Heavy-set Americans are starting to throw their weight around in the health-care reform debate. If that sounds ridiculous, it's because it is. If the advocates for grossly overweight people have their way, this nation might as well collectively commit suicide one jelly doughnut at a time.
As The New York Times reported this month, a movement has sprung up to make sure the obese are not picked on by new health-care legislation. There's even a group called the National Association to Advance Fat Acceptance, which is lobbying members of Congress. This might be a joke if it were not so tragic.
To make their case seem more plausible, the fat-is-OK advocates echo more conventional complaints about discrimination -- such as those made by women, minorities and the elderly. But those claims are much more sympathetic because nobody has a say in how they were born or can be blamed for growing old. But people who are too fat for their own good often do have a choice. They alone decide how much they eat and how much they exercise (or how little).
For those in denial of this fact, the "fat pride" community has authors to reinforce its own worst instincts. The recent Times story quotes the felicitously named Linda Bacon, a nutrition professor from San Francisco, as saying: "What we're doing in public health-care policy is harmful. We give a direct and clear message that there's something wrong with being fat."
But there is something wrong with being fat. The scientific evidence is clear: It can kill you. As the Centers for Disease Control and Prevention say, once people reach the levels defined as overweight or obese, the risk of falling prey to a host of serious conditions increases, including coronary heart disease, Type 2 diabetes, cancers (endometrial, breast and colon), hypertension (high blood pressure), stroke, liver and gallbladder disease, osteoarthritis and even gynecological problems.
Worse yet, the numbers of the overweight or obese in this nation have reached epidemic proportions, so that these health problems have descended upon a greater number of Americans like a biblical plague. A third of U.S. adults and 16 percent of children are obese, according to the CDC.
As we have observed before, not one state in the nation in 1990 had an obesity rate that exceeded 15 percent. Now not one state has a rate under 15 percent. In 32 states, at least one-quarter of the people are obese.
The fear of a stigma against the obese can't be allowed to stand in the way of engaging the problem -- that does no favors to anyone. The problem is well known and so is the remedy. For most people, being overweight or obese is the predictable result of eating too many calories and not getting enough exercise.
If anything, the message from the government has been way too tolerant of America's expanding waist lines. On Feb. 24, 2008, Post-Gazette Publisher and Editor-in-Chief John Robinson Block presented presidential candidate Barack Obama with an inscribed copy of "Cleveland Clinic Healthy Heart Lifestyle Guide and Cookbook." Steven E. Nissen, M.D., chairman of the clinic's Department of Cardiovascular Medicine, wrote in the foreword that if Americans followed the book's advice, "Whole wings of our hospitals would have to be shut down. I, and most of my colleagues, could be thrown out onto the streets, unemployed. It would be the happiest day of my life." Now President Obama finds that the very problem addressed by the book threatens to overwhelm his health-care reform. He needs to pay attention.
The nation can't go on committing death by doughnut without the associated costs burying all hopes of reform. A report called "The Future Costs of Obesity" was released last week. Based on research by Kenneth E. Thorpe, Ph.D, of Emory University, it put the extent of the crisis in stark terms.
Among its findings is that obesity is growing faster than any previous public health issue the nation has faced and, if current trends continue, 103 million Americans will be considered obese by 2018. Given that, the United States will spend $344 billion on health care attributable to obesity nine years from now.
But an encouragement lurks in the statistics, too: If obesity rates were held at present rates, the report says, the United States could save almost $200 billion in health-care costs by 2018, an estimated $820 per adult.
The fate of health reform depends on ending this epidemic and Congress needs to reject any notion that there's nothing wrong with being fat. In fact, there's everything wrong with it.