Introduction
Going through a list of the deadliest health problems plaguing the American people, one would expect to see heart disease, variations of cancer, type 2 diabetes, high cholesterol,
hypertension among other sedentary lifestyle diseases. A close inspection would reveal an underlying factor in all these diseases and conditions. Obesity. Obesity has evolved to
become the bogeyman in American healthcare. Its rapid advance and shocking prevalence rates have shaken the healthcare establishment to its core. This phenomenon is not an isolated one. Obesity has been running rampage in most countries. But none more so than the United States, which is often regarded as the birthplace of fast food and an advocate of junk food. This has resonated in its obesity rates, at 38.2% obesity rate among adults, America is the most obese country in the world rights after Mexico. In response to the rising obesity rates, the World Health Organisation (WHO) has labeled obesity as a world health problem. Like many issues that ail our world, they tend to affect the children disproportionately—obesity is no different. The prevalence rates among children are rising year on year on average and the figures in 2016 the number at 18.5%. Obesity in children has the effect of exacerbating the issues it brings. Take type 2 diabetes, for example. It is an open secret that obesity is either a precursor or an enabler of type 2 diabetes, bringing with it medical complications and dietary restrictions. In children, high obesity rates may mean an earlier onset of diabetes, and with it, higher chances of medical complications. It also puts the child on a path towards more and more medicine. With time child will become almost entirely dependent on drugs for survival.
The problem becomes even worse when you bring inequality and income parity into the fold. Obesity does not affect all children proportionately; it does so with a bias. Children born into poor households, paradoxically, tend to have higher obesity rates. Similarly, children of Hispanic and non-Hispanic black populations had higher obesity prevalence rates. Not only is obesity in children a failure of the collective public health system, but it is also indicative of the existing income disparity in America. Obesity is never regarded as a health problem, at least not seriously enough. But how did we get here?
Obesity: Definition and its Roots
To understand the gargantuan problem of obesity, we first need to understand the term. Although there are many measures of weight, the consensus is that the Body Mass
Index (BMI) is reliable and consistent. BMI is gotten by dividing one’s weight in kilograms by their height in meters squared. The resulting figure is rounded to one decimal place for
purposes of comparison. The general guidelines are
BMI of less than 18.5 – underweight
BMI of 18.5 to less than 25 – average weight
BMI of between 25 and 30 – overweight
BMI of more than 30 – obese
It is important to note that BMI is not an all-encompassing measure of obesity and overweight. It is merely a tool, a yardstick, to measure whether one is obese quickly. More
comprehensive tests exist to determine the general health of a person. But when did the rain start beating us? Although there is no single moment in history where this obesity epidemic started, like many things, it can be traced back to the 1970s. The considerable population surge that ensued World War 2, aptly given the moniker “Baby Boomers” were in an immediate need for food. Coupled with the rise in globalization and rapidly evolving technology, it was only a matter of time before cheap, mass-produced foods were introduced
to feed the masses. To provide the increased population and to preserve food independence, the government subsidized the production of corn. And the farmers obliged, producing more corn than they knew what to do with.
At the time, sugar was the de facto sweetener in any manufactured product and had been for a long time. President Nixon’s administration, however, encouraged farmers and
manufacturers to convert the excess corn into high fructose corn syrup, which is glucose that has undergone enzymatic processing to turn it into sweeter fructose. The results were phenomenal. For the first time, there was a substance that packed more sweetness than sugar itself—this revolutionized food and beverage production, not only in the United States but in the world. In many ways, the rising obesity rates can be traced back to this period in history, the industrialization of high fructose corn syrup. President Nixon is known for his infamous Watergate scandal, but this was one of his most spectacular policy failures, condemning millions of people around the world to the horrors of obesity. In truth, he and his administration had no clue as to the monster they were creating. An innocent agricultural policy was ruthlessly exploited by the second culprit in this epidemic, corporations.
It is no secret that the bottom line drives corporations, and they will do anything to preserve their bottom line and make profits. According to Kaczynski, his was no different in
the 70s when high fructose corn syrup was introduced. Since it was cheaper than sugar, firms no longer had to import expensive sugar from faraway countries such as Brazil, where they had to set up large scale operations. They could use corn syrup as a ready and cheap substitute (7). And so, they did. Although its use has been dialed back a bit due to its health
complications, fructose corn syrup is found in soft drinks, ice cream, snack bars, chocolates, milk products, and confectionaries. This widespread adoption has improved its advantages of scale, making it even cheaper. The problem with fructose lies in how it affects our biochemical processes. Fructose inhibits the functioning of the hormone leptin. Leptin is the hormone responsible for telling the stomach that it is full and that you should stop eating. But leptin stops working when the liver is overloaded with sugar, as is the case with leptin, inducing your brain into thinking you are starving and hence want to eat some more. This vicious cycle of consumption is what fills our bodies with fats and cholesterol and contributes immensely to being overweight.
