weight — stayed fairly level at 15% from 1960 to 1980.
Since then, it climbed to 36% in 2010, an
all-time high. If it continues to grow, about 42% of Americans may end up obese
by 2030, according to a projection from researchers with RTI International, a
non-profit organization in North Carolina's Research Triangle Park.
"If you go with the flow in America today,
you will end up overweight or obese, as two-thirds of all adults do," says
Thomas Frieden, director of the Centers for Disease Control and Prevention.
The project offers a way for family members to get in shape
together.(Photo: USA TODAY)
Obesity is "one of the few things that has
gotten worse quickly," he says. "It really is a very serious health
problem."
Obesity takes a huge toll on people's health.
"Obesity is not just a cosmetic problem. It contributes to a long list of
serious health problems — diabetes, cardiovascular disease, liver problems,
degenerative joint disease, and even cancer," says Francis Collins,
director of the National Institutes of Health.
Those extra pounds rack up billions of dollars in
weight-related medical bills. It costs about $1,400 more a year to treat an
obese patient compared with a person at a healthy weight, Frieden says. It
costs $6,600 more a year to treat someone with diabetes, he says.
So where did we go wrong, and what will it take
to reverse the trend?
National obesity experts say that over the past
three decades, Americans' eating habits have changed dramatically. Food
marketers, manufacturers and restaurants are selling us more food in bigger
portions — and we're happy to wolf down much more than we used to.
The culprit behind the epidemic is that "we
are eating significantly more calories now" than 30 years ago, Frieden
says. "At its most basic level, obesity is a problem of calories."
A number of observers cite a litany of changes
that have reshaped food consumption: Fast-food chains are pushing bigger
hamburgers, beverages and servings of french fries; restaurants have doubled
the portion sizes of their meals.
Meanwhile, jobs put fewer physical demands on
workers, and physical education has been squeezed out of many schools.
These and many other changes, big and small, have
led to "the perfect storm that has caused the obesity rate we have
today," says James Hill, executive director of the Anschutz Health and
Wellness Center at University of Colorado.
States, cities and communities have taken action
across the country to reverse the trend. Schools are being pushed to offer
healthier foods to kids, and programs such as first lady Michelle Obama's Let's
Move are trying to get them to exercise more.
In one of the most high-profile efforts, New York
City is putting a 16-ounce cap on sweetened bottled drinks and fountain
beverages sold at city restaurants, delis, movie theaters, sports venues and
street carts.
Though many people consider sugar one of the big villains,
it doesn't bear sole responsibility, Hill says.
"I'm not here to defend sugar," but the
causes of obesity are more complex than just sugar intake, he says. Many
Americans are following high-fat, high-calorie diets, and they are not moving
nearly as much as they should, he says.
"There's a lot we don't know about
obesity," Frieden adds. "I don't think we can blame our genes,
because we have basically the same genetic makeup we had 40 years ago. It's not
that we have gotten less self-disciplined. What has happened is the structure
of our society has changed in ways that make it difficult to maintain a healthy
weight."
SURROUNDED BY FOOD
So how much more are we eating?
Research suggests different amounts. It's in the
"ballpark" of maybe 200 to 400 more calories a day than 20 years or
so ago, says Marion Nestle, a nutrition professor at New York University and
co-author of Why Calories Count.
Collins says it's not hard to consume just 100
calories more each day than you need, but for an average person that would
result in a 10-pound weight gain over a year.
Where people eat has changed significantly as
well. They now gobble meals and snacks at the desk, in the car, standing up, in
food courts at malls, in gas stations, says Kelly Brownell, director of Yale
University's Rudd Center for Food Policy and Obesity. There are more
grab-and-go foods everywhere you turn.
"People tend to consume whatever they find
in a bag, bottle or box, and the sizes of all these things have increased
dramatically," Brownell says.
Lisa Young, an adjunct professor of nutrition at
New York University and author of The
Portion Teller Plan, has spent years studying the trends. The serving sizes
of foods sold in stores and restaurants — from candy bars to burgers and sodas
— have become much bigger since the early 1980s, Young says.
