American Obesity Costs Lives

A Nation Growing Heavier

Currently two-thirds of the United States population is overweight or obese. Americans generally eat too much, eat the wrong things and do not exercise. The problem has grown severe enough that the Coast Guard reduced the number of passengers allowed on boats because the average American is 9 percent heavier than at the last measurement.

Body Mass Index (BMI) offers a sobering reality check. A BMI between 25 and 30 is considered overweight, and above 30 is obese. Many people who do not feel fat discover their BMI places them in the borderline overweight category. The Mayo Clinic calculator provides a quick self-assessment that often surprises.

The trend keeps worsening. Colorado is the only state where the number of obese people sits under 20 percent. Yet in 1995, that same percentage would have made Colorado the worst state in the nation. The nation's slimmest state would have been its fattest just a generation ago. The states with the largest share of obese citizens include Louisiana, Mississippi and their neighbors. Fried food and a love of butter play a role, but the root cause is more likely poverty.

Poor People Eat Poorly

When you are wealthy, you enjoy more leisure time to exercise, more discretionary money and access to good groceries. Some joke that Whole Foods should be called Whole Paycheck. It is an odd problem that in many places it is easier to buy french fries than fruit or vegetables.

The United States Department of Agriculture (USDA) defines places where it is difficult to reach a supermarket or large grocery store as nutrition deserts. The threshold is one mile in the city and ten miles in rural areas. Residents in these pink-shaded zones have a tough time finding decent food. Instead, they eat fast food, canned goods and products filled with empty calories, sugar, corn syrup, nitrates and other non-nutritional additives. 1

Obesity Kills

Obesity creates a cascade of health problems including diabetes, high blood pressure, high cholesterol, liver disease, sleep apnea and joint pain. The number of Americans diagnosed with diabetes tripled to 21 million over 25 years. The surgeon general called obesity an epidemic, language that underscores the severity.

Chef Jamie Oliver delivered a damning TED talk about how children learn the wrong things about food in schools. Public schools serve 31 million meals daily, and much of that food is processed, canned and frozen. Children see the same fare at home. They are not learning life skills, and many cannot even identify common vegetables. 2

Obesity Is Expensive

According to a report from the Centers for Disease Control and Prevention (CDC), the annual medical costs associated with obesity were estimated at $147 billion. That figure may be conservative. A separate report from the Institute of Medicine projected obesity-related healthcare costs could reach $550 billion a year by 2030. 3

The obese workforce costs American businesses an estimated $73 billion per year. It is no wonder companies run wellness programs that encourage employees to lose weight and stop smoking. In one documented case, an IBM employee lost 16 pounds and received $1,800 in return. Incentives work when they are structured well.

Structuring the Problem Like a Consultant

As a consultant, the instinct is to think through problems tops-down and group root causes into a few buckets. After reading on the topic of obesity, the structure looks like this. First, Americans consume too many calories and the wrong types of calories. Second, Americans do not exercise enough. There is little argument on either front.

The surprising takeaway is that much of the problem stems from a lack of education and the willpower to fix it. As a society, Americans need to get smart on the topic and encourage each other and their children to live healthier lives.

There are things that governments, schools and civic organizations can help solve. They can provide better alternatives such as healthier foods in schools and fewer nutrition deserts. They can improve access through exercise in public schools and better bike and walking paths. That said, the majority of the fix lives in personal behavior and education.

Kids Do Not Know Food

Oliver's TED talk exposes how children learn the wrong lessons about food in school. The food at public schools is full of processed, canned and frozen items. That is what children see in caferooms and at home. They are not learning life skills. Many cannot even identify what common vegetables look like.

The Biggest Loser, a competitive dieting show, has been hugely popular over the years. It gives an honest look at how hard it is to lose weight and keep it off. It is a physical and mental battle, and the show now features teenage contestants. The popularity of the program signals a hunger for solutions.

Americans Do Not Walk Enough

Americans drive everywhere. Unless you live in a walkable city like New York, you probably drive one to two hours per day. Structural reasons abound, including urban planning, public transportation gaps, tax policies and gasoline prices. The net result is a lot of driving and not a lot of healthy walking.

Americans live sedentary lives filled with television, video games and computer time. The structural causes run deep, but the simple answer may be that people need to play outside more. Urban design that prioritizes walkability can shift behavior at scale.

Trick Ourselves to Eat Less

Cornell University runs a famous Food and Brand Lab that studies eating habits. The researchers there developed the 100-calorie snack pack and other innovations. They study Delboeuf's Illusion, where the same amount of food looks like more when served on a smaller plate. The black circles are the same size, but one appears smaller.

The smart researchers in Ithaca also discovered that strong color contrasts make food look bigger. White pasta on a red plate looks like a lot of food. White pasta on a white plate looks small. These small design choices nudge behavior in ways people never notice.

Yes, It Is an Epidemic

The surgeon general called obesity an epidemic. For many, the general consciousness around bad eating habits started about a decade ago with the publishing of Fast Food Nation and the movie Super Size Me. The film follows a man who eats only McDonald's for 30 days. He gained 24 pounds during the experiment and got sick.

Since then McDonald's has taken positive steps. They sell water, salad and chicken wraps. They publicly post calorie counts and cut sodium across their menu by 11 percent. One newspaper article called it stealth health, a phrase that captures the quiet progress possible when companies redesign defaults.

Should the Government Act?

Libertarians argue that people should choose for themselves. If they want to eat bad food, neglect their bodies and become obese, that is their business. Others counter that people are not always rational and that structural traps like poverty, nutrition deserts and sugar industry subsidies make obesity too easy. The debate is real, and the answer likely blends personal accountability with structural reform.

Consultants who approach obesity with clear buckets, honest data and practical interventions can help decision-makers move past the shouting. The epidemic will not retreat on its own. It requires the same disciplined problem-solving that consultants bring to any engagement, applied to one of the country's most expensive and deadly challenges.

• 1USDA mapping of food deserts in the United States
• 2Jamie Oliver's TED Prize wish to teach every child about food
• 3CDC adult obesity facts and cost estimates