Regulations and Lobbying
A vital sector like food and beverages ought to be, and is, regulated by the federal government through the Food and Drugs Administration (FDA). According to their website,
the FDA’s role is to safeguard public health by maintaining the safety and efficiency of human drugs and making sure that the nation’s food supply is safe. For now, we will dispense
with the regulatory role in the pharmaceutical industry and focus on the food supply chain. The FDA plays an essential role in regulating what ends on the shelves of your everyday
grocery store. They are responsible for the testing and grading of all foodstuffs that are sold in the American market, granting them immense power. They are not the only regulatory
bodies. Congressional committees on food and beverage industries also play a hand in determining food policy in the United States. Add onto this, the president and the
administration of the day and their affiliations with the voting bloc. Farmers in the rural parts of America make up a massive chunk of the voting bloc and as such their considerations are taken seriously. They have always formed the backbone of policy decisions and are recipients of massive subsidies from the government.
Favorable market conditions – falling prices of fructose corn syrup, favorable demographics, and increased rural to urban migration – have seen the rise of multinational
food corporations that have championed the advancement of fast foods. McDonald’s, KFC, Pizza Hut, Starbucks, Burger King are but a few of the many fast-food chains across
America. These corporations have grown to mammoth sizes, expanding their reach far beyond the borders of America. Their selling point is that fast foods are cheap and fast – it is
in the name after all. And they have been able to deliver on this, with fast food in America being one of the cheapest foods. This has fuelled their popularity, with about 50,000 fast food joints in continental America alone. Parents no longer want the hustle of preparing food and instead go for the cheapest option in fast foods. Consequently, children grow up liking junk food, and they continue the same patterns of consumption, not knowing the deleterious effects it poses. The FDA and members of Congress are supposed to protect innocent Americans from the harmful substance are in their foods and drinks. By failing to rein in these industries, they have created monsters that are now difficult to slay. Attempts made by independent think tanks and scientific groups to nudge Congress into taking a stand and protecting the nation’s children have fallen on deaf ears. Not that the esteemed members of Congress are not listening, the food corporations have a massive war chest. And they use this to lobby and sway members of Congress into seeing their world view. Food lobbyist groups have increased in both numbers and frequency in the last few decades, aiming to protect their interests by swaying the policymakers. Attempts to reform the public-school menus – a predominantly high fructose-based menu – has repeatedly hit a wall due to these efforts. This means that any effort to change the food system as it is right no requires enormous sums of money that the advocates do not have. No one is left to fight for the children’s right to healthy food. In America, it might be easier for a child to get a double whopper from Burger King than it might be to get a bowl of vegetables at a similar price. It is even worse for children living in more impoverished neighborhoods. For these children, a meal a day is all they want, and the cheapest option is often fast food. It is a policy failure of epic proportions to have obesity among children at this scale, to have millions of children susceptible to lifestyle sedentary diseases and conditions. It paints a dire picture of the regulatory powers that be –
Congress and federal agencies. It paints an even worse picture that the culprits of this modern epidemic use the proceeds of their plunder to enrich themselves and protect their positions. An overhaul of the system is required as the problem deteriorates further.
