Too Many Fat People. Why?

Storm clouds over Jersey fats. Paul Goldfinger photo

By Paul Goldfinger, MD, FACC

We all have heard that there is an epidemic of fat people in this country: 1/3 of the adult population is obese, and 1/3 is overweight. 18% of children are obese.  This trend has been rising since 1980 and continues to go up.  Obesity causes chronic diseases such as hypertension, heart disease, sleep apnea, and diabetes. These conditions in turn result in death and disability from a variety of complications such as heart attack, stroke and cancer.

Anatomically modern Homo sapiens appeared about 200,000 years ago.  During most of that history, food was scarce.  At first, modern man would forage for food, but later, farming was invented which created a more predictable food supply.

Around 1970, in the US,  government subsidies and scientific advances created a huge increase in  production by our farms.  The end result has been an oversupply of cheap food.  We eat too many calories, too often, and in too many places.*  The caloric intake of Americans has gone up along with our weight.  Now, obesity has become a norm in our society, and the image of obesity seems to be acceptable.  This phenomenon of excess food intake is, according to experts, new in human history, and our species has so far adjusted poorly.

The food industry has been making huge profits by marketing foods that are high in sugar, salt and fat. These cheap foods contain excess calories and are tempting because they stimulate centers in the brain which release chemicals such as dopamine which reward the pleasure receptors that make us want more. We tend to underestimate our caloric intake and we eat more than our bodies require for normal function.

This topic is very complicated, but here are some factoids that represent the latest knowledge in the field:

—Weight gain and weight loss are usually  slow processes.  If you reduce your caloric intake by perhaps 200 calories a day, you will lose some weight, but it can take a year or more.

—Our agriculture industry is producing massive amounts of corn and soy beans.  These are used to feed cows instead of hay, oats and alfalfa. Cheap animal food results in inexpensive  fatty meats.  Processed foods contain huge amounts of corn derived sugar, in the form of high fructose corn syrup. Such carbohydrates are concealed in foods such as cereals, yogurt, and peanut butter.

—Cheap sugary drinks are sold to kids in 64 ounce cups of soda which contain 800 calories. Many other foods  are now sold in bigger portions including cookies and bagels.  Portion sizes, in general, at home and in restaurants, have become larger than ever before.  The ready availability of inexpensive and highly profitable high calorie foods has enabled the omnipresent and generally unhealthy fast food industry.

—25% of Americans get no exercise at all.  Our jobs and life styles are sedentary.  This is a change which continues to get worse, as we burn less calories. This is one of many modern trends which have come together to produce the obesity epidemic.

–There is little profit in growing fruits and vegetables.  The agriculture industry is not interested in this kind of farming. There are no federal subsidies for growing apples or spinach.

–How to combat the epidemic? Mostly it’s a question of knowledge and self control.  Government policies can help, especially in the area of subsidies.  Parents need to get serious about this issue for their kids.


“Weight of the Nation,”   HBO documentary , May 2012

“A Mathematical Challenge to Obesity,”  NY Times, May 15, 2012

“Calories are everywhere, yet Hard to Track,”   NY Times, March 20, 2012

Blogfinger articles  (links):

Getting fatter in America

Looking for food in all the wrong places.  *

“Prevention Does Work:  A Guide to a Healthy Heart” (2011) by  Paul Goldfinger, MD and  Eileen Goldfinger, BA.  Available at the Comfort Zone,,   and BarnesandNoble. com.