The Silent Killer That No One Likes To Talk About

It is the second leading cause of preventable deaths.  An estimated 300,000 people die annually from diseases related to this condition. Yet the issue lurks in the shadows because of unhealthy anguish about social stigma. By not shining a light on the subject, America is inviting a catastrophic health crisis.

Obesity is a health risk the nation can no longer ignore.  Obesity is linked to chronic medical conditions, including Type 2 diabetes, heart attack, stroke, kidney failure, nerve damage, gum diseases and some forms of cancer.  And there are a host of lesser disorders, such as sleep apnea.     

Statistics document that obesity is one of the most serious public health challenges of the 21st century:

• Data shows that 41.9% of adults are obese according to data from the Centers for Disease Control and Prevention (CDC).  In 1995, obesity affected 15.3% of adults.  Adult obesity rates have increased 37% since 2008.

• More than 80% of obese people develop Type 2 diabetes, according to research from the National Institutes of Health (NIH). Obesity related cardiovascular disease deaths tripled between 1999 and 2020, reports the American Heart Association. 

• The American Cancer Society data found excess body weight is responsible for about 7% of all cancer deaths in the country, including 11% in women and 5% in men.  

• The rate of childhood obesity is increasing at a faster rate than adult obesity. As of 2023, one in five children in the country is obese. Youth obesity rates have increased 42% since 2008. 

• A recent report by the Milken Institute estimates the annual medical and economic impact of obesity exceeds $1.3 trillion. The direct medical costs to treat obesity related diseases ranges from $147 billion to $260 billion annually, reports the CDC. 

Who is considered obese?  Answering that question would appear simple.  The process involves a calculation based on a person's weight in pounds, divided by the height in inches squared, multiplied by 703, to determine a Body Mass Index (BMI).  The number is adjusted for age and gender.  

For the average American, it sounds like voodoo medicine.  A study reported by the NIH found only 22% of obese women and 6.7% of obese men correctly classified themselves as obese. Complexity is the enemy of dealing with preventable health issues.

Improbably, the American Medical Association has been at the forefront of quashing honest discussions about obesity and its impact on health. A report in the AMA Journal of Ethics stated that focus on BMI and weight has "yielded few health benefits and contributed to weight related discrimination."

How can the country tackle obesity if the leading medical group hushes information about unhealthy weight gain?  Apparently, the medical profession prefers to treat obesity related diseases rather than target prevention. No wonder U.S. medical costs are soaring, reaching $4.5 trillion in 2022.

Another impediment is the country's obsession with race.  Since African-Americans are disproportionately impacted by obesity, many academics and medical groups blame systemic racism for the rise of obesity.  Even pointing out the statistics is considered racist.  What does that solve?

Lifestyle choices play a large role in obesity.  Unhealthy diets and Americans addiction to screen time --cell phones, computers, video games and television--contribute to sedentary lifestyles. Only 28% of adults and 22% of adolescents meet the CDC's physical activity guidelines.

Prevention can be as simple as a healthy diet and exercise, such as walking 20 minutes a few times a week.  But let's acknowledge that for some, hormones and genetics make some people predisposed to obesity or excessive weight gain.  Unhealthy stress can also be a contributing factor. 

But why eat healthy and exercise when a drug can do the heavy lifting? It's the American way, and pharmaceutical companies are eager to profit from the solution.  The Food and Drug Administration has approved two Type 2 diabetes drugs, administered with an epipen, for weight loss.  

Diabetes medications Mounjaro from Eli Lilly and Ozempic from Novo Nordisk are soon expected to be rebranded and marketed for weight loss. Currently, the drugs cost about $1,000 to $1,200 for a month's supply. No prices have been announced for the weight loss versions.

Today most insurance companies do not cover weight loss drugs.  A 2003 law prohibits Medicare from doing so.  However, given the size of the obesity cohort, expect growing political pressure for insurance companies to cover the drugs, which will raise the cost of health premiums for everyone.

The sensible solution is for the medical profession and public health organizations to launch campaigns to increase education about the causes of obesity, while describing its harmful effects.  The campaign should include information on unhealthy foods and the benefits of physical activity. 

Unfortunately, many medical organizations and health advocates want the government to step in and legislate health.  Zealots want Washington to pass laws mandating better food labeling, healthier fast food, organic vegetables while outlawing red meat.

Onerous federal edicts are not the answer.  Arresting obesity rates requires individuals and families to take responsibility for their health. Prevention starts in the home with healthy food and physical activity. That means arming Americans with facts, not silencing discussion of obesity.