Health Impact and Costs
The health effects of obesity in children are well documented. It not only impacts the health and well-being of the child – exposing the child at an early age to the adverse effects
of sedentary and lifestyle diseases – it also puts a strain on the scarce resources of the healthcare industry. In 2019 alone, the estimated costs of obesity in medical-related costs was
a staggering $190 billion, or roughly a fifth of the total annual medical spending in the United States. Child obesity consumed $14 billion in direct medical expenditures on its own. These are crazy numbers that go to show the scale of the problem we face. These figures are just a ballpark estimate of the direct costs. In terms of indirect costs, it is estimated to cost the American economy a whopping $1.24 trillion, or roughly 9.3% of annual GDP, in lost productivity (Finkelstein et al. 859). If not for anything else, these figures should provide ample motivation to reverse this trend. This is despite the billions of dollars spent each year in the prevention and education of the populace about the effects of obesity. Most of this education is aimed towards children, who are seen are the most vulnerable groups. And rightly so. Children are expected to one day take over vast swathes of the
productive workforce. A sickly workforce will not benefit anyone in the slightest. They might be even worse off than their predecessors, with more considerable productivity losses and increased medical care costs. The problem with obesity in children is that it promotes the early onset of lifestyle diseases and conditions such as heart disease – the leading killer in America – hypertension and other chronic non-communicable diseases. This exacerbates the pressure on healthcare resources from an early age and dramatically reduces the quality of life for the child (Kumanyika 4). Obesity’s tentacles stretch into many facets of one’s life, and for a child, the effects are doubly worse. A child with obesity is at a higher risk of developing lifestyle complications. Therefore, they are subject to higher insurance premiums than fellow children without such problems. This sets up children poorly for the future, with little prospects in a financial and healthcare point of view. Given that children are the future, child obesity is setting up to be one of the worst policy failures of our time.
The impacts of child obesity are not only contained top children and their future. As demonstrated above, obesity threatens to unravel and reach into various sectors of the
economy and wreak havoc. In terms of productivity, the amount of money lost to unproductive workers due to obesity-related downtimes is expected to increase to roughly
$4.3 billion in the coming years. This does not portend well for children now. One research study suggests that a ten-year-old child with obesity is expected, over their lifetime, is likely to spend between $12,000 and $19,000. The health impact of obesity in children are diverse, ranging from increased cardiovascular diseases, often preceded by high cholesterol and high blood pressure. Development of insulin resistance and the onset of early type 2 diabetes. Since the child is still developing and growing, the added weight resulting from obesity puts a strain on their skeleton, which can create musculoskeletal pain. In other cases, this can be a precursor to cancer. Mental health problems in children with obesity are also magnified, with psychological conditions such as anxiety and depression.
Conclusion
The United States has been grappling with obesity for a long time; in some ways, it has become the poster child for obesity and fast foods. Its multinational corporations have
exported this philosophy to all corners of the globe, in turn increasing global obesity rates. Children in the United States have been particularly struck by obesity, with rising prevalence rates in the past few years. This does not portend well for the millions of children in America, who may have a mirky future due to the harmful effects obesity can bring with it. The drag of obesity on the economy has already been established, and this downward effect on the economy is only expected to increase, with the rise in healthcare costs. A drop in productivity and an increased proportion of expenditure going towards healthcare costs does not reveal a bright future for our children. One would argue that it is in schools where children should be taught about the importance of a good and healthy diet and the adverse effects of a fast-food diet. But the reality is far from this. In schools, a huge battle is ongoing over the content of the menus, whether to abolish some foods that are either high in fructose corn syrup or those containing high amounts of salt, sugar, and fat. In Canada, after recognizing the adverse effects milk and its products had on a child’s development and growth, they removed milk from the national curricula and public school menus. They also banned the advertisement of milk as a healthy and reliable source of calcium. The United States is a bit different, with corporate interests striving to keep the status quo and continue using cheap available high fructose corn syrup to improve their bottom lines and make more profits. Blame does not lie squarely on these corporations’ shoulders; they also lie with the oversight and regulatory bodies, who have failed to rein in on the runaway obesity problem in America. As with any crisis, it builds over time and explodes with a bang. Child obesity is building at the moment;
the bang is yet to come.
Works Cited
“Childhood Obesity.” Gale Opposing Viewpoints Online Collection, Gale, 2019. Gale In Context: Opposing Viewpoints, https://link.gale.com/apps/doc/KAJHYO545776248/OVIC?u=chic13716&sid=OVIC &xid=a4906165. Accessed 2 Nov. 2020.
Finkelstein, Eric Andrew, Wan Chen Kang Graham, and Rahul Malhotra. “Lifetime direct medical costs of childhood obesity.” Pediatrics 133.5 (2014): 854-862.
Kaczynski, Andrew T., et al. “Development of a national childhood obesogenic environment index in the United States: differences by region and rurality.” International Journal of
Behavioral Nutrition and Physical Activity 17.1 (2020): 1-11.
Kumanyika, S. K. “Supplement overview: what the Healthy Communities Study is telling us about childhood obesity prevention in US communities.” Pediatric obesity 13 (2018):
3-6.
