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.
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.
while the concern about obesity may have hit the national
consciousness, it hasn't really shown up on the bathroom scale for most
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
"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
Obesity is "one of the few things that has gotten worse quickly," he says. "It really is a very serious health problem."
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?
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.
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.
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.
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?
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.
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.
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.
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,
"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.
Nestle, "There were enormous changes, and of course, they happened
without anyone realizing it because they came in one by one."
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."
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."
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.
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."
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."
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
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
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.
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."
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."