IF YOU STILL need convincing that America has a serious problem with obesity, you should grab a copy of "F as in Fat: How Obesity Threatens America's Future," a report released late last year by the Trust for America's Health and the Robert Wood Johnson Foundation.
It's a disturbing read (http://tinyurl.com/9vmpqvl). With the adult obesity rate in the United States already setting a new world record at about 36 percent, the authors of "F as in Fat" peer ahead to the year 2030, when that figure will reach at least 45 percent in every state, if current trends remain unchanged.
In that flabby future, adult obesity rates will exceed 50 percent in 39 states, with rates topping 60 percent in at least 13 of those states, according to the report. In California the rate will reach nearly 47 percent, up from the 2011 level of about 24 percent, if the current trajectory continues.
All that added weight will cause substantial increases in new cases of diabetes, heart disease, stroke, arthritis and cancer, the report asserts. For example, it estimates that the growth in obesity would cause more than 6 million new cases of Type 2 diabetes, 5 million new cases of coronary heart disease and stroke, and more than 400,000 new cases of cancer in the next two decades.
Beyond the personal costs of all that new obesity-related illness, the burgeoning epidemic would tack $48 billion to $66 billion more onto the nation's health care bill, the report says. That added cost — paid by every one of us in our taxes or health insurance premiums — would come on top of the excess health care costs of $147 billion to $210 billion a year attributable to obesity today.
One reason the report can confidently predict such a high obesity level among adults 17 years ahead is the unprecedented rate of obesity seen right now among the nation's children and adolescents. That rate has soared to nearly one in five, according to the CDC, more than double the level seen a generation ago.
Think for minute what life in America might look like in the year 2030. If the new report's projections prove true, it isn't that roughly half the population will be a little overweight. It means that by the year 2030 roughly half the population will be living with a serious medical condition that puts them at markedly increased risk of chronic illness and early death.
Adults are considered obese if their body mass index, a composite measure of weight and height is calculated at 30 or greater. So an adult who is five feet, nine inches tall is considered obese if he or she weighs 203 pounds or more. Imagine a future where such weight is fairly typical — even normal.
If the report's projections come true, even those who are not obese will bear much of the burden. In addition to the added medical costs, the report predicts that obesity will cause economic productivity losses throughout America amounting to between $390 billion and $580 billion a year by 2030.
Such losses would put the competitiveness of US businesses at a clear-cut disadvantage internationally, which over time could undermine our high standard of living, leaving America to trail behind in the global economy. As we get fatter and fatter, we just may become poorer and poorer.
But not all the news in the report is grim. It also provides an alternative picture of America's future, one where we all take this problem seriously and achieve a populationwide decrease in body mass of 5 percent, or about 10 pounds for an average man and 8 pounds for an average woman.
In that rosier scenario, California's obesity rate would climb only to about 41 percent by the year 2030. Statewide that would translate to about 800,000 fewer new cases of diabetes, 650,000 fewer heart attacks and strokes, and 50,000 fewer obesity-related cancers over the next 20 years, as compared to the "business as usual" projection.
Who would have thought that shedding just those few pounds could make such a huge difference in health! An 8- to 10-pound weight loss across the board also would knock about $82 billion off California's health care costs during that time, according to the report.
So how do we reach the goal of a 5 percent reduction in body mass throughout the population? Clearly there is little achieved when we browbeat individuals to eat less and exercise more. What's needed is collective action that makes it far easier than it is today for busy people to eat better diets and get the physical activity they need to burn off excess calories.
For health care providers such action means measuring the body mass index in every physical examination, and offering counseling and support for all patients who are overweight or obese.
For employers it means providing incentives for physical activity and healthy eating among the health benefits they offer their workers. It also means establishing policies that encourage exercise breaks, healthy eating in the workplace, use of stairwells instead of elevators, and more active transportation to and from work.
For public officials it means providing incentives for restaurants to offer healthier options and smaller portions, for supermarkets to put more stores in so-called "food deserts" and for all food outlets to increase their shelf space for healthy food and beverage options. It also means expanding the pedestrian and bicycle network, supporting community recreation programs and promoting more mixed-use development that fosters less driving and more sustainable public transportation.
None of these steps can unravel decades of worsening obesity by themselves, but together they could make the nightmare scenario of ubiquitous obesity by the year 2030 much less likely.
Dr. Eberhart-Phillips is the former Marin County Public Health Officer, whose column appears every third Monday. He is a specialist in preventive medicine and the author of two books on emerging infectious diseases.