Super-sized nation a deadly trend

Fed by poor nutrition and a lack of activity, obesity could become the No. 1 killer of Americans by the end of 2005


March 10, 2004

Americans need to keep tabs on their weight or they will face an increasing risk of developing health problems, according to a new study. An estimated 130 million Americans, or 64 percent, are overweight or obese, resulting in $117 billion in medical and other expenses in 2000.

Unhealthy eating habits and sedentary lifestyles are quickly closing in on tobacco use as the nation's leading cause of avoidable deaths, a new government study has found.

According to researchers at the Centers for Disease Control and Prevention, poor nutrition and physical inactivity caused 400,000 deaths in the United States in 2000 – a 33 percent jump from 1990.

Tobacco use remains the No. 1 killer with 435,000 annual deaths. But by the end of next year, if trends stay the same, more people will die from eating unhealthy foods and idleness than from lung cancer and other smoking-related illnesses combined, the study said.

One-third of deaths every year could be avoided by improving health behaviors, according to the report.

"We knew the epidemic in obesity was occurring, but we were surprised it showed up so soon with such a large increase in the number of deaths," said Dr. James Marks, one of four authors of the analysis. "We've got to make the healthier choices."

Tobacco use, obesity and inactivity increase the risks for major killers such as heart disease, cancer and cerebrovascular ailments such as strokes. Obesity and a sedentary lifestyle also strongly increase the risk of diabetes.

Results of the study were reported today in the Journal of the American Medical Association.

In 1990, smoking was the nation's top killer, claiming 400,000 lives or 19 percent of deaths, the study said. In the same year, inactivity and poor diet combined to kill 300,000 people, which was 14 percent of all fatalities.

A typical man is considered overweight when he is 20 pounds above the average for his age and height. He is obese at 40 pounds above the norm, according to federal standards.

Researchers saw that gap close sharply in 2000. Tobacco use accounted for 18 percent of all deaths, but unhealthy eating and lack of exercise climbed to 16.6 percent of fatalities.

Federal officials were so alarmed by the findings, they announced a public-awareness campaign to promote better nutrition and fitness.

According to the government, nearly 130 million Americans are overweight or obese – a condition that cost the nation $117 billion in medical and other expenses in 2000.

"Americans need to understand that overweight and obesity are literally killing us," Secretary of Health and Human Services Tommy Thompson said. "We're just too darn fat, ladies and gentlemen, and we're going to do something about it."

Public-service announcements urging people to watch what they eat and exercise more often will begin airing in cities across the country today. Also today, Congress is scheduled to consider a ban on obesity lawsuits against restaurants.

Despite the new ad campaign, the Bush administration is proposing to slash more than $30 million from a CDC program that promotes physical activity among 9-to 13-year-olds.

Many industries have begun to change in response to the rising number of overweight Americans.

McDonald's Corp. announced last week that it would no longer offer "super-sized" sodas and fries. Casket makers offer oversized coffins and clothing designers are giving greater attention to fashions for plus-size customers.

Health experts in San Diego were not surprised by the findings of government scientists. Many physicians and dietitians have been dealing with obesity and overeating among patients and clients for years.

Jeffrey Schwimmer, an assistant professor of pediatrics at the University of California San Diego, said the problem may grow worse before it improves.

"Many people do not realize the health impact of their daily decisions," Schwimmer said. "It's not what a person does for just one day or one week that matters. It's what we do day-in and day-out over the long term."

Experts say technology, from computer use to remote controls, also has limited the physical activity of millions of Americans.

"It is all the little advances in society that allow us to accomplish our daily tasks while expending less activity," Schwimmer said. "It reduces our energy expenditure."

Brenda Reynosa, who oversees the preparation of 100,000 lunches every day for students in the San Diego Unified School District, said dietary changes in recent years can also be traced to more working parents and hectic schedules.

"There's not a lot of time to go home and make a meal and eat together, so of course they stop and pick up fast food," she said.

These days, parents are more likely to fill cupboards with high-sugar, high-fat foods, Reynosa said. "When I was a child, you got a soda when you went out to dinner. It wasn't a daily option."

The study's co-author said it is only a matter of time before more Americans begin complaining about rising health-care costs because of obesity. "Those concerns are real," he said. "That backlash will happen."

An unrelated study by Rand released yesterday found health care spending on obesity among Americans between 50 and 69 years old will climb by 50 percent by 2020.

Rick Stephenson, who owns the World Gym in Pacific Beach and travels frequently to Europe, blamed fast-food restaurants and laziness for the growing numbers of overweight Americans.

"In Sweden, you don't see a fast-food facility on every single corner like you see here, Stephenson said. "If you're going to go get a burger over there, you have to look around."

Jeff McDonald: (619) 542-4585;

The Associated Press contributed to this report.