Over the past three decades, food companies and restaurants competed
by offering consumers larger portions and thus more calories for their money.
And studies show that when you give people more food, they consume more, Young
says.
"Portion sizes at restaurants are marketed
in a way that makes you want to supersize for just pennies more, when in
reality, it's adding on hundreds more calories and sometimes even
thousands," says Heather Burczynski, 37, an administrative assistant in
Nashville.
Adds Nestle, "There were enormous changes,
and of course, they happened without anyone realizing it because they came in
one by one."
Nestle and Young are convinced that these bigger portions account for
much of the weight gain over the past 30 years.
"I don't think you need anything more than
larger portions to account for the increase in obesity. It is sufficient,"
Nestle says. "Larger portions have more calories."
But Sean McBride of the Grocery Manufacturers
Association, a group that represents the food and beverage industry, says its
member companies "want to make sure they are providing consumers with the
product choices they need for their changing preferences and lifestyles."
"Parents don't want to be told what they
should or shouldn't buy, they want information and options, and that's what
we're working to provide them," says Susan Neely, president of the
American Beverage Association.
Registered dietitian Joy Dubost, director of
nutrition for the National Restaurant Association, adds: "Just to blame
obesity on portion size is shortsighted. It gives people a false sense of
security that if they just cut portions they are going to lose weight.
"It's about how much you eat and how much
you burn. The exercise portion of the equation has been missed in the debate of
what caused obesity."
It's not only food that is to blame, Hill agrees.
"If we were as active as we were in the 1950s, I don't think we'd have
nearly the problem with obesity, even with our current food environment."
Kevin Fowler, 53, of Farmington, Minn., a safety director at an
electric company, has seen the problem even in the way kids get to burn off
energy: "I don't see the all-day-long kid-organized pickup baseball and
football games at the park anymore like we used to do as kids. Those kinds of
opportunities to be active every day not only gave us great memories, but they
helped to develop habits that can last a lifetime. Instead, kids' sports today
are too structured, too specialized and too expensive for a lot of
families."
MORE SITTING, LESS
MOVING
Tim Church, director of preventive-medicine research at the Pennington
Biomedical Research Center in Baton Rouge, points out that work-related
physical activity also has decreased dramatically over the past 40 years.
He and colleagues analyzed data from the U.S.
Bureau of Labor Statistics from the 1960s to 2008 and found that today's
workers are burning an average of 120 to 140 fewer calories a day at their jobs
than workers in the 1960s. Men burn an average 142 fewer calories a day at
work; women burn an average 124.
The lower activity level is the result of a
dramatic drop in the number of active jobs in manufacturing and farming and an
increase in office jobs that are mostly sedentary, Church says. "We have
transitioned from the 1960s, when most Americans were essentially exercising at
work to now, where almost everyone sits the majority of the workday."
In a recent government study, about 48% of people
in 2010 said they were meeting the government's physical activity guidelines —
at least 150 minutes of moderate-intensity aerobic activity, such as brisk
walking, a week. The finding was based on their self-reports about how active
they are. But researchers with the National Cancer Institute, using actual
motion sensors, found that less than 5% of adults in this USA get at least 30
minutes a day of moderate intensity physical activity in bouts of at least 10
minutes.
"I am convinced that activity levels have
declined, and personally I am convinced that declining physical activity may be
the key factor underlying the obesity epidemic," says Russell Pate, an
exercise researcher at the University of South Carolina.
Hill says society has "engineered activity out of our lives. How
many remote controls do you have in your house? Most people are so sedentary
that their energy balance regulation system doesn't work very well."
"Now we know that being sedentary is another
risk factor for premature death," Hill says. In one recent study,
Pennington researchers found that if most people spent less than three hours a
day sitting, it would add two years to the average life expectancy in the USA.
Scientists believe that what's called "sitting disease" is a risk
factor for early death, on par with smoking
Says Hill: "It's a fallacy to think you could change one thing and
fix obesity. Many things need to change to turn this problem around."