two terms this chapter defines. And movie titles aside, the kids are not all right. Overall, the 2013 National Survey of Children’s Health reported that more than one in every five American children age 12 to 19 weigh too much. This excess poundage isn’t pretty, and it comes at a cost to our health. One 2019 study that followed more than 1,000,000 American women showed a link between obesity in middle age and dementia later in life. Another suggested that childhood obesity may affect the accuracy of routine blood tests. There’s also a cost in dollars and cents. The CDC puts the price of treating obesity-related illnesses at nearly $200 billion each year, an amount equal to about 6 percent of all medical spending in the United States.
If these trends continue, researchers at the Johns Hopkins Bloomberg School of Public Health, the Agency for Healthcare Research and Quality, and the University of Pennsylvania School of Medicine predict that by the year 2030, nearly 90 percent of American adults will be overweight, at which point the cost of treating their obesity-related health problems will approach $1 trillion a year. No wonder the American Heart Association says we’re in the grip of an obesity epidemic. And that is only one of the topics I cover in this chapter. Add on how much your own body should weigh, the methods by which to judge your obesity or lack thereof (and how to evaluate the accuracy of the numbers), plus the conditions that make obesity more hazardous to your health, and you have a lot to put on your plate about weight.
The Obesity Epidemic
The word epidemic conjures up images of polio, plague, flu, measles — a host of contagious illnesses that pass more or less easily from one person to another. But does obesity qualify? Believe it or not, maybe.
In 2007, Harvard sociologist Nicholas Christakis and James Fowler, a political scientist at the University of California, San Diego, suggested in The New England Journal of Medicine that gaining weight may be a “socially contagious” event. In other words, people in groups tend to adopt similar behavior, and gaining or losing weight right along with friends and relatives may be one of those activities.
To reach this conclusion, Christakis and Fowler analyzed more than 30 years’ worth of information for more than 12,000 volunteers in the famed Framingham Heart Study, the project that has tracked the incidence and causes of heart disease in a Massachusetts city since 1948.
The Framingham people were weighed during checkups every two to four years. When Christakis and Fowler toted up the results, they discovered that the risk of becoming obese rose nearly 60 percent for someone with an obese friend, 40 percent for someone with an obese brother or sister, and 37 percent for someone whose husband or wife is obese. And these people didn’t even have to live close to each other for the risk to rise: The coincidence of obesity existed even when the subjects lived in different cities, which leads right to the next section, stats showing the cities and states where overweight Americans are most likely to be found.
Observing the Obesity Map
How many people are fat and how many leans varies from state to state and city to city depending on a whole list of variables ranging from genetics to physical activity and, of course, the local diet. Table 4-1 shows the ten leanest and fattest states. Table 4-2 does the same for the top ten fattest and leanest cities. In both cases, the information is solidly reliable drawn from such eminent statistics sources as the Centers for Disease Control and Prevention, the U.S. Census, and the U.S. Department of Agriculture.
What do the fattest cities and states have in common? According to Michael Wimberly of the Geographic Information Science Center of Excellence at South Dakota State University, the people living there are
Less likely to engage in physical activity
Less likely to eat five servings of fruits and vegetables a day
More likely to eat the “wrong” foods
More likely to be living somewhere pretty far away from a really good supermarket
TABLE 4-1 The Ten Fattest and Leanest U.S. States
| Fattest States (Fattest First) | Leanest States (Leanest First) |
|---|---|
| Mississippi | Utah |
| Kentucky | Colorado |
| Oklahoma | Connecticut |
| West Virginia | Idaho |
| Tennessee | Oregon |
| Alabama | Minnesota |
| Arkansas | Montana |
| Louisiana | Massachusetts |
| Michigan | Alaska |
| Ohio | Washington |
From “Fattest States in the U.S.” https://wallethub.com/edu/fattest-states/16585/
TABLE 4-2 The Ten Fattest and Leanest American Cities
| Fattest Cities (Fattest First) | Leanest Cities (Leanest First) |
|---|---|
| McAllen-Edinburg-Mission, TX | San Francisco-Oakland, CA |
| Shreveport-Bossier City, LA | Honolulu, HI |
| Memphis, TN | Minneapolis-St Paul, MN |
| Jackson, MS | Seattle-Tacoma-Belleville, WA |
| Knoxville, TN | Portland, OR |
| Tulsa, OK | Boston, MA |
| Mobile, AL | Denver, CO |
| Nashville, TN | Alexandria-D.C., VA |
| Columbia, SC | Colorado Springs, CO |
| Lafayette, LA | Salt Lake City, UT |
From https://walletyhub.com/edu/fattest-cities-in-america/10532
Wimberly calls this an obesogenic environment, a situation that encourages weight gain.
Determining How Much You Should Weigh
Over the years, many health organizations ranging from insurance companies to the U.S. federal government have created