President's Column

The United States leads the world in many areas; unfortunately, obesity is one of them.1 Two-thirds of U.S. adults are overweight and one-third are obese. This has not always been the case. U.S. obesity rates have escalated rapidly in the last 20 years. In 1990, no state had an obesity rate of greater than 19 percent. By 2010, no state had an obesity rate of less than 20 percent.2 In fact, in the United States, being overweight has become the "new normal."

The cost of the obesity epidemic is enormous. Obesity is now the second leading cause of the death in the United States—just behind smoking—and is expected to become the leading cause.3 Unless the obesity epidemic is successfully addressed, life expectancy will decline in the United States, with our children having shorter life expectancies than we do.4

Obesity underlies a growing diabetes epidemic, with all the co-morbid disorders that entails: heart disease, kidney failure, leg amputations, blindness.5 Obesity and its co-morbidities will have a profound economic impact on our health-care system. Health care for obese individuals costs more than for normal-weight individuals, and the costs increase with increasing levels of obesity. The annual health-care costs for people who are extremely obese are almost twice those of normal-weight people. Very sobering is the fact that severe obesity is increasing at a much faster rate than moderate obesity, quadrupling from 1986–2000.6

Some have argued that focusing on obesity only further stigmatizes overweight people. There is no question that obese individuals face stigmatization and discrimination in employment, education, interpersonal relationships, health care and the media.7, 8 Psychologists have played an important role in highlighting the pervasiveness of weight bias and its multiple serious negative consequences. Overweight children and adults are stereotyped as lazy, unmotivated and lacking in self-discipline.7, 9 In other words, overweight people are often blamed for their condition and as a consequence, some believe the solution to the obesity epidemic is one of personal responsibility.

But stigmatizing people in this way is counterproductive. There is no evidence that it motivates people to make healthier choices and in fact may have the opposite effect, increasing stress and unhealthy eating and deterring people from exercise.7, 9 Further, by blaming the individual, the real culprit behind the obesity epidemic—an obesogenic environment—can be ignored. The obesity epidemic is not the result of an increase in laziness and a decrease in motivation and self-discipline in U.S. adults and children. The fast food industry—a central player in our obesogenic environment—carefully targets the minority populations who suffer most from high obesity rates,10 while arguing against New York City's restriction on the size of sugary drinks as unfairly restricting personal choice.11 It is no accident that industry-supported groups like the Center for Consumer Freedom: Promoting Personal Responsibility and Protecting Consumer Choice12 create Web and other information products for the public such as obesitymyths.com, which, in my mind, is misinformation that promotes obesity as a personal choice, but is very good for their bottom line. As psychologists, we know that blaming the victim does not work. Psychologists must lead by addressing public policy and the multiple factors that create the obesogenic world we live in every day.

1 www.oecd.org/health/healthpoliciesanddata/49716427.pdf

2 www.cdc.gov/obesity/data/trends.html

3 JAMA, 2004:291:1238-1245

4 Ann of Int Med, 2003:138:24-32

5 JAMA, 2003;290:1884–1890

6 Obesity Research, 2004:12: 1936–1943

7 Obesity, 2009:17:941-964

8 J of Health Commun: Int Perspectives, 2011:16:976-987

9 Psychological Bulletin, 2007:133:557-580

10 http://fastfoodmarketing.org/media/FastFoodFACTS_Report_Summary.pdf