Why America Has to Be Fat

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By Michael S. Rosenwald
Washington Post Staff Writer
Sunday, January 22, 2006

I am fat. Sixty pounds too hefty, in my doctor's opinion. Probably 80 pounds, in my fiancee's view.

Being fat makes me a lot of things -- a top contender for type II diabetes, for instance, or a heart attack, or stroke, maybe even a replacement knee or hip. My girth also puts me in familiar company, with about two-thirds of the U.S. population now considered overweight.

But in many ways, my being fat also makes me pretty good for the economy.

You've read the headlines: America's problem with bulging waistlines has reached pandemic proportions, according to federal health officials, who warn that obesity is becoming society's No. 1 killer. But as doctors wrestle with the problem, economists have been pondering which corporations and industries benefit, and the role that changes in the overall economy have played in making us fat to begin with.

It turns out, economists say, that changes in food technology (producing tasty, easy-to-cook food, such as french fries) and changes in labor (we use to be paid to exercise at work, now we pay to exercise after work) combined with women's importance in the workforce, not the kitchen, have combined to produce industries able to cheaply and efficiently meet the demands of our busy lives. The cookie industry. The fast-food industry. Potato chips. Soda. The chain-restaurant industry, with its heaping portions of low-priced, high-calorie foods.

In some ways, we are better off in this Fat Economy. Many people work in easier, better-paying jobs, which help pay for their big homes in the suburbs. Women don't have to spend two hours preparing dinner every night; many have risen to unprecedented levels of corporate and political power. Flat-panel plasma TVs hang over fireplaces, which can be lit using the same remote control for flipping channels. But the unintended consequence of these economic changes is that many of us have become fat. An efficient economy produces sluggish, inefficient bodies.

"The obesity problem is really a side effect of things that are good for the economy," said Tomas J. Philipson, an economics professor who studies obesity at the University of Chicago, a city recently named the fattest in America. "But we would rather take improvements in technology and agriculture than go back to the way we lived in the 1950s when everyone was thin. Nobody wants to sweat at work for 10 hours a day and be poor. Yes, you're obese, but you have a life that is much more comfortable."

For many corporations, and even for physicians, Americans' obesity has also fattened the bottom line. William L. Weis, a management professor at Seattle University, says revenue from the "obesity industries" will likely top $315 billion this year, and perhaps far more. That includes $133.7 billion for fast-food restaurants, $124.7 billion for medical treatments related to obesity, and $1.8 billion just for diet books -- all told, nearly 3 percent of the overall U.S. economy.

Did you know, according to consumer-research firm Mintel Group, that we guzzled $37 billion in carbonated beverages in 2004? The same year, we spent $3.9 billion on cookies -- $244 million of which were Oreo cookies sold by Kraft Foods for about $3.69 a package. In 2003, we splurged $57.2 billion on meals at restaurants such as Denny's, Chili's and Outback Steakhouse (a personal favorite). Potato chip sales hit $6.2 billion in 2004.

"Put simply, there is a lot of money being made, and to be made, in feeding both oversized stomachs and feeding those enterprises selling fixes for oversized stomachs," Weis wrote in 2005 in the Academy of Health Care Management Journal. "And both industries -- those selling junk food and those selling fat cures -- depend for their future on a prevalence of obesity."

And the prevalence of obesity won't fade anytime soon. According to David M. Cutler, an economist at Harvard University, Americans' waistlines are caught in a simple accounting quagmire. In a 2003 paper titled "Why Have Americans Become More Obese?" Cutler wrote: "As an accounting statement, people gain weight if there is an increase in calories taken in or a decrease in calories expended."

On the calories-expended side of the Fat Economy, economists have noted that changes in the workplace have caused us to burn fewer calories. Prior to the 1950s, jobs often meant hard labor. We lifted heavy things. We worked outside. Our desks -- if we had them -- did not come equipped with computers. We lived in urban environments, walking most places.

Now many Americans work in offices in buildings with elevators. If we walk anywhere, it's to lunch -- to TGI Friday's or the corner burrito shop. We live in the suburbs, we drive to and from work and -- in my case -- to and from the mailbox. We pay $60 a month for the privilege of lifting something heavy in a gym we have to drive to. (I belong to two gyms, in the hope that guilt will cause me to visit at least one.) And we also must pay to exercise by giving up our free time. Do we work out, or do we drive the kids to their soccer game, where we can sit and watch? Do we work out, or do we download new songs from iTunes?

"People are just not willing to give up their leisure time," Philipson said. "People don't want to pay to exercise with their leisure time."

Which brings us to the calories-consumed side of the ledger. If we don't expend calories, they add up and turn into pounds. Thirty-five hundred calories generally equals one pound. So behold, for argument's sake, the french fry. An order of large fries at McDonald's puts 520 calories into one's body. It is well known, at least by this consumer, that an order of large fries can generally be placed, filled and consumed in a matter of minutes.

But this was not always so, Cutler said.

Before World War II, if you wanted a french fry, you went to the store, bought potatoes, took them home, washed them, peeled them, sliced them and fried them. "Without expensive machinery, these activities take a lot of time," Cutler said. "In the postwar period, a number of innovations allowed the centralization of french fry production." Now fries are prepped in factories using sophisticated technologies, then frozen at sub-40-degree temperatures and shipped to a restaurant, where they are deep-fried, or to someone's home, where they are microwaved. Either way, they are served up in a matter of minutes.

French fries helped drive up U.S. potato consumption by 30 percent between 1977 and 1995, but they mean more than that -- they symbolize the convergence of the economic and technological changes that have made us fat. Cutler and Philipson have noted that when women joined the workplace, they left behind some of the labor that traditionally went into cooking meals. This happened as technology increasingly allowed for mass production and preparation of food. Much of this type of food -- be it french fries, potato chips, frozen dinners or quick meals at restaurants -- contains more calories.

We expend fewer calories and take more in. The pounds add up. Hence, the Fat Economy.

"The structure of the economy has made us more obese," Cutler said. "That is clearly true. What businesses do is they cater to what we want, whether what we want is really in our long-term interests or not. So people are obese and they want to diet, but they also want things to be immediately there. Manufacturers and storeowners make that possible. The upside is nobody spends two hours a day cooking anymore."

So do Americans have to be fat for the economy to thrive? The economy would not exactly crash if people stopped spending money on french fries and meals at TGI Friday's. Economists think the money would just be spent differently or in different places. Specific industries would adapt -- as many have already, offering more healthful choices -- to meet changing demands. No business can survive by selling things people don't want.

In fact the overall long-term economic costs of obesity are many. The $10,000 of extra medical care that the overweight require over their lifetimes certainly makes a doctor's wallet fatter, but it could bankrupt the health insurance industry. Also, research shows that while more women have entered the workforce, their wages, particularly for white women, sink if they are overweight.

Much of the long-term financial burden for obesity will fall on the shoulders of U.S. corporations, which already fork out billions of dollars a year in sick time and insurance costs related to obesity illnesses, and on American taxpayers, through their contributions for programs such as Medicare and Medicaid. What's more, shorter lifespans will more quickly take millions of educated people out of the workforce.

For that last problem, the Fat Economy has already found ways to innovate and profit. In Lynn, Ind., there is a company called Goliath Casket that makes caskets up to 52 inches wide. The company's Web site, which can be found at http://www.oversizecasket.com/ , notes that Goliath's founder quit his job as a welder in 1985, saying: "Boys, I'm gonna go home and build oversize caskets that you would be proud to put your mother in."


© 2006 The Washington Post Company

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