American Obesity Crisis Paradox: The Richest Country With the Best Doctors Has a 35.7% Obesity Rate

The numbers are shocking. Almost every week it seems that a new report is released that announces startling statistics about the health of the American population. The latest statistics now reveal that 35.7% of all adult Americans are obese, while type 2 diabetes in children has risen 21% in a span of just 8 years. Moreover, these diseases are all associated with complications such as heart disease, stroke, and kidney failure, that are both deadly and costly. In fact, it is these chronic diseases (along with cancer and arthritis) that account for approximately 75% of all health care costs.

What is consistently frustrating about these numbers is that most of these diseases are preventable, and can be traced back to common, but modifiable behaviors: tobacco use, excessive alcohol use, insufficient physical activity, and poor eating habits. The first two behaviors can be approached with an “abstinence only” attitude. We’ve known that smoking is bad for us for years now. And common sense dictates that the binge drinking that 1 in 6 Americans do every month probably isn’t healthy. Exercise and nutrition, however, are unique because their effects are often interrelated, and there are many "rules of thumb" for proper exercise and eating. What's more confusing is that in recent years, science is showing us that diet and genetics, and not our exercise habits, may be the key determinants of many illnesses.

The many conflicting voices, opinions, and authorities in the world of nutrition make informed decisions about what to eat both difficult and almost paralytic. Every few months, a new dieting trend comes out, and we rush to pick up the new literature, demonize whatever macronutrient is chosen as the villain, and buy the processed foods that declare themselves to be free of the offending macronutrient. This is an example of reductionism and it’s a game that we have played numerous times with fat, and now carbohydrates, and our nation as a whole hasn’t gotten any healthier. This is the American paradox: a nation that spends so much time discussing and debating diet and health care, and yet boasts an increasingly unhealthy population. 

The reductionist approach that we’ve taken to understanding the foods that we eat have resulted in guiding principles that, unfortunately, are often misleading. Psychologist Paul Rozin noted many of these fallacies in his 1996 study on how Americans simplify nutrition information according to a set of flawed rules. For example, the “abstinence only” approach that makes sense in the context of tobacco use is troublesome in our understanding of nutrition. In Rozin’s study, a third of participants across a wide sample believed that a diet absolutely free of fat was better than one with just a small amount of fat. The participants were misinformed by the faulty heuristic that something harmful at high levels would subsequently be harmful at low levels. This misconception is a result of years of the low fat theory dominance that has trained Americans to avoid fats, while pushing them towards carbohydrates. This has occurred in spite of the fact that fats are essential to the human diet and excessive consumption of simple carbohydrates can lead to the ensuing development of diabetes.

Fundamentally, the root of the incongruence between how much we know about our food and our health stems from our inability to make informed decisions about what we’re eating. The Western diet is unique in many aspects, but probably its most remarkable characteristic is the sheer quantity of food that we’re exposed to, and the proportion of it that is energy dense and nutrient poor. We eat large portions of these foods and burn even less of them, resulting in another paradox: a nation that is overfed and undernourished. Not only are Americans an ill-fed population, but we are also afflicted by chronic diseases with overwhelming health care costs. To think that your lunchtime decision carries future hidden costs is intimidating, but it speaks to the reality that we need to make informed decisions about the food that we choose to consume.

In a world where food decisions are being made in restaurants, grocery stores, and vending machines, it’s imperative that people possess tools that can inform their specific decisions with knowledge suiting their needs and interests. The statistics speak for themselves. Americans are facing a health crisis rooted in misguided decisions about the foods we eat, despite the amount of knowledge that we possess about nutrition. The trick is to insert this knowledge seamlessly into the daily food decisions that we make.

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