Is Obesity a Lifestyle Choice?

A new book, "The Fattening of America", suggests that obesity is a lifestyle choice. From the article:

* "Obesity is a natural extension of an advancing economy. As you become a First World economy and you get all these labor-saving devices and low-cost, easily accessible foods, people are going to eat more and exercise less," health economist Eric Finkelstein told AFP.
* "When you have a first-rate medical system that can cure the diseases that obesity promotes, you no longer need to worry so much about being obese," he told AFP.
* "People make choices, and some people will choose a weight that the public health community might be unhappy about. Why should we try to make them thinner?" Finkelstein said.

I have a couple of problems with the above comments. While clearly more Americans are overweight and obese than previous generations. I doubt that it people are choosing an unhealthy weight. The issue is that the environment around them, specifically the food options are far larger in size and loaded in calories than in the past. Check how serving sizes have changed over the past two decades by taking the Portion Distortion quiz.

In my experience, many of my patients who are obese actually didn't have a weight problem as a young adult (i.e. high school graduate), but years later. The most common cause was inactivity and eating too much (i.e. supersizing everything). Many didn't see much of a problem until I calculated their body mass index.

A first-rate medical system does undoubtedly fix the problems caused by obesity. A first-rate healthcare system, however, should prevent the obesity problem to begin with. Unless we focus on keeping people healthy instead of treating the problems after they have occurred, the next generation of Americans will be the first not to live as long as their parents.