Friday, July 06, 2007

Ramblings on Obesity

So every American knows that obesity is a problem in the United States. Now I do not mean big boned kind of fat where the people are going to be built stocky or have an apple body shape. I am talking obese. We practically glorify eating with hot dog, pie, lobster eating contests like the Romans with their vomitoriums. Obesity rates are rising very fast in this nation, more data here, and obesity is defined as having a BMI over 30. Now this is a setting where BMI is over 30, but you do not look like weightlifter, more like Mr. Softee. Being overweight used to be a sign of wealth, and some cultures valued being overweight (Caribbean cultures come to mind from an anthro class I once took).This is a problem that really does threaten the nation (other countries are seeing rising obesity rates as well). There have to be some solutions to this problem.

There have been studies, papers, essays, tv specials, documentaries, and other bits of media explaining our obesity problem. Here is my list of reasons for this rising problem (I do not care if I am politically incorrect):
1. Lower levels of physical activity
2. Higher calorie intake
3. Higher sugar and simple carb intake
4. Higher fat intake
5. Increase in general laziness
6. Increase in consumption of processed foods
7. Fewer home cooked meals because both parents work
8. Humans once required 6000+ calories a day to surive. It is now around 1500; our bodies are having difficulty adjusting.
9. Indifference to weight because science and medicine will find a cure
10. The survival rate of humankind is extremely high; survival of the fittest not happening right now

To use an analogy, I see the obesity problem like a clogged artery: it is straining us now little by little, but down the road, we're going to be fucked. I would not be surprised if we get a boost in foreign born surgeons in the US over the next 25 years to grapple with the boost in obesity related surgeries. The clogged artery that is obesity is going to fuck us up as a society as soon as the baby boomers start to reach prime 'heart disease' age. Odd since the boomers were the first to take up jogging and weightlifting, they'd somehow drop that for cream filled donuts. Add that to the baby boomer hypocrisy pile.

Now I am 27 and have all 4 of my grandparents still breathing sweet air. Having seen them and their peers age, I can assume that it is ok to have a little extra padding going into your retirement and a healthy appetite for good food, but an extra 25 lbs is only going to lead to heart, foot, and joint problems. Not everyone is going to be built like an Olympic swimmer until the day they die, but not drinking heavily, having a healthy diet, and getting in a daily walk can do a lot to keep excess weight off. This is all it takes folks, all it fucking takes.

Liberals will say more education is needed. Hog-fucking-wash. People in the 1950s did not know what was good for them, but obesity rates were lower. Heck, people in the 50s thought smoking was good for them! What can be done to combat this issue nationwide since food and nutrition education just do not seem to be working? I say they are not working since health classes in school drill it into students to eat right and be active, and yet, childhood obesity rates are skyrocketing. Believe me, I hope my future kids are built like my wife and I. I would cry myself to sleep at night if I had an obese child. It is everywhere on women's magazines but women have higher obesity rates. Across the nation, people subject themselves to radical gastric bypass surgeries which act as a 'choker' on the stomach. This reinforces my laziness point from above; too lazy to do the little things to stay healthy.

I am trying to approach this is a Libertarian way, and not have any heavy handed government programs. People should be free to become pigs if they want. Can we make add incentives for good behavior? Can we make obesity and being overweight such a horrible social stigma that we change behavior? It worked for cigarette smoking, which might be the greatest public health initiative since the shaving/stop spitting move that limited the spread of disease back in the day. Here are some ideas (some are intended for comic relief):

1. Use the BMI to set higher rates for insurance premiums.
People on government programs would have a higher fee as well. Believe me, insurance companies would be all over this. It might be more administratively, but they would gladly demand BMI measurements at annual or bi-annual frequencies with covered people's physicals. The companies would gladly gamble that people cannot keep the pounds off. Could people crash diet for the weigh in, sure. The selection would be for people right on the obesity line who only need to lose 10 lbs or less. People would have a financial incentive to stay in better than deadly shape; people respond to money. It is the American Way.
2. Charge premiums on procedures for obese individuals.
The premium on top of 'normie' rates would have to be picked up by the obese patient. If an obese person needs knee replacement surgery, tack some extra $$ on it. Angioplasty on a 40 year old 300 lb man? Double it up! I have a feeling, this would end up reducing the costs of many procedures for healthy weight (normies) people. I also think the threat of high medical bills would scare the bejeezus out of obese people.
3. Gastric Bypass surgery treated as a purely elective surgery with no insurance coverage whatsoever.
Gastric surgery would come out of the individuals pocket from dollar one. Insurance companies now cover GB if it is medically necessary (morbid obesity counts). So everyone who is in the pool of insurance pays for your fat ass to have a surgery that will do what your willpower could not do? Hell no. With the rising cost of health care and medical insurance premiums, this is a no brainer. If the bill is put back on the consumer, they will understand the impact of the surgery. This will also reduce hospital bed, ICU and recovery unit utilization. God knows, the health care works RNs, LPNs and doctors to the bone.
4. Set up bicycle buildings with dozens of bikes set up to generators; make anyone within 10% of obese/overweight line ride them until the BMI is 10% below the Obese/Overweight line (exclude people with healthy bodyfats so pro-athletes are not on duty).
Draconian, but it could also help solve energy needs as well as health needs. If they slip to the Obese/Overweight line again on random inspection by the mailmen (multitask so to keep admin costs down), report for bike duty. Bicycling does not generate much electricity, but could add some electricty to the grid. Utility companies would pay the health orgs for the output. Obese people would not see a dime. Name these bike pools something scary like "Obesteries".
5. Send people who are measured as obese (exclude low body fat people) for 3 consecutive years to do humanitarian aid in regions known for cannibalism.
Talk about goodwill in the 3rd world.
6. Deny all health care and medication to people measured obese (above exclusion honored) for 3 consecutive years.
I know yo-yo dieting might become a problem, but the fat bastards would be doing something about it. The threat of no medical treatment would scare the shit out of the extremely large, and that would be a lot of feces. This might create a black market of procedures, medicine and treatment for the obese, but then we could fine, jail, or strip the license of the MDs, pharmacists and RNs who provide help at extremely high rates to discourage the black market help.
7. After 5 consecutive years measured at an obese level (prior exclusions honored), exile.
They can be exiled to a deserted island and fight amongst each other for the limited food. Televise it as Must Eat TV.

1 comment:

Working Class Schlep said...

There actually was a time in this country when it was acceptable to say "fat" in place of "person of size" or the clinical "obese." Some dept stores actually had "fat sections." I say bring that back!