The Fattening of America (eBook)

ERIC A. FINKELSTEIN, PHD, MHA, is a nationally acclaimed expert on the subject of economics and obesity. He is a health economist with the research organization RTI International in Research Triangle Park, North Carolina, and teaches health economics at Duke University. His work focuses on the economic causes and consequences of health-related behaviors, with a primary emphasis on obesity. Finkelstein has published over thirty peer-reviewed articles on the economics of obesity and related behaviors. His research has been featured on the front page of USA Today and has been covered in the Economist, the New York Times, Forbes, the Washington Post, and many other newspaper, radio, and television outlets. LAURIE ZUCKERMAN left her corporate PR job in 1999 to make writing her full-time career. She contributes columns and feature articles to a number of business journals and lifestyle magazines, and writes for businesses ranging from Fortune 500s to startups, with a focus on health care, high tech, and business.

Introduction: Answering the Age-Old Question: Why is Uncle Al So Fat? ix

Chapter 1 Craze or Crisis? 1

So Why Now? 2

My Soccer Team Eats Oranges 3

So How about Adults? Are We Gaining, Too? 7

A Growing Waistline Can Be Bad for Your Health 10

But Are We the Only Ones Gaining Weight? 13

The Longer You Stay, the Bigger You Get 16

Chapter 2 I'll Take a Deep-Fried Coca-Cola 17

First Things First 18

Cheap Food Gets Cheaper 19

The Rise of French-Fried Potatoes 22

Please Pass the High-Fructose Corn Syrup 24

A Full Pound of Sausage, Bacon, and Ham: Have a Meaty Morning 28

Too Much of a Good Thing 31

Kids Are Also Drinking the Kool-Aid 33

When is Enough Enough? 34

Chapter 3 Why We're Moving Less (Hint: It's Not Just the La-Z-Boy) 37

But I Don't Have Time! 38

Not Quite the Jetsons, But . . . 40

Just Be a Marathon Runner 44

We're Not Farmers Anymore 45

Sprawling Out 47

Our Kids Are Also Slowing Down 48

Wrapping It Up 49

Chapter 4 So Where Else Can We Lay the Blame? 51

Blame Mom and Dad 52

Then Just Blame Mom (You Know You Will Anyway) 55

Blame the Meds 56

Blame the Cigs (One More Theory Goes Up in Smoke) 59

Blame the All-Nighter 61

Blame the Air Conditioner (Not Cool) 62

Blame Pollution (It's a Dirty Business) 63

Blame That Nasty "Fat Bug" 64

It's the Economy, Stupid 67

Chapter 5 Beware: Moral Hazard 69

Just Bill My Health Insurance 71

Is Obesity as Bad as It Used to Be? 74

Just Take a Pill or Get a Procedure 76

Chapter 6 So We're Fat--Who Cares? 81

Is Uncle Al Overweight? 82

C'mon Now, We're Only Utility Maximizing 85

Now, Let's Tear This Argument Apart (and Put It Back Together) 88

So Should Dad (and the Government) Care that Uncle Al is Obese? 91

Just Follow the Money 93

Chapter 7 The Role of Government 101

Market Failures 103

Externalities 105

Market Power 107

Public Goods 108

Obesity and National Defense 109

Imperfect (Asymmetric) Information 111

Is There a Role for Government? 115

Chapter 8 Weighing the Public Policy Issues (for Adults) 117

Equity 118

Irrationality 122

Compelling Public Need 123

Revisiting Past Policy 125

The Road Ahead 138

Summing Up 151

Chapter 9 Weighing the Public Policy Issues (for Kids) 153

First, a Step Back 155

Child Abuse? 160

School-Based Regulations 161

Your Mouth Will Really Groove 175

In Closing 179

Chapter 10 The Employer's Dilemma 181

Why Don't Businesses Invest More in the Health of Their Workforce? 182

The Dirty Secret about Employee Wellness Programs 189

So What's an Employer to Do? 192

Could These Programs Get Me in Legal Hot Water? 201

Chapter 11 The ObesEconomy 203

Just How Big is the Weight-Loss Industry? 204

Just Take a Pill 209

Bigger and Better 214

Invest in New Technology 219

In the Name of Progress 221

Chapter 12 How to Lose Weight Like an Economist 223

Economic Weight-Loss Techniques 226

A Few More Secrets to Success 231

Conclusion 234

Notes 239

About the Authors 267

Index 269

"Fatty, fat, fat, fat," chants Bart Simpson. He has a
point. Americans are getting fatter. But health economist
Finkelstein (public health economics program, Research Triangle
Inst.; coauthor, with Phaedra S. Corso and Ted R. Miller, The
Incidence and Economic Burden of Injuries in the United States)
and business writer Zuckerman (coauthor with Mary Cantando, Nine
Lives: Stories of Women Business Owners Landing on Their Feet)
analyze the finances behind the fat. They trace some of the
familiar causes of the bulging American waistline that Greg Critzer
identified in Fat Land: How Americans Became the Fattest People
in the World. They weigh in on the economics of obesity, which
they trace back to predictable sources such as school lunch rooms,
fast food, television, commuting, and working moms. Then they
target some surprising causes, including health insurance. On the
flip side, they detail the economic consequences of obesity. For
instance, obese employees take more sick days than do normal-weight
employees-and their paychecks are slimmer. The authors highlight
fascinating new scientific research into the causes of obesity and
offer tips on lightening your load over the long haul. This book
serves up a healthy selection for public and academic library
business collections.--Carol J. Elsen, Univ. of Wisconsin,
Whitewater (Library Journal, January 2008)

Everyone knows Americans are growing fatter, but health
economist Finkelstein crunches the economic figures behind the
nation's obesity epidemic and the results aren't pretty. Along with
health-care writer Zuckerman, researcher Finkelstein delves into
how modern technology reduces the cost of producing higher-calorie
processed goods, decreases our activity level and puts our health
in danger. Finkelstein debunks myths about the long-range cost of
food production and consumption and scrutinizes the impact of
genetics and U.S. fiscal policy on the nation's waistline,
frequently using economics metrics in his analysis. Generous with
summaries of major points, Finkelstein simplifies current stats to
explain how the country's thunderous weight gain is straining
Medicare and Medicaid and hurting our military readiness. The only
positive effect he sees from the obesity epidemic is the creation
of the "ObesEconomy"--a market sustained by gyms,
diet drugs and other products and services designed to curb weight
gain. Horrified by studies that reveal that obese children have a
quality of life similar to children with cancer, the investigatory
economist even throws in some health tips on dropping pounds.
Despite a frequent reliance on economic tools and indicators, this
combination study/motivational guide makes for a pleasant
educational read, comparable to a vegetable puree snuck into a
dessert. (Jan.) (Publishers Weekly, December 3,
2007)

"Finkelstein's tone is chatty and
accessible...obesity is ultimately bad economics."
(Financial Times, Saturday 16th February 2008)

"The authors show there is a casual relationship between
the growth of the waistline and the changing shape of the
economy." (Securities & Investment Review,
March 2008)